From famine to feast as dual diagnosis features in new UK government policy and strategy

2017 ◽  
Vol 10 (3) ◽  
pp. 120-122
Author(s):  
Ian Hamilton
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Dual Diagnosis ◽  
Policy Development ◽  
Rapid Review ◽  
Content Type ◽  
Substance Use Problems ◽  
Policy And Strategy ◽  
Uk Government ◽  
The Uk

Purpose The purpose of this paper is to outline the latest policy announcements by the UK Government and how they relate to people who have co-occurring mental health and substance use problems. Design/methodology/approach A rapid review was undertaken of policy, strategy and guidance. Findings All three publications are united by their ambition to improve the care and treatment for people who have developed problems with substances and their mental health. The challenge will be to realise these ambitions in an environment where financial and human resources are contracting. Originality/value It is important for clinicians, commissioners of treatment and researchers to be kept informed of policy development and how these initiatives will affect people with mental health and substance use problems.

Hope and recovery: a scoping review

2014 ◽  
Vol 7 (2) ◽  
pp. 63-72 ◽  
Author(s):  
Knut Tore Sælør ◽  
Ottar Ness ◽  
Helge Holgersen ◽  
Larry Davidson
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Limited Attention ◽  
Research Activity ◽  
Content Type ◽  
Recovery Processes ◽  
Ovid Medline ◽  
Substance Use Problems ◽  
Literature Searches ◽  
Broad Approach

Purpose – Hope is regarded as central to recovery processes. The phenomenon along with its implications for research and practice has, however, gained limited attention within the fields of mental health and substance use. The purpose of this paper is to explore how hope, and what may inspire it, is described within the literature by persons experiencing co-occurring mental health and substance use problems. Design/methodology/approach – The method chosen when conducting this literature review was a scoping study. This allows for a broad approach, aiming to examine research activity and identifying potential gaps within existing literature. Searches were conducted in EMBASE Ovid, PsychINFO Ovid, MEDLINE Ovid, CINAHL Ebsco, SveMed+ and Brithish Nursing Index. Findings – The authors included five articles and one book. None of these presented first-hand experiences of hope and there appears to be a gap in the literature. All included material underlined the importance of the phenomenon to those experiencing co-occurring mental health and substance use problems. Originality/value – Hope seems as important to people experiencing co-occurring problems as to anyone else. There appears to be a need for further research on how persons experiencing co-occurring problems perceive hope and what may inspire it. Hope and what people hope for take many forms and can arise unexpectedly. Practitioners need to take in account the diversity of the phenomenon and find ways of inspiring hope in collaboration with those in need of support.

Dual diagnosis in older drinkers during the COVID-19 pandemic

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Rahul Rao ◽  
Christoph Mueller ◽  
Matthew Broadbent
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Alcohol Use ◽  
Mental Health Services ◽  
Health Services ◽  
Older People ◽  
Substance Use Disorder ◽  
Dual Diagnosis ◽  
Opioid Use ◽  
Content Type

Purpose There is a dearth of literature examining the impact of the COVID-19 pandemic on older people with dual diagnosis referred to mental health services. The purpose of this study was to compare dual diagnosis before and after lockdown in people aged between 55 and 74 with alcohol use. Design/methodology/approach Data were collected for people referred to mental health services using an anonymised database of de-identified records to identify people with both substance use disorder alone, or accompanied by co-existing mental disorders. Findings In total, 366 older people were assessed with the Alcohol Use Disorders Identification Test (AUDIT), 185 before and 181 after lockdown. People with dual diagnosis were more likely to be referred than those without, after compared to before lockdown (13 and 6%, respectively, p < 0.05). People with any substance use disorder with and without dual diagnosis showed an even greater likelihood of referral after, compared with before, lockdown (61 and 34%, respectively, p < 0.0001). Opioid use more than once a month was more likely to be reported after, compared with before, lockdown (66 and 36%, respectively, p < 0.005). Research limitations/implications The finding of a higher likelihood of opioid use after compared with before lockdown during the COVID-19 pandemic warrants further exploration. There is also further scope for further studies that involve older non-drinkers. Originality/value A greater likelihood of both dual diagnosis and substance use disorder alone after, compared with before lockdown has implications for both mental health and addiction service provision during a pandemic.

