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Addressing the needs of older people with co-morbid alcohol and mental health disorders: a case series from a London Community Mental Health Team (CMHT)
- Authors:
- ANDREWS Tresa, REDDY Lenna, WHELAN Paul
- Journal article citation:
- Advances in Dual Diagnosis, 4(1), 2011, pp.8-16.
- Publisher:
- Emerald
Community mental health teams (CMHTs) for older adults inevitably encounter service users with alcohol use disorders (AUDs). However, little attention has been given to the needs of older adults with a dual diagnosis. This paper argues against a wholesale transfer of knowledge and practices from working age adults with dual diagnosis to the older age group. Drawing on the experience of care professionals in a central London’s CMHT between 2008 and 2010, the paper illustrates the challenges encountered when working with older adults with co-morbid mental health problems and AUDs. The management and progress of 4 older adult service users are described. This case study series illuminates some of the clinical and professional dilemmas and challenges encountered when working with this group. Suggestions of how to respond to some of these challenges are provided by focussing on aspects of identification, assessment and treatment.
The bounds of liberty: lessons learnt from treating a man with alcohol use disorder, autism and learning disability
- Authors:
- DRAKE Alexander C.L., et al
- Journal article citation:
- Tizard Learning Disability Review, 23(1), 2018, pp.27-34.
- Publisher:
- Emerald
Purpose: A man in his 40s with alcohol use disorder, learning disability and autism was referred to the learning disability team due to anxiety and low mood. He had been abstinent from alcohol for ten years prior to a recent relapse. The purpose of this paper is to describe his case. Design/methodology/approach: Treatment was person centred, followed standard practice for clients with alcohol use disorder and targeted harm minimisation. Initially, alcohol consumption reduced; however, at month three, he relapsed. Thereafter, he was repeatedly admitted to inpatient settings, drank excessively and engaged in risky behaviours. Findings: Conventional approaches to treating alcohol dependence may not be entirely appropriate for this client group. The client’s alcohol consumption was only curtailed with the use of restrictions to his liberty agreed by him and incorporated into his tenancy agreement. Originality/value: To the best of the authors’ knowledge, this is the first paper to discuss issues pertaining to people with co-occurring learning disability, autism and alcohol dependence. The authors discuss the use of restrictions, reasonable adjustments and policy issues relevant to treating this complex client group. (Publisher abstract)
Commentary on “The bounds of liberty: lessons learnt from treating a man with alcohol use disorder, autism and learning disability”
- Author:
- BROWN Hilary
- Journal article citation:
- Tizard Learning Disability Review, 23(1), 2018, pp.35-41.
- Publisher:
- Emerald
Purpose: In commenting on the issues raised by Drake et al. the purpose of this paper is to discuss three areas of practice: assessing capacity in the presence of intransigence and/or rigid patterns of thinking and behaviour; understanding addiction in this context; and identifying “reasonable adjustments” in the way addiction and substance misuse services are provided to this client group. Design/methodology/approach: As well as discussing the issues raised by Drake et al. the commentary refers to a serious case review exploring similar issues. Findings: Both the case discussed by Drake et al. and the serious case review draw attention to the importance of identifying “reasonable adjustments” to current practice. Research limitations/implications: While the implications of the cases discussed are very significant, further work quantifying the scope of the problems identified would be very useful. Practical implications: The 1995 Disability Discrimination Act (UK) requires public services to make “reasonable adjustments” in order for people with a range of disabilities to access their services on an equitable basis. This paper identifies what some of those areas of difficulty might be. Originality/value: This is a relatively new area of work and expertise in both mainstream addiction and specialist intellectual disability and mental health services needs to be developed in order for them to provide more coherent and accessible programmes to individuals. (Publisher abstract)
Public health transformation four years on: maximising the use of limited resources
- Author:
- LOCAL GOVERNMENT ASSOCIATION
- Publisher:
- Local Government Association
- Publication year:
- 2017
- Pagination:
- 63
- Place of publication:
- London
This compilation of case studies is intended to show how local authorities continue to make progress on improving health and wellbeing and tackling health inequalities since public health was formally transferred from the NHS in April 2013. Public health teams, working with a ‘Health in All Policies' approach across councils, are tackling persistent problems like adult and childhood obesity, mental illness, alcohol abuse, sexually transmitted infections and the health impact of isolation and loneliness in old age, as well as addressing some of the serious health inequalities that still exist within and between communities. These case studies aim to show what potential there is for public health, if properly resourced, to make inroads in improving health and wellbeing. The case study sites cover Birmingham City Council; Cambridgeshire County Council and Peterborough City Council; Cheshire and Merseyside Public Health Collaborative (Champs); London Borough of Redbridge; Redcar and Cleveland Council; Sheffield City Council; Somerset County Council; and London Borough of Tower Hamlets. (Edited publisher abstract)
Skills for recovery: a recovery-oriented dual diagnosis group for veterans with serious mental illness and substance abuse
- Authors:
- TOPOR David R., et al
- Journal article citation:
- Social Work with Groups, 36(2/3), 2013, pp.222-235.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Individuals with serious mental illness (SMI) are at a high risk for abusing alcohol and illicit substances relative to the general population. This use, even in small quantities, can negatively affect mental and physical health. Group therapy is an evidence-based treatment for individuals dually diagnosed with SMI and a substance abuse disorder. The Skills for Recovery group used a recovery-oriented therapy manual for dual diagnoses and was informed by the International Association for Social Work with Groups' Standards for Social Work Practice with Groups throughout the development and implementation of the group. (Publisher abstract)