Many His Way residents arrive with current or past formal psychiatric diagnoses. We must ask two important questions: First, since the wide range of possible behaviors displayed by individuals with a substance use problem can closely mimic those of nearly every mental health condition listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR), is the original diagnosis accurate? And second, if it is accurate, is the condition severe enough to require medication?
Research shows that the most effective treatment for mental health conditions includes both medication and therapy. However, if a person can thrive at His Way without psychiatric medication, our program can still offer significant benefits.
Counseling and Medication
Our counselors are credentialed to assist individuals dealing with psychiatric issues. If a resident’s condition is not severe enough to require medication, the counselors will focus on their mental health in addition to other issues, such as trauma, family problems, grief, and more. If we have any concerns about a resident’s mental health, we refer them to Wellstone Behavioral Health (4040 S. Memorial Parkway, Huntsville, AL, 35801) for an evaluation to determine if medication is necessary.
In cases where the condition appears serious enough for such a consultation, the individual often does require psychiatric medication. At that point, we will refer them to a more appropriate facility that can meet their needs. The decision to use psychiatric medication is a critical factor in determining if a person is suited for our program, especially since many residents come to us through the court system or the Alabama Department of Corrections.
Wellstone will initially assign the individual to a Licensed Professional Counselor (LPC) or a Licensed Clinical Social Worker (LCSW) to assess their mental health, and then a psychiatrist will determine if medication is needed. If the resident has insurance or can afford private care, they may seek the help of private mental health professionals for this purpose. If medication is not required, His Way’s staff and contracted professionals can provide the necessary support for other therapeutic needs.
It is clear, then, that having an accurate mental health diagnosis is crucial, although it can sometimes be difficult to obtain.
The Problem of Misdiagnosis
Unfortunately, individuals who are labeled with a substance use disorder (SUD) are often misdiagnosed by professionals who can only focus on symptoms which are immediately available to them. This is not a criticism of any profession dedicated to assisting the mentally ill. They often work under great stress, time restraints, and limited staff. In such settings as jails, prisons, and ER’s, the timeline and context needed for a reliable diagnosis are often missing or difficult to obtain. Such information is frequently gathered from sources who have only a brief knowledge of the patient, such as overtaxed law enforcement officers, weary guards, or busy emergency room staff. In some cases, possibly unreliable informants such as drug associates, drinking buddies, or even the patients themselves are the only source of information available and they may not provide accurate details.
In many cases, individuals have also been medicated in correctional facilities for reasons unrelated to their therapeutic needs—such as preventing lawsuits, promoting compliance, or reducing disruptive behavior. These circumstances can lead to misdiagnoses that persist for years, affecting the person’s subsequent treatment and eventual recovery.
This is the first post in a two-part series on a substance abuse, mental illness, and recovery. Read part two here.
If you or someone you care about is struggling with mental illness and a Substance Abuse Diagnosis, contact us at His Way. Our experienced team is here to help.
Written by Don Phillips
Don Phillips is a Licensed Professional Counselor (LPC) with more than 27 years of experience in behavioral health and 35 years of personal recovery from chemical addiction. He holds a Bachelor’s degree in General Psychology from Athens State University and a Master’s degree in Counseling Psychology from Alabama A&M University. He is an Advanced Alcohol & Drug Counselor (AADC) and Internationally Certified AADC (ICAADC).