As a public health physician and psychiatrist who has described the development of people with co-occurring mental health and substance abuse disorders over the past twenty years, I was honored to participate in the session, Blamed and Ashamed, at the recent Federation’s Annual Conference. The presentation took place in Washington, D.C. on December 2, 2000. I am pleased to recap my remarks for the published report. When I first read the draft report of this project I was astonished to find how closely the findings, produced by focus groups of adolescents with co-occurring disorders and their families matched my own work. The material I have gathered from research and clinical experience dovetails perfectly with the findings and recommendations of the focus groups.