Inpatient staff perceptions in providing care to individuals with co-occurring mental health problems and illicit substance use

Abstract

The extent of illicit substance use within inpatient mental health settings is becoming a major cause of concern. This poses growing challenges not only for the management of inpatient units, but also for providing continuity of care. Service users with co-occurring substance use are more likely to disengage from services. The process of engagement can be hindered by negative attitudes of staff. This study aimed to identify and explore multidisciplinary staff attitudes and experiences in caring for inpatients with co-occurring ill-mental health problems and illicit substance use. A questionnaire incorporating the Drug and Drugs Problems Perceptions Questionnaire (DDPPQ) was used with a non-probability sample of 84 multidisciplinary staff working on nine mental health units. Semi-structured interviews were then carried out with 10 members of staff. Overall, respondents reported: lack of training; difficulty in accessing support structures; and problematic issues with multidisciplinary decision making and processes. The DDPPQ results showed that staff who had received training held less negative attitudes towards illicit substance users regardless of their length of clinical work experience or type of work setting. Recommendations are made about the importance of training and staff support for the development of less negative attitudes towards this client group.

Assessing and responding to hazardous and risky alcohol and other drug use: The practice, knowledge and attitudes of staff working in mental health services

“…Gilchrist et al, 2011;Ralley, Allott, Hare, & Wittkowski, 2009) and on the other, some substance misuse services struggle to work beyond an abstinence paradigm, where for example, consumers may be on psychotropic medications for a mental illness whilst dealing with an addiction (Saunders & Robinson, 2002). The end users of these two seemingly parallel approaches can be rendered disengaged in the system and in their care (Howard & Holmshaw, 2010). Having staff who are equipped to handle this complexity is necessary to ensure continuity and effective care.…”

“…Barriers to appropriate service delivery for this complex Correspondence: Amanda Wheeler, Griffith Health Institute, Griffith University, Brisbane, Australia. E-mail: a.wheeler@griffith.edu.au consumer group include: appropriate screening for AOD use (such as availability and training to use structured tools), lack of staff training and knowledge (Christie, Black, Dunbar, Pulford, & Wheeler, 2013), inadequate support structures and complex multidisciplinary team dynamics (such as ineffective team communication, lack of consistent therapeutic approaches and frameworks) (Howard & Holmshaw, 2010). Reasons for the service delivery challenges go beyond the complexity of knowledge and skill requirements of the workforce.…”

“Turning the tide” in Treatment of substance use: A nursing response

“…[50][51][52] While intervention skills play a role in nurses' approach or avoidance to any behavioral issue, attitudes are also a major component. [53] In addition to the engagement barriers generated by stigma, research demonstrates that healthcare professionals are often uncomfortable discussing substance use with patients.…”

Assessing knowledge and attitudes towards addictions in medical residents of a general hospital

“…Previous literature has intended to address physician's and medical students knowledge and attitudes towards addictions in several settings (such as primary care, general psychiatry or specialised addiction services), underscoring the importance of training and supervisor's support (Gilchrist et al, 2011;Howard & Holmshaw, 2010;Kelleher & Cotter, 2009), and the need to improve different aspects of medical education . In this regard, the need to integrate addiction training into the general medical curriculum, with the objective of overcoming the lack of knowledge in this area, has been already highlighted (Strobel et al, 2012).…”