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My name is Deborah. I have been living with clinical depression for most of my life. I am also an addict -- a recovering addict, that is -- for 12 years now. Depression is hereditary in my family. So is a predisposition to substance abuse. So, it seems, is denial and ignorance.

In 1987, after a major depressive episode preceded by a weekend of heavy drinking, I was fortunate enough to commit myself to one of the first programs for co-occurring disorders, attached to a psychiatric facility near where I grew up in New England. I was also lucky enough to have private insurance, which at the time covered my entire six-week stay at the program. This program not only gave me the therapy I needed to recover from my depression, but it also showed me the tools I needed to recover from my addiction -- and to understand the link between my depression and my addiction.

More than a decade later, things have changed -- but not for the better. Two years ago, while seeking help for a family member, I called this same program. I was told that, even with private insurance, the maximum stay an insurance program would authorize is now only 10 days -- barely enough time for a person to get "clean" and start dealing with recovery and with her underlying psychiatric disorder.

Dual diagnosis seems to be the latest rage, but true co-occurring treatment services are a much-touted concept rather than a reality. The gap that exists between the substance abuse and mental health communities is still huge. Private insurance companies still treat substance abuse as the poor cousin of mental health, and we all know how inadequately they fund mental health services. Funding for any of these services is still compartmentalized. All of this makes it difficult, at best, for programs to provide the integrated services to holistically treat an individual with schizophrenia who quiets his voices with heroin, or someone who uses alcohol to self-medicate her undiagnosed depression.

I now live in rural New Mexico, where my work connects me with people like me -- sometimes several generations of a family -- who live believing their despair and their need to escape is normal. But now they have a neighbor who knows their lives can be different -- and who is working to show them how.