Service integration for the dually diagnosed

Abstract

The needs of dually diagnosed clients in mental health services have been and remain a focus for service development and improvement in Australia. The Council of Australian Governments committed to a five-year National Action Plan on Mental Health with a $1.8 billion injection into mental health services. In Australia there have been great advances in the service initiatives and service deliverables to those clients who experience a dual diagnosis. These advances include that dual diagnosis is systematically identified and responded to in a timely, evidence-based manner as a core business in mental health and alcohol and other drug services. These advances are brought to life by specialist mental health and alcohol and other drug services that establish effective partnerships and agreed mechanisms to support integrated care and collaborative practice. Here, four case studies are offered as a means of illustrating the ways in which projects undertaken in local community health services have approached dual diagnosis treatment for clients. These case studies reflect how cooperation and cross-referral between services, as well as effective management of dual diagnosis clients by suitably qualified staff can produce benefits to clients who use the service.

Dual diagnosis: A systematic review of the organization of community health services

“…Institutional support is important for sustaining the integration process, but also changing practices takes time. Integration is a complex and dynamic process, and context matters when initiating integration processes; client characteristics often extend the boundaries of integration projects; communication, training and sharing of expertise are essential levers for developing integrated approaches (Brousselle et al, 2010; Edward et al, 2012; Mancini & Miner, 2013; Merkes et al, 2010).…”

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

“…service access and entry through any service or via any health professional) reduces negative clinical outcomes, functional deficits, impulsive behaviours and cost of treatment (Centre for Substance Abuse Services, 2006), particularly where the comorbidity is diagnosed and responded to efficiently through collaboration and open communication between services (Edward, Hearity, & Felstead, 2012). However, mental health and AOD services are often separated making seamless integration a difficult challenge for the sector (Edward et al, 2012). Barriers to effective integration of AOD and mental health care within service settings includes: ineffective leaders, high staff turnover and insufficient financial resources (Brunette et al, 2008).…”

Care for Psychiatric Patients that Use Drugs: Management and Perceptions of Professionals

“…In this sense, the fact that the participants did not mention any joint work with experts in the treatment of drugs draws attention. Alternatives such as shared care through discussions between mental health service teams and specialized services in alcohol and other drugs can also be promising in this area, however, it is necessary for professionals in both services to overcome barriers and recognize inherent limitations to their specialty, seeking to jointly discuss measures to be implemented case-by-case (Edward, Hearity, & Felstead, 2012). Group therapeutic strategies carried out in mental health services for people who use drugs can also be effective because they provide a space to talk about these issues, leading to more awareness and management.…”