I'm a bit confused to the topic so please forgive me if I'm not hitting it right on. I do know that mental illness and substance abuse often go hand in hand and like the chicken or the egg, is just as difficult figuring out which came first or what the underlying cause is. Often the symptoms are identical for both. As for outpatient care is where I am confused. Here in my area we do have outpatient programs for both mental illness and substance abuse. I've been to both and found substance abuse programs to be ineffective and boring for me. I have benefited greatly from outpatient MI. As for the stigma, I think it's worse for MI because it's more of a mystery and filled with false myths and also, MI tends to be for life. Sorry if I did not address this as intended.