Facilitators and barriers in dual recovery: a literature review of first-person perspectives

2014 ◽  
Vol 7 (3) ◽  
pp. 107-117 ◽  
Author(s):  
Ottar Ness ◽  
Marit Borg ◽  
Larry Davidson
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Social Life ◽  
Future Orientation ◽  
Small Scale ◽  
General View ◽  
First Person ◽  
Content Type ◽  
Substance Use Problems ◽  
Facilitators And Barriers

Purpose – The co-occurrence of mental health and substance use problems is prevalent, and has been problematic both in terms of its complexity for the person and of the challenges it poses to health care practitioners. Recovery in co-occurring mental health and substance use problems is viewed as with multiple challenges embedded in it. As most of the existing literature on recovery tends to treat recovery in mental health and substance use problems separately, it is critical to assess the nature of our current understanding of what has been described as “complex” or “dual” recovery. The purpose of this paper is to identify and discuss what persons with co-occurring mental health and substance use problems describe as facilitators and barriers in their recovery process as revealed in the literature. Design/methodology/approach – The method used for this study was a small-scale review of the literature gleaned from a wider general view. Searches were conducted in CINAHL, Psych info, Medline, Embase, SweMed+, and NORART. Findings – Three overarching themes were identified as facilitators of dual recovery: first, meaningful everyday life; second, focus on strengths and future orientation; and third, re-establishing a social life and supportive relationships. Two overarching themes were identified as barriers to dual recovery: first, lack of tailored help and second, complex systems and uncoordinated services. Originality/value – The recovery literature mostly focuses on recovery in mental health and substance use problems separately, with less attention being paid in the first-person literature to what helps and what hinders dual recovery.

The 10 most important debates surrounding dual diagnosis

2014 ◽  
Vol 7 (3) ◽  
pp. 118-128 ◽  
Author(s):  
Ian Hamilton
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Dual Diagnosis ◽  
Design Methodology ◽  
Collective Knowledge ◽  
Policy Makers ◽  
Content Type ◽  
The Relationship ◽  
Made In

Purpose – It is more than 30 years since attention turned to the issue of the relationship between substance use and mental health. The purpose of this paper is to reflect on the progress to date that has been made in advancing the knowledge and understanding. Design/methodology/approach – The author has drawn on the available literature, identifying key contributions from a variety of fields which have helped to shape the understanding of the issues in relation to dual diagnosis. The ten themes are not presented in order of importance. Findings – Achievements have been made in attracting the attention of clinicians, researchers, policy makers and commissioners to this issue. Overall the author is left with a clearer understanding of what treatments are not effective and the challenges of determining what is. Originality/value – This paper seeks to instigate a discussion about where the collective knowledge stands on this important and challenging area of practice and research.

An outcomes study of eTherapy for dual diagnosis using Breaking Free Online

2014 ◽  
Vol 7 (2) ◽  
pp. 52-62 ◽  
Author(s):  
Sarah Elison ◽  
Jonathan Ward ◽  
Glyn Davies ◽  
Nicky Lidbetter ◽  
Daniel Hulme ◽  
...  
Keyword(s):  
Mental Health ◽  
Dual Diagnosis ◽  
Substance Dependence ◽  
Clinical Effectiveness ◽  
Outcome Data ◽  
Post Treatment ◽  
Service Users ◽  
Original Cohort ◽  
Content Type ◽  
Self Help

Purpose – In recent years there has been a proliferation of computer-based psychotherapeutic interventions for common mental health difficulties. Building on this, a small number of such interventions have now been developed to address substance dependence, one of which is Breaking Free Online (BFO). A new “eTherapy” self-help service, which was set up by the UK mental health charity Self-Help Services, has provided access to BFO to service users presenting with comorbid mental health and substance misuse difficulties. The purpose of this paper is to evaluate a range of clinical outcomes in the first cohort of service users accessing this dual diagnosis service. Design/methodology/approach – A number of standardised psychometric assessments were conducted with service users at baseline and post-treatment at discharge from the service. Outcome data were available for 47 service users out of an original cohort of 74. Findings – Statistically significant improvements were found in terms of measures of social functioning, depression, anxiety, alcohol and drug use and social anxiety. Clinically relevant gains were also identified, with fewer service users reaching threshold scores for depression and anxiety at post-treatment compared to baseline. Effect sizes also indicated that the identified improvements across the psychometric measures were robust and significant. Research limitations/implications – These findings provide further support for the clinical effectiveness of BFO, and also provide evidence that an eTherapy self-help service may be appropriate for some individuals presenting with dual diagnosis. Further research is underway with larger and alternative clinical populations to examine the effectiveness of BFO and also this novel eTherapy self-help approach. Originality/value – This paper has provided initial data to support effectiveness of a novel eTherapy service for dual diagnosis.

scholarly journals Multidisciplinary team meetings in community mental health: a systematic review of their functions

2016 ◽  
Vol 21 (2) ◽  
pp. 119-140 ◽  
Author(s):  
Caoimhe Nic a Bháird ◽  
Penny Xanthopoulou ◽  
Georgia Black ◽  
Susan Michie ◽  
Nora Pashayan ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Community Mental Health ◽  
Multidisciplinary Team ◽  
Community Mental Health Services ◽  
Content Type ◽  
Team Members ◽  
Team Meetings ◽  
Unwarranted Variation ◽  
The Uk

