Dual Diagnosis Treatment in Texas

Addiction rarely shows up alone. Depression, anxiety, PTSD, bipolar disorder and other mental health conditions often come with it, sometimes driving the drinking or drug use, sometimes caused or worsened by it. Dual diagnosis treatment, also called co-occurring disorder treatment, treats both at the same time, with the same team, instead of sending people back and forth between separate systems.

This page explains what Texas rules require of programs serving people with co-occurring conditions, how to recognize an integrated program, where to get crisis help in every Texas county, and how insurance covers dual diagnosis care. Programs are listed by region and city below.

Why treat both together

SAMHSA defines co-occurring disorders as a mental health condition and a substance use disorder happening at the same time, and notes that more than one in four adults with serious mental health problems also has a substance use problem. NIDA's research finds that people with addiction and another mental disorder generally do best when both are treated at the same time in an integrated way. Treating one and ignoring the other is a common reason people relapse.

What Texas rules say

Texas uses the term COPSD, for co-occurring psychiatric and substance use disorders, in its treatment facility rules (26 Texas Administrative Code Sec. 564.906). Licensed programs may not exclude someone because of a mental illness history, current psychiatric medications or past treatment outcomes, or assume they can't benefit from treatment. Screening, assessment, treatment and referral have to stay connected for each client, and refusing one service can't block access to other needed services. Separately, licensed programs can't deny admission to, or discharge, someone just because they take prescribed medication.

What an integrated program looks like

• A psychiatric evaluation early in treatment, not weeks later.
• A psychiatrist or psychiatric nurse practitioner who manages medications on site or on a set schedule.
• Therapy approaches suited to both conditions, such as trauma-focused therapy for PTSD.
• One treatment plan covering both conditions, and discharge planning that includes ongoing psychiatric care.

Ask programs directly how they handle each of these. "We treat co-occurring disorders" can mean anything from a full psychiatric team to a referral list.

Crisis help in every Texas county

Every Texas county is served by a local mental health authority (LMHA) or local behavioral health authority (LBHA) with a 24-hour crisis line, and 988 connects to trained crisis counselors anywhere in the state. Find your county's crisis line on our Texas crisis help page. If someone is in immediate danger, call 911.

Dual Diagnosis Treatment in Texas at a glance

Counts come from this directory, which combines the SAMHSA National Directory of Substance Use Treatment Facilities with public business listings. "Confirmed" programs are those whose SAMHSA service codes or listings show residential, inpatient or detox care; 54 report accepting private health insurance in the SAMHSA directory. Always confirm services directly.

Insurance for dual diagnosis care

Texas parity law (House Bill 10) and the federal Mental Health Parity and Addiction Equity Act require fully insured plans to cover mental health and substance use disorder benefits at parity with medical care, and Texas plans must keep enough in-network behavioral health providers for routine and emergency care. Inpatient and residential care for dual diagnosis usually requires prior authorization.

Major Texas carriers and dual diagnosis treatment

Plan rules vary, and self-funded employer plans can differ. Always confirm benefits with the member services number on your ID card.

Court-ordered treatment when both conditions are present

Texas has separate commitment laws for chemical dependency (Chapter 462) and mental illness (Chapters 573 and 574). Which one fits depends on what's driving the danger. See Chapter 462 vs mental health commitment.

Dual Diagnosis Treatment by region

Texas's Health and Human Services Commission organizes services into 11 health service regions. Here's where dual diagnosis programs on our list are located.

Common co-occurring conditions

Depression and anxiety disorders are the most common companions of addiction. PTSD frequently travels with alcohol and opioid use, often among people with histories of trauma, military service or first-responder work. Bipolar disorder can drive periods of heavy use, and ADHD is common among people with stimulant and alcohol problems. Psychotic symptoms can be caused by stimulants or cannabis, or reflect a separate condition that needs its own treatment. A thorough psychiatric assessment early in treatment helps sort out what's what.

Questions to ask a dual diagnosis program

• Who does the psychiatric evaluation, and how soon after admission?
• How often will I see a psychiatrist or psychiatric nurse practitioner?
• Which conditions does the program treat, and which does it refer out?
• How do you handle psychiatric medications during detox and treatment?
• Who will manage my psychiatric care after discharge?

