Vol. 2, Issue 2, Part A (2025)

Background: Co-occurring mental health and substance use disorders (dual diagnosis) present a significant clinical and public health challenge due to complex symptom interactions, fragmented service delivery, and high relapse and utilization rates. Nurse-led integrated care models offer a promising approach to addressing these challenges through systematic screening, evidence-based interventions, and coordinated care.
Objective: This study aimed to evaluate the effectiveness of a nurse-led integrated intervention in improving substance use and mental health outcomes among adults with dual diagnosis, while also examining its impact on treatment engagement and service utilization.
Methods: A quasi-experimental study design was employed in three urban community health centers, enrolling 200 adults with co-occurring mental health and substance use disorders. Participants were assigned to an integrated care group (n = 100) receiving nurse-delivered screening, motivational and cognitive-behavioral interventions, contingency management, and coordinated referrals, or a treatment-as-usual group (n = 100). Primary outcomes were measured using AUDIT, PHQ-9, and GAD-7 scores at baseline, 3 months, and 6 months. Secondary outcomes included treatment retention, hospitalization rates, and emergency department visits. Statistical analyses involved repeated measures ANOVA, chi-square, and t-tests.
Results: The integrated care group showed significant improvements in substance use and psychiatric symptoms over 6 months, with AUDIT, PHQ-9, and GAD-7 scores decreasing more substantially than in the treatment-as-usual group (p<0.001). Engagement and retention rates were higher in the integrated care group (82% vs 61%), with lower hospitalization (8% vs 18%) and emergency visit rates. These outcomes demonstrate the clinical and service-delivery advantages of nurse-led integrated approaches.
Conclusion: Nurse-led integrated care models effectively address the dual challenge of mental health and substance use disorders by improving clinical outcomes, enhancing patient engagement, and reducing acute service utilization. Embedding validated screening tools, structured psychosocial interventions, and coordinated referral pathways within nursing practice can bridge existing gaps in care. This approach provides a scalable and sustainable strategy to strengthen dual-diagnosis services and align with global recommendations for integrated mental health and addiction care.