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Studying implementation of dual diagnosis services: a review
- Authors:
- SYLVAIN Chantal, LAMOTHE Lise
- Journal article citation:
- Journal of Dual Diagnosis, 9(2), 2013, pp.195-207.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Over the past 15 years, considerable time and energy has been devoted to implementing integrated services for individuals with dual disorders. While the key factors in the successful implementation of such services have been documented, applying them remains a challenge. In this article the authors attempt to answer question of 'what is missing?' by examining how implementation studies of integrated services have been carried out. The aim is to identify possible avenues for future implementation research. Methods: Update of a recent literature review of published studies on service implementation. Articles written in English and organisation-level factors were included. The reviewed articles were categorised based on two aspects of their methodology: their approach to the implementation process (content- or process-centered) and their objective (descriptive or explanatory). Results: In the 15 studies reviewed, a tendency toward a content-centered approach (n = 9) with a majority having an explanatory objective was observed. Studies that reflected this trend identified the most common determining factors in order to explain the level of implementation achieved within a given period of time. These studies did not examine the sequencing and transformation of the implementation process over time. Such a process-centered approach was used in only six studies. Conclusions: Research exploring the evolutive dynamics of implementation projects should be prioritised to counter the lack of knowledge on the subject. Such studies have the potential to greatly enhance our understanding as well as our capacity to master the implementation of integrated services. (Publisher abstract)
SCIE research briefing 30: the relationship between dual diagnosis: substance misuse and dealing with health issues
- Authors:
- SOCIAL CARE INSTITUTE FOR EXCELLENCE, CROME Ilana, et al
- Publisher:
- Social Care Institute for Excellence
- Publication year:
- 2009
- Pagination:
- 23p.
- Place of publication:
- London
This briefing examines the issues presented by service users with dual diagnosis for UK practitioners in health and social care. Confusingly, the term ‘dual diagnosis’ is used to describe several combinations of physical, psychological or developmental conditions; but for the purpose of this briefing, it refers to the co-existence of substance misuse and mental health problems. This briefing considers all age groups and uses the term ‘substance’ to refer to illegal or illicit drugs; alcohol; nicotine and prescription drugs. The terms ‘substance’ and ‘drug’ are used interchangeably. ‘Mental health problems’ refers to severe or enduring conditions, while ‘substance misuse’ refers to chronic or complex substance use problems. The briefing does not consider specific pharmacological or other treatment interventions in detail, but focuses on issues arising at the health and social care interface. It draws on research and literature from other countries, including the US where the majority of research on dual diagnosis has been conducted; to provide an overview for health and social care practitioners in the UK. Where there are gaps in the research, for example, in regard to service user involvement, recovery approaches and personalisation of services, the briefing draws upon evidence from relevant fields such as mental health and substance misuse. Throughout this briefing the terms, patient, client, and service user are used interchangeably to reflect the different usages prevalent within different sectors of health and social care.
[…] you feel there’s nowhere left to go: the barriers to support among women who experience substance use and domestic abuse in the UK
- Author:
- FOX Sarah
- Journal article citation:
- Advances in Dual Diagnosis, 13(2), 2020, pp.57-71.
- Publisher:
- Emerald
Domestic abuse victimisation is a common experience among women with problematic substance use, but support provision for both issues is siloed within the UK. Research on the topic focuses on practitioner responses, dominating women’s voices within research, policy and practice. As such, knowledge about women’s experiences of help-seeking is missing. This study therefore aims to fill a gap in knowledge by exploring the lived experiences of supporting seeking among women impacted by domestic abuse and substance use.Design/methodology/approach: Semi-structured interviews were conducted with 12 women who had a history of co-occurring problematic substance use and domestic abuse. Influenced by interpretive phenomenological analysis and feminist research praxis, the study explored how women with dual needs navigated support and help seeking and the barriers they faced. Findings: The women reported the biggest barrier was the disconnect between substance use and domestic abuse support, including a gap in the communication of information. This resulted in them having to choose which of their needs to seek support for. None of the women received support for their combined experiences, and most of the women never received support for their domestic abuse experiences alone. Originality/value: This is the first piece of research from the UK to explore, in-depth, women’s journey through support for their co-occurring substance use and domestic abuse victimisation. Previous research has not consulted with women to understand how they navigate the complex support systems available. This paper is, therefore, important, because it demonstrates the journeys to services these women take and the barriers they have to overcome. (Publisher abstract)
Developing a capable dual diagnosis strategy: a good practice guide
- Authors:
- HUGHES Liz, GORRY Ann, DODD Tom
- Publisher:
- National Mental Health Development Unit
- Publication year:
- 2009
- Pagination:
- 11p., bibliog.
- Place of publication:
- London
This document, for commissioners and lead providers of services involved in the care and treatment of people with a dual diagnosis, describes how a Dual Diagnosis Strategy will set out the vision and values for local service provision and be the focal point for collaboration between all key stakeholders at a local level. People with a dual diagnosis of mental health and substance use often have multiple and complex long term needs, which require a comprehensive, coordinated, seamless, multi-agency response. However, due to a variety of factors (such as resources, lack of clarity around local service responses, and a lack of workforce skills), this group often fail to receive good quality and consistent care. A robust local Dual Diagnosis Strategy will set out the vision and values for local service provision, and be the focal point for collaboration between all key stakeholders at a local level. A successful strategy will be able to account for the varying needs of all groups and will be comprehensive and flexible in its approach. This document is designed to support the development of a capable dual diagnosis strategy built on recommendations from national policy guidance and best practice.
