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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.
Living with dual diagnosis and homelessness: marginalized within a marginalized group
- Authors:
- SCHUTZ Christian G., et al
- Journal article citation:
- Journal of Dual Diagnosis, 15(2), 2019, pp.88-94.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Objective: Concurrent mental and substance use disorders or dual diagnosis are highly prevalent among individuals experiencing homelessness. Studies have indicated that dual diagnosis leads to poorer health outcomes and higher health service utilization among those affected. This study aims to estimate the prevalence of dual diagnoses among homeless populations in British Columbia (BC), Canada, and understand their characteristics and specific factors associated with dual diagnoses. Methods: The BC Health of the Homeless Survey is a cross-sectional study involving the homeless population of three cities in BC. The survey assessed addiction and concurrent disorders with standardized interviews—the Mini-International Neuropsychiatric Interview Plus, the Maudsley Addiction Profile, and the Brief Symptom Inventory—in a sample of 500 individuals who are homeless living in shelters or on the street. Individuals were characterized into four groups: those without any current mental disorder, those with substance use disorders only, those with mental disorders only, and those with concurrent substance use and mental disorders. Focusing on the concurrent disorder group, multivariate analysis comparing individuals with dual diagnosis to those without concurrent disorders was completed. Results: Consistent with previous studies, individuals with dual diagnoses report more severe physical and psychological symptoms. Among the homeless, they were more likely to be Aboriginal and younger and more likely to not make it into a shelter. They also reported substantially more difficulties in getting the health care service that they need. Conclusions: Within this marginalized group, individuals with dual diagnosis were more likely to be from groups considered to be more vulnerable with more complex needs. They were having more problems accessing even basic support, such as shelters and health care. Without a systematic approach in providing appropriate care to individuals with dual diagnosis, the most vulnerable clients are not only the ones likely to suffer the most but also the ones having the most problems meeting their basic needs. (Edited publisher abstract)
Personal and relational empowerment: a framework for family recovery
- Authors:
- BUCKLEY-WALKER Kellie, CROWE Trevor P., CAPUTI Peter
- Journal article citation:
- Advances in Dual Diagnosis, 10(1), 2017, pp.25-38.
- Publisher:
- Emerald
Purpose: Caring for a person with a substance use disorder (SUD) and/or mental health disorder (MHD) represents a significant burden for family members. The features of “carers/family members” experiences reflect trauma signatures. Consequently, working through this trauma for carers corresponds with psychological recovery, empowerment processes and intrapersonal/interpersonal needs. The purpose of this paper is to outline a framework called the “personal and relational empowerment (PRE)” framework which enables family support practitioners to help family members to be able to take control of their own lives, develop meaningful relationships and live purposeful and fulfilling lives, regardless of whether the person with the SUD and/or MHD is in recovery or not. Design/methodology/approach: This paper critically reviews existing frameworks for carer recovery, through a systematic literature search, and proposes a “PRE” alternative to redress the shortfalls in these existing frameworks. Findings: The PRE framework takes a multi-level needs-based approach to understand carer recovery. This framework links the concepts – psychological recovery, empowerment processes and intrapersonal/interpersonal needs. Practical implications: The PRE framework recognises the importance of recovery support practitioners being able to balance the immediate carer crisis intervention needs responses with personal growth and well-being supporting interventions. Originality/value: The PRE framework of family recovery attempts to answer the need to broaden the focus on the family journey to better reflect the principles and practices of contemporary SUD and/or MHD recovery-based support. (Publisher abstract)
Closing the gap: a capability framework for working effectively with people with combined mental health and substance use problems (dual diagnosis)
- Author:
- HUGHES Liz
- Publisher:
- University of Lincoln. Centre for Clinical and Academic Workforce Innovation
- Publication year:
- 2006
- Pagination:
- 25p., bibliog.
- Place of publication:
- Mansfield
This report highlights how people with combined mental health problems represent a third of mental health service users, half of substance use service users, and 70% of prisoner. Their needs are high and treatment outcomes are poor. This report suggests that rather than seeing people with dual diagnosis as having two main problems, it may be more useful to acknowledge that they have complex needs including physical health, social issues such as housing, relationship and family problems, risk of suicide, victimisation and violence. They face social exclusion and often have difficulty accessing appropriate services due to their complex presentations. One of the main problems is the lack of skills and knowledge in the workforce to address their complex needs in an integrated and effective way. This report describes the development of a dual diagnosis framework to assist in the implementation of the ‘Department of Health Dual Diagnosis Practice Implementation Guide (2002)’. It highlights the roles and responsibilities of the various agencies involved in providing care, and establishes core competencies required to deliver effective care. The Framework is divided into three sections: values and attitudes, utilising knowledge and skills; and practice development. There are three levels to each capability: core, generalist and specialist.
Co-occurring disorders among female jail detainees: implications for service delivery
- Authors:
- FARKAS Kathleen J., HROUDA Debra R.
