States' Early Experience in Improving Systems-Level Care for Persons with Co-Occurring Disorders

This column discusses the experiences of the original cohort of seven states participating in the first two years of a national demonstration project known as the Co-occurring State Incentive Grant (COSIG) initiative. COSIG was designed to help state mental health and substance abuse authorities develop innovative strategies to better integrate or coordinate services for persons with co-occurring mental and substance use disorders. Powerful factors of early project success included careful planning, which was based on experience with anticipating and planning around bureaucratic barriers, and gaining early consensus from a few key stakeholders. The column describes the implementation successes and challenges of these states and the lessons learned from these experiences so that states in the planning phases of similar projects or other infrastructure improvement projects may benefit.