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Page 1 Behavioral Health Services 21Day Inpatient Dual Diagnosis Program Referral Packet (Revised April 2013) We are a tobacco free facility Bradford Regional Medical Center Upper Allegheny Health
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How to fill out 21-day inpatient dual diagnosis

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How to fill out 21-day inpatient dual diagnosis:

01
Gather necessary information: Start by collecting all relevant personal information such as name, age, address, contact details, and insurance information. This will ensure accurate identification and smooth coordination during the treatment process.
02
Complete medical history form: Provide detailed information about your medical history, including any past diagnoses, current medications, and previous treatments. This will help the healthcare professionals understand your specific needs and tailor the treatment plan accordingly.
03
Describe symptoms and concerns: Clearly articulate the symptoms you are experiencing, the duration, and any concerns or challenges you are facing. This will assist the healthcare team in formulating an effective treatment plan to address your specific needs.
04
Collaborate in creating treatment goals: Work with the healthcare team to establish realistic and personalized treatment goals. This collaborative approach ensures that your treatment aligns with your specific needs and aspirations.
05
Understand and provide consent: Familiarize yourself with all the information provided by the treatment facility regarding the program, therapies, medications, and potential risks. Make sure to clarify any doubts or concerns before providing informed consent to proceed with the treatment.

Who needs 21-day inpatient dual diagnosis:

01
Individuals struggling with substance abuse and mental health issues: Dual diagnosis, or co-occurring disorders, refers to the presence of both a substance use disorder and a mental health disorder. Inpatient dual diagnosis treatment is suitable for individuals dealing with this complex combination, providing comprehensive care in a structured environment.
02
Those requiring intensive treatment and support: The 21-day inpatient program is designed for individuals who require a higher level of care due to the severity of their substance abuse and mental health challenges. This residential treatment offers round-the-clock support, therapy, and medical intervention to address the individual's needs effectively.
03
People who have not responded well to outpatient treatment: In cases where outpatient treatment has not yielded desired results, opting for inpatient dual diagnosis can offer a more intensive and immersive experience, facilitating greater focus on recovery by removing external triggers and distractions.
04
Individuals in need of a safe and supportive environment: Inpatient dual diagnosis treatment provides a safe and structured environment where individuals can receive support from healthcare professionals and connect with peers facing similar challenges. This environment encourages personal growth, skill-building, and the development of healthy coping mechanisms.
It is essential to consult with a healthcare professional or treatment provider to determine if the 21-day inpatient dual diagnosis program is suitable for your specific needs and circumstances.
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21-day inpatient dual diagnosis refers to a treatment program designed for individuals with co-occurring mental health and substance use disorders that lasts for 21 days.
Healthcare providers, treatment facilities, and professionals who provide care for individuals with dual diagnosis disorders are required to file 21-day inpatient dual diagnosis.
To fill out 21-day inpatient dual diagnosis, providers must document the patient's mental health diagnosis, substance use disorder diagnosis, treatment plan, progress notes, and any relevant information related to the care provided.
The purpose of 21-day inpatient dual diagnosis is to provide comprehensive treatment and support for individuals with co-occurring mental health and substance use disorders.
Information such as patient's diagnoses, treatment plan, progress notes, medications prescribed, and any other relevant information related to the care provided must be reported on 21-day inpatient dual diagnosis.
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