Quality care for individuals with dual diagnosis: the legal and ethical imperative to provide qualified staff.

An evaluation of the treatment and habilitation services being provided to individuals with dual diagnoses of mental retardation and mental illness was presented. The current status of service delivery is identified as unacceptable. Legal issues relating to the obligation to provide quality services were discussed as were ethical issues relating to where the responsibility for providing such service lies. General ethical principles of nonmaleficence and beneficence were defined, and the codes of ethics for two professional groups were invoked to bolster the position that administrators and supervisors are ultimately responsible for the quality of service provided by their organizations. Recommendations for staff competencies necessary to improve treatment for individuals with dual diagnosis were made.