DDCMHT – II. Program Milieu


Definition: Persons with co-occurring disorders are welcomed by the program or facility, and this concept is communicated in supporting documents. Persons who present with co-occurring substance use disorders are not rejected from the program because of the presence of this disorder.

Source: Observation of milieu and physical environment, including posters on walls in waiting rooms and group rooms, as well as interviews with clinical staff, support staff, and patients.

Item Response Coding: Coding of this item requires a review of staff attitudes and behaviors, as well as the program’s philosophy reflected in the organization’s mission statement and values.

Those with dual disorders are likely to feel more welcome if a service provider communicates a matter-of-fact expectation that many individuals seeking services have co-occurring recovery needs. Among the ways this can be communicated is the intentional and visible display of posters and/or pamphlets that give a hopeful recovery message. The following are resources that may be downloaded and printed, or ordered from SAMHSA at no cost – visit SAMHSA’s National Recovery month webpages for more details and resources, including all downloadable Banners, Logos, Flyers, and Posters:



Definition: Programs that treat persons with co-occurring disorders create an environment which displays and provides literature and educational materials that address both mental health and substance use disorders.

Source: Observation of milieu and physical settings, review of documentation of patient handouts, videos, brochures, posters, and materials for patients and families that are available and/or used in groups. Patient interviews are also completed.

Item Response Coding: Coding this item depends on examination of the clinic environment and waiting areas. Specifically, the different types and displays of educational materials and public notices are considered.

The following are among the many client education resources that are available and in the public domain:

  • To navigate to Integrated Recovery‘s extensive library of viewable and/or downloadable informational resources about substances of abuse, click here.