Continuing care in Texas

After residential treatment, ongoing psychiatric care matters as much as addiction aftercare. Local mental health authorities serve every Texas county and offer outpatient mental health services in addition to crisis lines. Many people continue with a private psychiatrist and therapist covered by insurance, plus support groups for both recovery and mental health.

Find dual diagnosis treatment near you

Dual Diagnosis Treatment in Texas's largest cities

• Dallas (54 within 25 mi)
• Houston (52 within 25 mi)
• San Antonio (16 within 25 mi)
• Austin (44 within 25 mi)
• Fort Worth (35 within 25 mi)
• El Paso (8 within 25 mi)
• McAllen (6 within 25 mi)
• Denton (28 within 25 mi)
• Arlington (48 within 25 mi)
• Corpus Christi (2 within 25 mi)
• Plano (56 within 25 mi)
• Lubbock (2 within 25 mi)
• Laredo (3 within 25 mi)
• McKinney (36 within 25 mi)
• Killeen (3 within 25 mi)
• Garland (52 within 25 mi)
• Irving (65 within 25 mi)
• Brownsville (3 within 25 mi)
• College Station (2 within 25 mi)
• Amarillo (5 within 25 mi)
• Frisco (48 within 25 mi)
• Grand Prairie (54 within 25 mi)
• Waco (5 within 25 mi)
• Odessa (4 within 25 mi)
• Midland (4 within 25 mi)
• Port Arthur (5 within 25 mi)
• Pasadena (38 within 25 mi)
• Beaumont (5 within 25 mi)
• Tyler (4 within 25 mi)
• Mesquite (36 within 25 mi)

Dual Diagnosis Treatment programs across Texas

One program from each of several Texas counties, confirmed programs first. Use the county and city links for the closest options to you.

Dual Diagnosis Treatment by county

• Harris County (41)
• Travis County (29)
• Tarrant County (26)
• Dallas County (23)
• Denton County (17)
• Collin County (17)
• Bexar County (16)
• Fort Bend County (12)
• Williamson County (9)
• Brazoria County (8)
• El Paso County (8)
• Hidalgo County (6)
• Hays County (6)
• Galveston County (6)
• Potter County (5)
• McLennan County (5)
• Kaufman County (5)
• Montgomery County (5)
• Grayson County (5)
• Jefferson County (5)
• Smith County (4)
• Bastrop County (4)
• Cameron County (3)
• Wichita County (3)
• Johnson County (3)
• Gregg County (3)
• Rockwall County (3)
• Kerr County (3)
• Comal County (3)
• Bell County (3)
• Webb County (3)
• Ellis County (3)
• Liberty County (2)
• Hutchinson County (2)
• Parker County (2)
• Angelina County (2)
• Midland County (2)
• Ector County (2)
• Nueces County (2)
• Lubbock County (2)
• Brazos County (2)
• Ochiltree County (2)
• Starr County (1)
• Walker County (1)
• Deaf Smith County (1)
• Hamilton County (1)
• Bailey County (1)
• Hunt County (1)
• Van Zandt County (1)
• Austin County (1)
• Hale County (1)
• Pecos County (1)
• Caldwell County (1)
• Bandera County (1)
• Wood County (1)
• Wilbarger County (1)
• Moore County (1)
• Waller County (1)
• Taylor County (1)
• Tom Green County (1)
• Cherokee County (1)
• Howard County (1)
• Anderson County (1)
• Gonzales County (1)
• Maverick County (1)
• Fayette County (1)
• Polk County (1)
• Harrison County (1)

Don't see your county? Every county has a page with the nearest programs: browse all 254 Texas counties.

Other types of care

Related guides

• Chapter 462 vs Mental Health Commitment in Texas
• How to Choose a Rehab in Texas: Questions, Licenses and Red Flags
• How to Help a Loved One Into Addiction Treatment in Texas
• Rehab for Veterans in Texas: VA, TRICARE and Community Options
• Sober Living and Aftercare in Texas: What Comes After Rehab
• Does Aetna Cover Rehab in Texas?

This page is general information, not medical or legal advice. Confirm services, licensing and insurance directly with any program.