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The Legistlative Perspective

Mental illness and addiction are prevalent among adults in the United States. An estimated 46.6 million have a mental health issues, and 18.7 million have a substance use disorder. It is estimated that 8.5 million people or 3.4% of adults in the United States are struggling with co-occurring disorders. Over one-half of individuals in need of treatment were unable to access services.

  • In 2016, 14,004 Tennesseans were admitted to publicly-funded treatment for substance use disorders. Opioids, alcohol, and marijuana accounted for 73.5% of all substances of abuse among adults entering treatment.
  • In Tennessee, 43%, or approximately 351,000, of people in need of treatment for mental health issues accessed treatment. Among people accessing treatment for mental health issues, 29% were diagnosed with a co-occurring substance use disorder.

FAMILIES AND INDIVIDUALS

  • In Tennessee the number of children entering custody due to parental substance use disorders increased by 12%, with 2,040 children entering custody specifically due to this issue.
  • People with COD are particularly vulnerable to the effects of adverse childhood experiences and have a higher prevalence of childhood trauma than those without co-occurring disorders. There is a strong association between adverse childhood experiences, post-traumatic stress disorder, alcohol dependence, injection drug use, tobacco use, sex work, and chronic medical problems for people with co-occurring disorders.
  • Risk of substance use disorders and mental illness are increased when children are exposed to trauma. There is a direct association between the number of adverse experiences and increased risk of the development of disorders in adulthood.
  • Over the past decade, there has been a nearly ten-fold rise in the incidence of babies born with neonatal abstinence in Tennessee.

COMMUNITIES

  • Individuals with co-occurring disorders have higher rates of chronic medical conditions than the general population. Hypertension, asthma, arthritis, and smoking are seen in greater proportions among people with co-occurring disorders.
  • Over 80% of increased expenses were due to medical conditions experienced by people with mental health issues, including substance use disorders.
  • People who experience co-occurring disorders usually have more episodes of relapse and more emergency room visits.
  • Individuals with co-occurring disorders have to go to inpatient hospitals to address symptoms of mental illness and addiction more often than people who are dealing with one disease.
  • At least 50% of people who are homeless have co-occurring disorders. Left untreated, they have little chance at obtaining jobs and permanent housing.

BUSINESS AND WORKFORCE

  • Co-occurring disorders are of particular concern among working aged adults.
  • Substance use and misuse costs Americans over $700 billion per year in increased health care costs, crime, and lost productivity.
  • Depression costs an estimated $51 billion in lost productivity due to absenteeism.
  • In Tennessee, 30.1% of adults between ages 18-20 accessing publicly-funded mental health services were not in the labor force, and 43.8% were unemployed.
  • Among adults between 21-64 accessing publicly-funded mental health services, 48.4% were not in the labor force, and 29.4% were unemployed.

JUDICIAL AND CRIMINAL JUSTICE SYSTEMS

  • There are approximately 11,000 inmates with co-occurring disorder in Tennessee’s prisons and local jails.
  • In the local jail systems, nearly 25% of all inmates have mental health issues, and 76% of inmates with mental health issues reported substance use.
  • Police estimate that 7 to 10% of their encounters are with individuals who have mental illness.

WAYS YOU, AS A LEGISLATOR, CAN INITIATE CHANGE TO REDUCE THE IMPACT OF CO-OCCURRING DISORDERS.

Treatment works and recovery is real!

Support Enhanced Treatment

Support a “no wrong door” community-based integrated treatment approach where the presence of co-occurring disorders is considered an expectation rather than an exception. Regardless of where an individual goes for treatment, they will be able to get the help they need.

Support routine co-occurring disorders screenings and treatment referrals for individuals entering the criminal justice system and the development of adequate treatment options and resources that have been shown to be effective.

Pave the Way for Adequate Funding for Effective Behavioral Healthcare Treatment Options

Pass laws which focus on a variety of treatment options including, but not limited to, inpatient and outpatient care, supportive housing, and peer-to-peer support as these treatment techniques provide the best possible opportunity for recovery.

Advocate for Awareness and Education on the Impact of Co-Occurring Disorders

Be an advocate for local community partnerships with their community-based behavioral health agencies and advocacy organizations in educating and bringing about awareness of co-occurring disorders and their impact on local communities.

Be an advocate for enhanced training and education for judicial and criminal justice personnel and developing an awareness of the needs of individuals experiencing co-occurring disorders.

Be an advocate for incentives for employers to offer Employee Assistance Programs (EAPs) and access to effective treatment programs for employees and their families experiencing co-occurring disorders.

CO-OCCURRING DISORDER FACTS

Familes

An estimated 60% of families of children in the child welfare system have substance use problems. At least one-half of those have a diagnosed co-occurring mental illness.

Communities

At least 50% of people who are homeless have co-occurring disorders. Left untreated, they have little chance at obtaining jobs and permanent housing.

JUDICIAL AND CRIMINAL JUSTICE SYSTEMS

In the criminal justice system, 76% of inmates with mental health issues reported substance use.

Suicide Fact

51% of suicide completers have both substance abuse and mood disorders (Suominen et al., 1996)