This is an excellent question.
Two years ago we reviewed our competencies using the CCSA competency list. We did a survey across the country and took a look at where we were at.
We guarantee that each one of our teams has outpatient level 2 competencies, which means that they can screen and assess. They can determine the severity of the problem. If the persons have enough control over their addiction problem that they can complete the rest of their treatment—say, for major depression, PTSD, or whatever—then it is treated concurrently and in an integrated fashion, because that is the best practice.
If, however, the persons' condition has advanced to the point where they have completely lost control over the behaviour, then we do what is called “stepped care”. We will refer them to a designated facility with level 3 or 4 competencies, with the assurance that we will take them seamlessly as soon as they come back. We work in collaboration with them so that, as their discharge approaches, we start harmonizing the care plans. That is the best practice, and that is how we operate.