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Substance use and mental health disorders: why do some people suffer from both?
- Authors:
- REEDY Amanda R., KOBAYASHI Rie
- Journal article citation:
- Social Work in Mental Health, 10(6), 2012, pp.496-517.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Co-occurring substance use disorders (SUD) and mental health disorders (MHD) are prevalent in the United States, affecting between 7 and 10 million adults. Social workers frequently practice in mental health and substance use disorder treatment settings where they are likely to encounter clients who have co-occurring disorders. Therefore, social workers should be familiar with the various etiological models of co-occurring disorders and the strengths and weaknesses of these models, in order to effectively assess and assist clients with co-occurring disorders. The purpose of this article is to describe and critique 4 different models of the etiology of co-occurring disorders: MHD leads to SUD - the self-medication model; SUD leads to MHD model; common factor model; and the combination model. The theory that social workers are most familiar with is the self-medication model, but this may not best explain the client's experience. While there is not definitive support for any of the models, each one seems to have its place in helping researchers and practitioners better understand co-occurring disorders. Implications for practice, policy, and research are discussed.
Mental health and substance use problems among patients in substance use disorder treatment as reported by patients versus treatment personnel
- Authors:
- BERGLY Tone H., HAGEN Roger, GRAWE Rolf W.
- Journal article citation:
- Journal of Substance Use, 20(4), 2015, pp.282-287.
- Publisher:
- Taylor and Francis
Objective: This study examines and compares mental health and substance use problems among patients in substance use disorder treatment as reported by both patients and treatment personnel, and explores the feasibility of the quadrant model in addressing severity of mental health and substance use based on reports by treatment personnel. Methods: Patients receiving inpatient substance use treatment at clinics in Norway were recruited for the study; 85 completed a cross-sectional survey. Treatment personnel completed a separate survey and gathered information from patient charts. Results: While there were minor differences in the patient and personnel reported prevalence of mental disorders in general (34 and 41%, respectively), there were significant differences in reported affective disorders and personality disorders. Based on the quadrant model, 70.2% of the patients had a high severity of substance use and low severity of mental health problems, while 21.4% had high severity of both. Conclusions: The differences in reports of mental disorders are important, and future research should aim to increase the validity and reliability of reported mental health problems among patients with substance use disorders. The quadrant model does seem to be a feasible model in addressing the severity of such co-occurring disorders. (Edited publisher abstract)
From "double trouble" to "dual recovery": integrating models of recovery in addiction and mental health
- Authors:
- DAVIDSON Larry, et al
- Journal article citation:
- Journal of Dual Diagnosis, 4(3), 2008, pp.273-290.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
It is increasingly recognised by both the mental health and substance misuse fields that people with mental illnesses and addictions are first and foremost people rather than diagnoses or disorders. As such, they are the experts in what it means to live through and recover from disorders, and their views need to be accessed in order for the person-first approach to become more than rhetoric. This paper reviews two models of recovery, one in mental health and the other in addictions, that were developed in collaboration with advocates and recovering individuals. These are then integrated to produce a strengths-based model of dual recovery. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Setting up a methadone maintenance clinic in a hostel in London’s West End
- Authors:
- DUNN John, et al
- Journal article citation:
- Psychiatric Bulletin, 30(9), September 2006, pp.337-339.
- Publisher:
- Royal College of Psychiatrists
A satellite methadone prescribing service was set up in a hostel in London’s West End. The aim was to investigate if it were feasible to engage and retain these hard-to-reach, chaotic, polydrug users in treatment. A basic needs assessment was undertaken with staff and clients at the hostel. Treatment outcomes were assessed at 16 weeks using the Maudsley Addiction Profile. At 16 weeks 87% of the original cohort (26 out of 30) were still in treatment. There were also significant reductions in mean heroin use (from 29.7 to 14.5 out of the past 30 days, P<0.001) and in the frequency of injecting (from 25.9 to 15.9 days, P<0.001). This outreach clinic offers a model for developing services to homeless people with substance misuse problems.
An audit of interventions for dual diagnosis in a psychiatric unit
- Author:
- SAUNDER Lorna
- Journal article citation:
- Nursing Times, 8.7.03, 2003, pp.34-36.
- Publisher:
- Nursing Times
Reports on a dual diagnosis training programme for mental health nurses working in an acute psychiatric unit, based on the recommendations in the Dual Diagnosis Good Practice Guide from the Department of Health. An audit of key standards were carried out to examine the interventions offered to patients with a dual diagnosis. An audit was repeated on month later. Concludes that although an improvement was observed in the standard of care, the sample size was small and without further statistical anlaysis it would be difficult to determine whether the improvement was statistically significant.
