Twenty years of integrated treatment of dual disorders in the netherlands: lessons learned

Background
Integrated treatment for co-occurring addiction and mental health disorders was introduced in The Netherlands in 2004 and has been followed with research since the start. In 2009 the National Expertise Centre on Dual Disorders (LEDD) was founded by the Trimbos-institute together with a number of mental health and addiction institutions to further promote and support integrated dual disorder treatment.  
Although there seems to be a consensus in most European countries that integrated treatment models are best fitted to help these clients, none of these have strong evidence, mostly due to methodological limitations in the studies. 
 
Methods
LEDD’s research or development themes are determined by the signals and questions the LEDD participants get back from their teams or collaborating partners. The researchers from the Trimbos-institute translate these signals into research projects and conduct the research in collaboration with professionals and peer workers. 
The LEDD has over the last years conducted a number of practice-oriented, often qualitative, research projects, to help professionals improve the care they give to these patients while also working towards gaining knowledge on the effectiveness of integrated treatment. This continued involvement has also given us insight in different implementation strategies and their outcomes.  
 
Results
In the last three years research projects have covered: a qualitative study of client experiences and outcomes of integrated treatment, a literature review on the importance of dual disorder self-help groups and a quickscan on the challenges of clients with dual diagnosis in sheltered living. LEDD has in 2024 began with working on implementation support package for mental health and addiction institutions that need support with making changes towards integrated treatment.  
 
Conclusion
Our presentation will give an overview of experiences with implementation strategies as well as current results of integrated treatment of co-occurring addiction and mental health disorders in the Netherlands.