Purpose – Previous research has identified a need for greater clarity regarding the functions of multidisciplinary team (MDT) meetings in UK community mental health services. The purpose of this paper is to identify the functions of these meetings by systematically reviewing both primary research and academic discussion papers. Design/methodology/approach – Papers relating to adult community mental health teams (CMHTs) in the UK and published between September 1999 and February 2014 were reviewed and appraised using NICE quality checklists. The search was broad in scope to include both general CMHTs and specialist CMHTs such as early intervention psychosis services and forensic mental health teams. A thematic synthesis of the findings was performed to develop an overarching thematic framework of the reported functions of MDT meetings. Findings – None of the 4,046 studies identified directly investigated the functions of MDT meetings. However, 49 mentioned functions in passing. These functions were categorised into four thematic domains: discussing the care of individual patients, teamwork, team management and learning and development. Several papers reported a lack of clarity about the purpose of MDT meetings and the roles of different team members which hindered effective collaboration. Practical implications – Without clearly agreed objectives for MDT meetings, monitoring their effectiveness is problematic. Unwarranted variation in their functioning may undermine the quality of care. Originality/value – This is the first systematic review to investigate the functions of CMHT MDT meetings in the UK. The findings highlight a need for empirical research to establish how MDT meetings are being used so that their effectiveness can be understood, monitored and evaluated.

scholarly journals Understanding the interplay of individual and social–developmental factors in the progression of substance use and mental health from childhood to adulthood

2016 ◽  
Vol 28 (3) ◽  
pp. 721-741 ◽  
Author(s):  
Tiffany M. Jones ◽  
Karl G. Hill ◽  
Marina Epstein ◽  
Jungeun Olivia Lee ◽  
J. David Hawkins ◽  
...  
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Social Environments ◽  
Developmental Factors ◽  
Substance Use Problems ◽  
History Of ◽  
Individual Functioning ◽  
Family History Of Depression ◽  
History Of Depression

AbstractThis study examines the interplay between individual and social–developmental factors in the development of positive functioning, substance use problems, and mental health problems. This interplay is nested within positive and negative developmental cascades that span childhood, adolescence, the transition to adulthood, and adulthood. Data are drawn from the Seattle Social Development Project, a gender-balanced, ethnically diverse community sample of 808 participants interviewed 12 times from ages 10 to 33. Path modeling showed short- and long-term cascading effects of positive social environments, family history of depression, and substance-using social environments throughout development. Positive family social environments set a template for future partner social environment interaction and had positive influences on proximal individual functioning, both in the next developmental period and long term. Family history of depression adversely affected mental health functioning throughout adulthood. Family substance use began a cascade of substance-specific social environments across development, which was the pathway through which increasing severity of substance use problems flowed. The model also indicated that adolescent, but not adult, individual functioning influenced selection into positive social environments, and significant cross-domain effects were found in which substance-using social environments affected subsequent mental health.

Young construction workers: substance use, mental health, and workplace psychosocial factors

2017 ◽  
Vol 10 (4) ◽  
pp. 155-168 ◽  
Author(s):  
Ken Pidd ◽  
Vinita Duraisingam ◽  
Ann Roche ◽  
Allan Trifonoff
Keyword(s):  
Mental Health ◽  
Social Support ◽  
Substance Use ◽  
Psychological Distress ◽  
Construction Industry ◽  
Psychosocial Factors ◽  
Job Stress ◽  
Poor Mental Health ◽  
Psychological Wellbeing ◽  
Content Type

Purpose Young Australian workers are at elevated risk of mental health and alcohol and other drug related problems. The purpose of this paper is to examine the relationship between alcohol and drug (AOD) use, psychological wellbeing, and the workplace psychosocial environment among young apprentices in the construction industry. Design/methodology/approach A cross-sectional survey of a cohort of 169 construction industry apprentices in their first year of training was undertaken. The survey included measures of psychological distress (K10), quantity/frequency measures of alcohol and illicit drug use, and workplace psychosocial factors. Findings Construction industry apprentices are at elevated risk of AOD related harm and poor mental health. Levels of psychological distress and substance use were substantially higher than age/gender equivalent Australian population norms. Job stress, workplace bullying, and general social support accounted for 38.2 per cent of the variance in psychological distress. General social support moderated the effects of job stress and bullying on psychological distress. Substance use was not associated with psychological distress. However, workplace social support accounted for 2.1 per cent of the variance in AUDIT-C scores, and 2.0 per cent of the variance in cannabis use. Workplace bullying explained 2.4 per cent of the variance in meth/amphetamine use. Practical implications Construction trades apprentices are a high-risk group for harmful substance use and poor mental health. Study results indicate that psychosocial wellbeing interventions are warranted as a harm reduction strategy. Originality/value This is the first study of its kind to describe a cohort of Australian construction trade apprentices in terms of their substance use and psychological wellbeing. The study shows workplace psychosocial factors may predict young workers psychological wellbeing.

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