Co-Occurring Disorder Facts


An estimated 60% of families of children in the child welfare system have substance use problems. At least one-half of those have a diagnosed co-occurring mental illness.


At least 50% of people who are homeless have co-occurring disorders. Left untreated, they have little chance at obtaining jobs and permanent housing.

Judicial and Criminal Justice Systems

In the criminal justice system, 76% of inmates with mental health issues reported substance use.

Suicide Fact

51% of suicide completers have both substance abuse and mood disorders (Suominen et al., 1996)

The Family Perspective

It is estimated that over 10 million people across the United States are struggling with co-occurring disorders. Many of these people do not access treatment services, and when they do, the treatment is often not "integrated" or delivered in a way that best meets their need.
Based on national prevalence data it is estimated that in Tennessee approximately 196,000 individuals are diagnosed with a co-occurring disorder.

A Family Perspective 

  • In the criminal justice systems, 76% of inmates with mental health issues reported substance use.

  • Untreated, co-occurring disorders are a strong predictor of recidivism for the criminal justice system.

  • An estimated 60% of families of children in the child welfare system have substance use problems. At least one-half of those have a diagnosed a co-occurring mental illness.

  • In 2013, Tennessee had approximately 8,200 children and adolescents in state custody. Prevalence data tells us that approximately 2,500 of the families in the state's foster care system are impacted by substance use and mental health disorders.

  • Co-occurring substance use and mental health disorders have a negative impact on health, relationships, safety, employment and education and pose a greater challenge in maintaining recovery or resiliency than those with a single diagnosis.

  • Unidentified and untreated disorders can affect children's critical developmental years.

  • 85.2% of children and youth are reported to have had biological family members with some type of mental illness, including drug and alcohol problems.

  • Approximately 69.9% of caregivers reported that their child had a biological family member who had been diagnosed with depression or shown signs of depression and 47.1% reported that their child had a biological family member with another type of mental illness. In addition, 60.8% of children and youth were reported to have a biological family member who had a drinking problem.

  • Most of the children served had one or more experiences in their lives that are associated with greater risk for mental health challenges, such as physical or sexual abuse or a history of drug or alcohol problems. Almost one-half of the children and youth lived in family situations that put them at greater risk for later mental health challenges (e.g., exposure to domestic violence).

Ways you can contribute to initiating change to reduce the impact of co-occurring disorders.

Support Enhanced Treatment

  • Support a "no wrong door" community-based integrated treatment approach where the presence of co-occurring disorders is considered an expectation rather than an exception. Regardless of where an individual goes for treatment, they will be able to get the help they need.
  • Support routine co-occurring disorders screenings and treatment referrals for individuals entering the criminal justice system and the development of adequate treatment options and resources that have been shown to be effective.

Effective Behavioral Healthcare Treatment Options

  • Be an advocate by encouraging your public policy-makers to pass laws which focus on a variety of treatment options including, but not limited to, inpatient and outpatient care, supportive housing, and peer-to-peer support as these treatment techniques provide the best possible opportunity for recovery.
  • Initiate conversations and efforts that provide your local community the resources to manage these diseases and the support to maintain life-long recovery.

Advocate for Awareness and Education on the Impact of Co-Occurring Disorders

  • Be an advocate for local community partnerships with their community-based behavioral health agencies and advocacy organizations in educating and bringing about awareness of co-occurring disorders and their impact on local communities.
  • Be an advocate for enhanced training and education for judicial and criminal justice personnel and developing an awareness of the needs of individuals experiencing co-occurring disorders.
  • Be an advocate for incentives for employers to offer Employee Assistance Programs (EAPs) and access to effective treatment programs for employees and their families experiencing co-occurring disorders.