This column was originally featured on Newportri.com.
When it comes to treating those who suffer from both a mental illness and substance use disorder, one of the most important shifts in healthcare today is the recognition that these conditions are often co-occurring.
Newport Mental Health offers an integrated care modeled that supports this. The launch of the state’s first Integrated Dual Disorder Treatment (IDDT) program was established here two years ago. IDDT is an evidence-based model recognized by the Substance Abuse and Mental Health Services Administration (SAMHSA) and used nationwide.
Rather than asking people to navigate separate systems for mental health care and addiction treatment, IDDT brings psychiatry, nursing, therapy, substance use counseling, case management, and vocational and community supports together under one multidisciplinary team. It’s a simple but powerful idea: when we treat the whole person, we create better opportunities for healing.
The need for this approach is clear. According to SAMHSA’s 2025 National Survey on Drug Use and Health, 21.2 million American adults are living with both a mental illness and a substance use disorder, yet fewer than one in six receive treatment for both conditions. As integrated care continues to gain momentum nationwide, our community is fortunate to already have access to a model that is helping people build healthier, more stable lives.
What is a co-occurring disorder?
Many people don’t realize that mental illness and substance use disorder often occur simultaneously. When they do, it’s known as a co-occurring condition, and treating both at the same time gives people the best opportunity for lasting recovery.
For many people living with a co-occurring disorder, the barriers to recovery extend beyond treatment. They include housing, income, transportation, and connection to community supports.
“Most of the time we are treating individuals who have severe mental illness and severe substance use disorders,” says Madisson Catanzaro, Division Director of Substance Use Services at Newport Mental Health. “They also have barriers related to the social determinants of health. They’re homeless, they have no income, and their peer relationships or family relationships are often strained or estranged.”
Housing instability is especially challenging for many people served through Newport Mental Health’s IDDT program. According to Rhode Island’s 2025 Point-in-Time Count, more than 2,000 Rhode Islanders were experiencing homelessness on a single night in January, and more than 40% had been unhoused for more than a year.
A further complication is that people may not realize they need help. Many are not actively seeking treatment when the team first encounters them.
“The whole fidelity of the program is to meet with people who are in the pre-contemplative or contemplative stages of change,” Catanzaro says. “They haven’t fully recognized the need for change or the need for support. A lot of what we do is focused on engagement, building trust, and providing wraparound services.”
Unlike traditional outpatient treatment, the work often begins outside the office.
Every member of the IDDT team spends time visiting shelters, familiar gathering places, and other locations where clients spend time. The team also partners with Newport Mental Health’s Rhode Island Outreach (RIO) and Street Outreach teams, and other community organizations, to locate individuals who have become disconnected from care.
“Our team members are out in the community every day,” Catanzaro says. “We’ll go to the places where we’ve seen people before or where they’ve told us they like to be. If we can’t find them, we work with outreach partners who help us reconnect.”
Referrals also come from many directions. Family members, hospitals, police departments, courts, homeless outreach workers, and other service providers can all recommend someone for the program.
“I’ll even make contact with individuals before they are officially involved in the program,” Catanzaro says. “Just to introduce myself, let them know about the services, and hopefully get them connected.”
One team caring for the whole person
Rather than sending someone to separate providers for mental health and substance use treatment, one coordinated team works together on every aspect of a person’s recovery.
“The therapist focuses on how mental health impacts substance use,” Catanzaro explains. “The licensed substance use specialist focuses on how substance use impacts mental health. It’s true co-occurring treatment.”
The communication among team members is constant.
“We have a daily team huddle,” she says about the team structure. “We have secure messaging where we’re giving each other updates in real time, and then we have a two-hour clinical meeting every week. We review every case every day.”
That level of coordination makes all the difference. The specialties work together to wrap around each person they serve.
Treatment isn’t one-size-fits-all
Unlike many treatment programs, IDDT has no predetermined end date. Participants remain connected to the team for as long as they need support.
“If someone has been in recovery for three years and still needs support, we’re there,” Catanzaro says. “If someone doesn’t even recognize that their mental health or substance use is an issue yet, we’re there too.”
Treatment is guided by each person’s stage of change. “If someone is in that pre-contemplative stage, we might not start traditional therapy right away,” she says. “We build rapport first. Building trust is therapeutic.”
Only after that trust develops are additional services introduced. “If they want to meet twice a week, we do that. If they need to meet every day, we do that. The person guides the treatment.”
Recovery is highly individualized
“Recovery looks different for every person,” Catanzaro says. “It incorporates safety, stabilization, relapse prevention, and harm reduction. Some people don’t want to stop using right now, and we work on helping them stay safe. Others want complete abstinence. Some don’t know what they want yet. They’ll discover that as they go.”
“One of the biggest misconceptions about addiction is that people simply choose substances over everything else,” says Dayna Gladstein, president & CEO of Newport Mental Health. “During my years working with pregnant women struggling with substance use disorders, I came to see addiction differently. I believe addiction is like a relationship. It’s not just a transaction. There are feelings. There’s irrationality. There’s passion. It’s like being in love with someone who’s going to hurt you.”
This comparison helps explain why someone might continue using despite devastating consequences. It’s physiological, but it’s emotional too.
Breaking that relationship requires treating both the addiction and the underlying mental illness together, the principle that is the cornerstone of IDDT.
A model built for the future
Today the program serves more than 100 people, and Catanzaro says demand continues to grow.
“This program is for people who haven’t responded to traditional therapeutic or case management interventions,” she says. “These are the people we’re trying to reach.”
Although Newport Mental Health primarily serves Newport County, the team works with neighboring communities whenever possible, coordinating transportation and partnerships with other agencies to ensure people receive care. The program accepts individuals regardless of insurance status.
The program reflects a broader shift in how behavioral health can be delivered. For too long, the question was, ‘Are you in addiction treatment or are you in mental health treatment?’ This model says ‘You’re a whole person, and we’re going to treat you that way.’
As Newport County continues to confront the intertwined challenges of mental illness, addiction, and housing instability, that philosophy may be one of the community’s most valuable resources. By meeting people where they are, treating the whole person, and staying with them for as long as recovery requires, Newport Mental Health’s IDDT program offers a new model of care, built not just around a diagnosis, but around the person. If you or someone you know is struggling, please call Newport Mental Health (401) 846-1213.
Dayna Gladstein is President & CEO of Newport Mental Health in Middletown. Peace of Mind, which is co-written with Kristan McClintock, runs in the Newport Daily News and online at newportri.com.