The story below is a real treatment summary from our clinical team, shared with identifying details removed. It follows a young woman who came to Destination Hope with a substance use disorder layered on top of untreated mental illness and trauma. We’re sharing it because her situation is common, and because it shows what happens when both conditions get treated at the same time instead of one at a time.
Cases like hers sit at the center of what we do. SAMHSA’s 2024 National Survey on Drug Use and Health estimated that roughly 21 million U.S. adults had both a mental illness and a substance use disorder in the same year, and the agency names integrated care, where both conditions are addressed together, as the standard for treating them. When a young adult shows up with suicidal thinking, daily substance use, and a trauma history all at once, treating the drinking alone misses the reason it started.
A 27-Year-Old Mother Admitted for Co-Occurring Substance Use and Mental Health
The client is a 27-year-old woman admitted to Destination Hope’s residential program for co-occurring substance use and mental health concerns. During her pre-admission, she reported suicidal ideation and risky behaviors that included driving under the influence and using substances in front of her children. She had been married for five years and described instability in the relationship tied to her substance use and her mental health. She has two children with her husband. She reported drinking alcohol and using other substances daily.
The consequences she named were serious. Strained family relationships, isolation, and supervised custody of her children because she couldn’t keep them safe on her own. She also reported a history of medication non-compliance and a history of traumatic experiences. That combination, an untreated psychiatric condition feeding a substance use disorder feeding more instability, is exactly the pattern a dual diagnosis program is built to interrupt.
Building Trust Before Building Skills
From the beginning, she presented as very guarded and unable to share past trauma. Through the unconditional positive regard of her therapist, she opened up more and more in individual sessions. She learned coping skills to manage her anxiety, including deep breathing, grounding, and reality testing.
For a while she continued to struggle with anger and irritability. She would lash out at staff and peers when frustrated, then report afterward that she didn’t want to act that way and didn’t know how to control her anger. Her therapist offered alternatives for releasing the anger safely: stepping away, deep breathing, and processing it later in group or session. Across group and individual therapy, she learned more about her mental health diagnoses and how they shaped both her daily life and her substance use.
Treating the Trauma Underneath the Substance Use
She was able to identify the negative consequences of her substance use. Working from a strengths-based perspective, her therapist helped her feel more capable of maintaining her recovery. They moved into inner child work to address her low self-esteem, her trauma reactions, and her destructive behaviors. She gained insight that let her start releasing the damaging beliefs she carried about herself and the world.
She willingly completed the homework her therapist assigned. To prepare for going home, she journaled about triggers that might come up and how she’d approach each one. By that point she had done a lot of self-reflection and built the confidence to make decisions based on what was best for her and her recovery. She seemed steady and genuinely excited to see her children, strengthen the relationship with her mother, and mend the relationship with her husband. Both her mother and her husband agreed to attend therapy with her.
What Progress Looked Like in Her Own Words
Toward the end of treatment, she could name her strengths, something she couldn’t do when she arrived. She said, “I like helping others. I’m loving and caring. I’m a good mother. I’m confident and loyal. I’m determined and compassionate.” She also tracked her own progress since admission: “My personality is coming back. I’m not seeing as much hatred towards others as I used to. I’m better at communicating effectively. I’m learning how to be a better version of myself. I’m also getting the patience thing down.”
She shared vulnerably in a group, another thing she had struggled with early on. She was discharged home to live with her mother and to continue intensive outpatient care locally, the kind of step-down that keeps the work going after residential treatment ends.
If This Sounds Like Someone You Love
You don’t have to wait for a crisis to get someone help, and you don’t have to choose between treating their mental health and treating their substance use. Our clinical team treats both together, with psychiatry, individual therapy, and family involvement under one roof. If you’re worried about a family member, call Destination Hope at (954) 302-4269 or start the admissions process to talk through what care could look like.
Crisis and Emergency Resources
If you or someone you know is in a substance use or mental health crisis, help is available now. Contact the SAMHSA National Helpline at 1-800-662-HELP (4357) for free, confidential treatment referrals 24/7. Reach the 988 Suicide and Crisis Lifeline by calling or texting 988. The Crisis Text Line is available by texting HOME to 741741. For emergencies, call 911.
