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Background There is evidence that separate service delivery for individuals with dual Mental Health and Substance Use Disorders is expensive and can have negative treatment implications. While redesigning the health system to provide integrative care is optimal, costs of this mean that the focus has generally been on developing models of care and best practice guidelines to improve the identification and treatment of dual diagnosis within current systems. ‘Shared care’ with MH and SUD services collaborating to coordinate delivery of interventions is considered the best option within these parameters. However, only a few projects have reported on the implementation of such highly collaborative models and many of these have not yet been systematically evaluated. The current study represents the implementation and evaluation of an Early Identification Model (EIM) in three health services settings. The EIM was created to support health services through the complex dynamics of becoming dual diagnosis capable. It consists of two primary components: two-step systematic screening, and clearly defined care pathways to ensure that dual diagnosis identification leads to appropriate follow up, referral, or delivery of evidence-based interventions for each individual.

How can mental health and substance use services become dual diagnosis capable? Moving from theory into practice