Estimating the prevalence of the 'toxic trio' of family issues for each local area in England: vulnerability technical report 2
- Author:
- CLARKE Tom
- Publisher:
- Children's Commissioner for England
- Publication year:
- 2019
- Pagination:
- 23
- Place of publication:
- London
Technical paper setting out the methodology used by the Children’s Commissioner’s Office to produce its estimated local area prevalence rates of children in households experiencing combinations of the ‘toxic trio’ risk factors. These are households where a parent has experienced combinations of: domestic violence, mental health problems and substance misuse. The modelling presented aims to estimate the prevalence of these issues within each English upper tier local authority and parliamentary constituency. It is one of three technical reports produced as part of the 2019 Vulnerability Report. (Edited publisher abstract)
Harm reduction in a Norwegian housing first project: a qualitative study of the treatment providers’ practice
- Authors:
- ANDVIG Ellen Sofie, SAELOR Knut Tore, OGUNDIPE Esther
- Journal article citation:
- Advances in Dual Diagnosis, 11(1), 2018, pp.4-15.
- Publisher:
- Emerald
Purpose: Little is known about how harm reduction is practiced in Norwegian housing first (HF) projects. The purpose of this paper is to explore, describe, and interpret how providers apply a harm reduction approach within a housing project focused on individuals who are homeless with co-morbid substance use and mental health problems. Design/methodology/approach: This qualitative study was part of a larger evaluation study of a three-year HF project in a Norwegian municipality. Data were collected using four multi-stage focus groups with five providers working in the HF project. Focus group interviews were transcribed verbatim and analysed using thematic analysis. Findings: Analysis resulted in three main themes: “Letting the service user sit in the driver’s seat,” “We don’t follow service provision contracts, we do everything,” and “Collaborating with the local community.” Research limitations/implications: There is a need to develop increased knowledge about service users’ experiences within the harm reduction approach. Practical implications: To practice effective harm reduction, treatment providers must have open authorisations and the opportunity to exercise professional judgement. Harm reduction practice must also focus on social, political, and economic factors influencing users’ everyday lives. Originality/value: The paper contributes to the knowledge base on harm reduction within HF practice that differs from a traditional model wherein clients are expected to abstain from substance use. It highlights important preconditions for challenges practitioners might encounter at both individual and service system levels. (Publisher abstract)
Modeling the relationships between discrimination, depression, substance use, and spirituality with Muslims in the United States
- Authors:
- HODGE David R., ZIDAN Tarek, HUSAIN Altaf
- Journal article citation:
- Social Work Research, 39(4), 2015, pp.223-233.
- Publisher:
- Oxford University Press
Little research has been conducted with Muslims despite the growing size of this population in the United States. This study addresses this gap in the literature by examining the relationship between discrimination and two consequential health outcomes—depression and substance use—in tandem with the protective effects of spirituality on these two outcomes. Drawing from stress and coping theory, a theoretically based model was developed and tested using structural equation modelling with a diverse community sample of Muslims (N = 265). The results indicate that discrimination predicts depression, but not substance use. Spirituality does not function as a mediator but rather exhibits a direct, independent effect on both depression and substance use. The findings underscore the importance of addressing discrimination directed toward Muslims. The results also imply that spirituality may play a critical role in helping Muslims ameliorate depression and substance use in direct practice settings. (Publisher abstract)
Goal setting in recovery: families where a parent has a mental illness or a dual diagnosis
- Authors:
- MAYBERY Darryl, REUPERT Andrea, GOODYEAR Melinda
- Journal article citation:
- Child and Family Social Work, 20(3), 2015, pp.354-363.
- Publisher:
- Wiley
Goal setting is an important element within mental health recovery models; however, parenting and children are rarely recognised in such approaches. This study outlines a family recovery planning model where a parent has a mental health or dual substance and mental health problem. The differences between family types (parent with a mental illness or parent with dual diagnosis) and family members (parent and children) are illustrated in terms of goals across 11 domains. There were a total of 33 parents and 50 children from 10 mental illness and 10 dual diagnosis families. Education and specifically mental health knowledge are important goals across all families and appear especially important for children whose parent has a dual diagnosis. Specific goals and achievement levels for each type of family and parents and children are also outlined. Clear areas for action by clinicians and family members are indicated by this study. (Publisher abstract)
Assertive community treatment and associations with substance abuse problems
- Authors:
- van VUGT Maaike D., et al
- Journal article citation:
- Community Mental Health Journal, 50(4), 2014, pp.460-465.
- Publisher:
- Springer
This study examined the associations between substance abuse problems in severely mentally ill patients, outcome and Assertive Community Treatment (ACT) model fidelity. In a prospective longitudinal study, ACT model fidelity and patient outcomes were assessed in 20 outpatient treatment teams using the Health of the Nation Outcome Scales, Camberwell Assessment of Needs short appraisal schedule and measures of service use. Five hundred and thirty severely mentally ill patients participated in the study. Substance abuse problems were assessed three times during a 2-year follow-up period. This study found that among patients with severe mental illness, patients with an addiction problem had more serious psychosocial problems at baseline. Substance abuse problems showed improvement over time, but this was not associated with ACT model fidelity. The study indicates that investment by teams to improve a patient’s psychosocial situation can lead to improvements on substance problems. (Publisher abstract)