Speaker: Dr. Mohit Singh
Session Description:
As presentations of concurrent mental health and substance use disorders become increasingly complex, clinicians must navigate structured placement criteria, clinical risk, and local resource realities to determine the most appropriate level of care. This session provides an evidence-informed, clinically practical approach to treatment matching for concurrent mental health and substance use disorders, anchored in multidimensional assessment and structured placement frameworks.
The presentation will outline a structured, multidimensional approach to clinical decision-making in treatment matching, emphasizing risk, complexity, functional impairment, and recovery environment. Rather than relying on single-diagnosis severity alone. Synthesizing withdrawal risk, psychiatric acuity, medical comorbidity, readiness for change, relapse vulnerability, and social context into a coherent placement rationale. Established placement frameworks, including the ASAM Criteria, will be referenced as part of this discussion, but the focus will remain on practical clinical reasoning that translates across settings.
Participants will review the current evidence comparing outpatient, intensive outpatient/partial hospital, residential, and medically managed services for concurrent disorders. We will examine which outcomes demonstrate the strongest support (e.g., retention, symptom reduction, safety stabilization), where evidence remains mixed, and how heterogeneity in populations and program models limits direct comparisons. Canadian and North American clinical guidelines will be integrated to illustrate how pharmacologic, psychosocial, and systems-level recommendations can inform real-world matching decisions and stepped-care pathways.
Learning Objectives:
1. Apply a multidimensional assessment framework to translate clinical findings into an initial level-of-care recommendation, with explicit documentation of risk, complexity, and protective factors.
2. Summarize the evidence base comparing outcomes across outpatient, intensive outpatient/partial hospital, and residential levels of care, including key limitations.
3. Integrate Canadian guideline recommendations into treatment-matching decisions for common concurrent-disorder scenarios and create a step-up/step-down monitoring plan that supports continuity and safety.
References:
1. Gastfriend DR. Thirty Years of The ASAM Criteria: A Report Card. The Psychiatric Clinics of North America. 2022.
2. The ASAM Criteria (4th ed.). Placement, continued stay, and transfer/discharge criteria for addiction and co-occurring conditions. American Society of Addiction Medicine. 2023.
3. Wood E, et al.; for the Canadian Alcohol Use Disorder Guideline Committee. Canadian guideline for the clinical management of high-risk drinking and alcohol use disorder. CMAJ. 2023;195(40):E1364–E1376.
4. de Andrade D, et al. The effectiveness of residential treatment services for individuals with substance use disorders: A systematic review. Drug and Alcohol Dependence. 2019.
5. CADTH. Concurrent Treatment for Substance Use Disorder and Trauma-Related Co-Morbidity: A Treatment Update. 2021
BIO:
Dr. Mohit Singh, MD, FRCPC, D.ABAM is a double board-certified psychiatrist and Co-Founder of Brick House Recovery Centre, a multidisciplinary addiction and mental health treatment program in Alberta. He obtained his medical degree and completed psychiatry residency at the University of British Columbia, followed by a Forensic Psychiatry fellowship at Yale University in New Haven, USA. He also completed a fellowship in Addiction Medicine at the British Columbia Centre on Substance Use.
Dr. Singh has extensive experience in the assessment and treatment of substance use and concurrent mental health disorders across outpatient and hospital settings. He has held leadership roles within provincial health systems and is committed to advancing recovery-oriented, evidence-based care. He serves as an Associate Clinical Professor at the University of Alberta and Associate Program Director for the Addiction Medicine Fellowship, where he is actively involved in teaching and mentorship.