Finding the right help for mental health and substance use isn’t always simple, especially when you’re caught in a cycle that involves more than one challenge. Dual-diagnosis rehab is a treatment approach that addresses mental health and addiction together for better outcomes.
If you or someone you love is struggling with a cycle of addiction and mental illness like anxiety or depression, understanding how dual-diagnosis care works can help. We dig into what dual diagnoses are below, including why it matters and where you can get treatment in Florida.
What Is Dual Diagnosis and Why It Matters in Treatment
A dual diagnosis means someone has a diagnosis for a mental health disorder and one for a substance use disorder. For example, they might struggle with alcohol addiction and depression. This combination of a substance abuse disorder and a mental health condition is common. According to data from the National Epidemiologic Survey on Alcohol and Related Conditions Wave III, around a third of individuals with a substance use disorder have a co-occurring mental health diagnosis. Around a quarter of those with a mental health diagnosis have a co-occurring secondary mental health diagnosis.
When mental health and substance abuse conditions occur together, they can make each other worse. Someone might use drugs or alcohol to cope with difficult emotions or symptoms stemming from their mental health condition — this is known as self-medicating. However, substance abuse can actually deepen depression or anxiety over time and make other mental health symptoms worse, creating a cycle that drives the person back to use more drugs or alcohol.
Understanding that you have a dual diagnosis is important because it changes the treatment you seek and how providers address your rehab. If only one issue is treated, your risk of relapse increases. For example, if you go to a rehab that only treats your addiction but doesn’t address any mental health concerns, the underlying issues that drove you to use alcohol or drugs in the first place may remain. Dual-diagnosis rehab focuses on treating both conditions at the same time, which can improve long-term recovery chances and overall quality of life.
Common Co-Occurring Disorders Treated in Florida Facilities
Dual-diagnosis therapy centers in Florida focus on providing holistic treatment that helps someone face substance abuse and mental health challenges. Common co-occurring disorders treated in Florida facilities include:
- Depression. Persistent sadness, low energy or hopelessness can lead someone to self-medicate with alcohol or drugs.
- Anxiety disorders. Conditions like generalized anxiety disorder or panic disorder can drive substance use as a coping tool.
- Post-traumatic stress disorder (PTSD). Trauma-related conditions often overlap with addiction, especially when someone is trying to numb emotional pain.
- Bipolar disorder. Mood swings and impulsive behavior may increase vulnerability to substance use.
- ADHD. Difficulty with focus and impulsivity can make managing cravings and emotions more difficult.
- Schizophrenia. Individuals with schizophrenia may use substances to manage symptoms like hallucinations or delusions, which can worsen both conditions.
How Insurance Typically Covers Dual-Diagnosis Care
Most health insurance providers offer some coverage for dual-diagnosis rehab, especially when it’s deemed medically necessary. Because dual-diagnosis treatment involves both a mental health disorder and a substance use disorder, insurers typically require formal diagnoses for both conditions to approve coverage.
That means a health care professional must evaluate you and provide documentation of each disorder. For instance, if you’re being treated for generalized anxiety disorder and alcohol use disorder, the provider can’t just submit claims with an alcohol use disorder diagnosis. Without both diagnoses, an insurance company might only cover one part of treatment, such as detox services for substance use.
Once both conditions are diagnosed, insurance coverage may extend to services like medical detox, residential treatment, therapy and psychiatric care. Coverage varies based on your insurance plan, the treatment center and whether providers are in-network. Some plans may require preauthorization or have limits on the length of stay or number of therapy sessions covered.
Understanding what your insurance plan covers ahead of time can help reduce stress and make it easier to focus on recovery.
Types of Plans and What They May Include
Different types of insurance plans may cover dual-diagnosis situations in varying degrees. Insurance coverage is a complex topic that can’t be addressed fully in such a brief guide, but here are some examples of various plan types and what they might cover:
- Private insurance plans. These are plans you get through your employer or the health insurance marketplace. Many cover dual-diagnosis rehab. Typically, they provide better coverage if you use an in-network provider. If you have this type of plan, you may have coverage for inpatient rehab, therapy, medication management and other services, while out-of-pocket costs like co-pays and deductibles depend on your plan.
- Medicaid. In Florida, Medicaid may cover dual-diagnosis treatment if the facility accepts Medicaid and services are deemed medically necessary. Coverage often includes outpatient therapy and psychiatric care. Sometimes residential treatment is also covered, but options may be more limited than with private insurance.
- Medicare. Medicare can cover dual-diagnosis care if certain criteria are met. Part A may cover inpatient hospitalization for mental health or addiction treatment. Part B often covers outpatient services like therapy or substance use counseling.
If you have private insurance, it might also matter whether you have an HMO or PPO plan. HMO plans often require referrals for specialty services and require you to use an in-network provider. PPO plans tend to offer more flexibility, but you might pay more out of pocket if you choose an out-of-network provider.
What to Ask Providers and Insurers About Coverage
Navigating insurance coverage for dual-diagnosis treatment can be confusing. Most providers offer guidance when you’re considering their services, and asking the right questions up front can help you avoid surprise costs later. Ask your provider questions like:
- Do I need a referral or preauthorization for treatment? Some plans require you to get approval before services are covered.
- What mental health and substance use services are included in my plan? Be specific about inpatient vs. outpatient, therapy and medically assisted detox.
- Are there limits on covered therapy sessions or length of stay? It’s important to know if there’s a cap on services.
- What’s my out-of-pocket cost for dual-diagnosis care? Ask about deductibles, co-pays and coinsurance.
- Is the treatment center in-network? Using in-network providers can reduce your overall cost.
- Does my plan cover aftercare or follow-up services? Recovery doesn’t end with rehab, and support after treatment matters.
Accessing Dual-Diagnosis Treatment at Our Florida Center
At FHE Health, we work to treat the entire person, including mental health and substance use disorders. Our team is also experienced at navigating insurance concerns and can help you understand the best next steps for your rehab journey and what your insurance might cover. Give us a call today or complete our online form to get started.