The effect of homelessness, housing type, functioning, and community reintegration supports on mental health court completion and recidivism
- Authors:
- BRONER Nahama, LANG Michelle, BEHLER Stefanie A.
- Journal article citation:
- Journal of Dual Diagnosis, 5(3), July 2009, pp.323-356.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Whilst mental health court has been shown to increase quality of life and functioning, it is unknown whether community stability indicators predict programme completion and delay re-arrest for homeless versus non-homeless mental health court participants. Self-reported quality of life, social support, administrative housing, and criminal justice data were collected for 589 Bronx Mental Health Court participants for 12 months. Comparison between 89 homeless and 500 housed individuals were made to determine predictors of court graduation and re-arrest. Findings showed that while homeless status did not predict graduation or re-arrest, and quality of life, social support, and housing type were not predictive of re-arrest, housing instability negatively affected outcomes for both homeless and non-homeless individuals. An increase in functioning and a slight improvement in social support were predictive of successful graduation for homeless individuals, whereas a large increase in social support and lower functioning had a negative impact. In contrast, positive life satisfaction was predictive of successful graduation in non-homeless participants. Those who did not complete mental health court, whether homeless or not, were more likely to be re-arrested, particularly for felony and drug-related offences than those who graduated. The authors concluded that mental health court was generally beneficial to mental health court participants. However, for those previously homeless, functioning and social support may play a unique and interconnected role in court graduations, whereas general life satisfaction may be a better indicator for programme completion for non-homeless individuals.
Service without substance: addressing the gaps in service provision for street homeless people with a dual diagnosis
- Author:
- SHELTER
- Publisher:
- Shelter
- Publication year:
- 2007
- Pagination:
- 4p.
- Place of publication:
- London
This briefing looks at addressing the gaps in service provision for street homeless people with a dual diagnosis. Mental health needs and drug/alcohol use can often be interrelated issues for street homeless people. This briefing looks at addressing both issues through collaborative working between service providers so that street homeless people with a dual diagnosis are provided with integrated treatment and support to address their complex needs.
Double take
- Author:
- GLASSMAN Julie
- Journal article citation:
- Care and Health Magazine, 64, 2004, pp.14-16.
- Publisher:
- Care and Health
Two years from the publication of the Department of Health guidance on treating 'dual diagnosis' patients, asks what services are in place for people needing simultaneous treatment for substance misuse and mental ill health.
Mind the gaps: meeting the needs of people with co-occurring substance misuse and mental health problems; report of the joint working group
- Authors:
- SCOTLAND. Scottish Executive. Scottish Advisory Committee on Drug Misuse, SCOTLAND. Scottish Executive. Scottish Advisory Committee on Alcohol Misuse
- Publisher:
- Scotland. Scottish Executive
- Publication year:
- 2003
- Pagination:
- 97p.
- Place of publication:
- Edinburgh
This is is a report for people with deep-seated and multiple problems which often have complex and multiple causes. They have co-occurring mental health and substance misuse problems and often occupy the margins of our society. Most can benefit from help and support of many types. But there are shortcomings and gaps in the help that is available. This report seeks to address them. The Working Group has taken account of the following policy initiatives, which already exist or are being developed; and all seek to narrow or close gaps in advice and support: towards social inclusion; towards a successful and sustainable economy, with good employment prospects, training experience and opportunities; towards reducing homelessness; towards targeted provision of housing support services; and towards creating equitable access to a range of care services, regardless of boundaries, and designed to meet the needs of people as clients or patients.
An organisational analysis of psychosocial and medical services in outpatient drug abuse treatment programmes
- Author:
- DURKIN Elizabeth M.
- Journal article citation:
- Social Service Review, 76(3), September 2002, pp.496-529.
- Publisher:
- University of Chicago Press
Substance abuse programmes do not universally comply with standards encouraging the provision of supplemental social, mental health, and medical services. Using a nationally representative panel study of outpatient treatment organizations, the author examined the relationships between provision of these services and internal and external elements of the organizational context. Actors in the organizational environment such as funders, regulators, and accrediting bodies were particularly important, but their exact relationships to service provision varied across services.
Mental health services for people with learning disabilities
- Authors:
- HASSIOTIS Angela, BARRON Phil, O'HARA Jean
- Journal article citation:
- British Medical Journal, 9.9.00, 2000, pp.583-584.
- Publisher:
- British Medical Association
Mental health services in the United Kingdom are set for dramatic restructuring in the light of recent government initiatives to improve quality of care and equity of provision. National standards for promoting mental health and treating mental illness are designed to reduce the risk of future tragedies and improve the quality of life of people with mental illness. But little thought has been given to the well documented mental health need of people with learning disabilities. A complete overhaul is needed with strong links to mainstream services.