- Journal article citation:
- Journal of Social Work Practice in the Addictions, 7(1/2), 2007, pp.51-67.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
The increase in the numbers of women incarcerated in prisons and jails in the United States has given rise to questions about their mental health and substance abuse treatment needs. This study used DSM-IV criteria to describe both lifetime and current diagnoses for substance use disorders, major depressive disorder, posttraumatic stress disorder and generalized anxiety disorder in a sample of 198 female jail detainees. Women were asked about readiness for treatment and AODA and mental health service use. Findings underscore the view that female jail detainees have complicated diagnostic histories and that the jail setting can provide opportunities for assessment and services. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Dual diagnosis among incarcerated populations: exception or rule?
- Authors:
- SCOTT Charles L., LEWIS Catherine F., MCDERMOTT Barbara E.
- Journal article citation:
- Journal of Dual Diagnosis, 3(1), 2006, pp.33-58.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Over 2 million individuals were incarcerated in jails and prisons in the United States in 2004. Multiple studies indicate that the prevalence of mental illness and substance use disorders is substantially higher in correctional environments when compared with rates in the community. The objective of this paper is to provide information on the prevalence of dual diagnosis among those incarcerated and the importance of assessing comorbidity for determining treatment needs of inmates. For the purposes of this article, the definition of dual diagnosis includes mental disorders and coexisting substance use disorders, mental disorders and coexisting developmental disabilities, and developmental disabilities and coexisting substance abuse disorders. An extensive electronic literature search was conducted through PubMed, Medline, Department of Justice, and the National Commission on Correctional Health Care. Studies examining the prevalence of mental illness and substance use in jails and prisons, female inmates, and inmates with developmental disabilities were reviewed. The literature reviewed indicated a high comorbidity of mental illness and substance use disorders in incarcerated individuals. Providers should be aware of issues regarding dual diagnosis in special populations among those incarcerated to include female offenders and offenders with developmental disabilities. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Mental health
- Author:
- RYAN Peter
- Journal article citation:
- Research Matters, 9, April 2000, pp.48-50.
- Publisher:
- Community Care
The needs of people with severe mental health problems who are also misusing substances are complex and challenging. Describes recent research that offers a valuable insight into the characteristics and incidence of dual diagnosis.
Dual diagnosis: approaches to the treatment of people with dual mental health and drug abuse problems
- Author:
- MANLEY David
- Journal article citation:
- Mental Health Care, 1(6), February 1998, pp.190-192.
- Publisher:
- Pavilion
People with a dual diagnosis of mental health and drug or alcohol abuse problems may fall between existing specialist services, which tend to focus on treating one or other problem. Argues the case for a flexible, individualised approach to treatment which acknowledges the biological and psychosocial features of the co-existent problems and draws on clinical knowledge and skills from both the mental health and substance addiction professions.
Crucial diagnosis
- Author:
- KERR Diana
- Journal article citation:
- Community Care, 5.2.98, 1998, pp.30-31.
- Publisher:
- Reed Business Information
Looks at how people with Down's Syndrome are particularly prone to Alzheimer's disease, yet people with a dual diagnosis can fall through the net when services are not equipped to meet their specific needs.
Findings from the Making Every Adult Matter (MEAM) service pilots: a summary paper
- Authors:
- BATTRICK Tim, HILBERY Oliver, HOLLOWAY Sue
- Journal article citation:
- Advances in Dual Diagnosis, 6(2), 2013, pp.66-75.
- Publisher:
- Emerald
This paper summarises the evaluation of three pilot programmes, supported by the Making Every Adult Matter (MEAM) coalition, which were designed to better coordinate existing local services for people facing multiple needs and exclusions. These individuals experience a combination of problems such as homelessness, substance misuse, mental health problems and offending. Many face difficulties consistent with dual diagnosis in its broadest sense. The evaluation was undertaken by FTI Consulting/Compass Lexecon in partnership with Pro Bono Economics. The evaluation examined the three pilots, which took place in Cambridgeshire, Derby and Somerset in England. The study looked at two main effects as individuals engaged with better coordinated services: changes in wellbeing and, changes in the use and cost of wider local services. Primary wellbeing data were collected from clients and primary service use data were collected directly from relevant local agencies (police, health, housing etc). The study followed 39 individuals across the pilot sites. The average period between initial and final measurements was nine months. The findings show significant improvements in wellbeing for nearly all clients across three quantitative measures. The evaluation also recorded changes in the use and cost of local services. Some costs decreased in the first year of the pilot, for example, criminal justice costs in the Cambridgeshire and Somerset pilot areas. Other costs increased in the first year as people accessed the help they needed. In Cambridgeshire, the reduction in crime costs (£100,000 or 31 percent) was large enough to lead to an overall cost reduction. The total cost of service use in the first year increased in the other two areas. (Edited publisher abstract)