Two Problems, Many Solutions, Confederation Report Turns Spotlight On Dual Diagnosis - The NHS Confederation

Main Category: Mental Health
Also Included In: Alcohol / Addiction / Illegal Drugs
Article Date: 27 Sep 2009 - 0:00 PDT

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NHS organisations need a mixture of improved training, greater awareness and partnership working to tackle the issues raised by patients with both a mental health condition and substance or alcohol misuse problems.

So says a report produced in partnership with the Primary Care Trust Network, Mental Health Network and National Mental Health Development Unit which says that a third of mental health users, half of substance misuse service users and 70 per cent of prisoners are subject to this kind of dual diagnosis.

The report, Seeing double: meeting the challenge of dual diagnosis , looks at the challenges posed to the NHS by people who have either developed problems with alcohol or drugs because of a pre-existing mental health condition, or have had a mental health condition caused by misusing alcohol or drugs.

It addresses the way provision of services for mental health and drug and alcohol misuse have developed separately and looks at how stronger links between the two, along with better workforce development and awareness, can provide a better service and potentially save money.

The report references research, which has shown service users with a dual diagnosis typically use NHS services more and cost more.

The report cites a study of services in south London, which found a greater proportion of patients with dual diagnosis used the support of community psychiatric nurses, inpatient care and emergency clinics.

Their analysis found dual diagnosis patients had significantly higher 'core' psychiatric service costs (a difference of £1,362) and non-accommodation service costs (£1,360) than patients without a dual diagnosis.

Steve Shrubb, director of the NHS Confederation's Mental Health Network, said the report was an important statement of the best current thinking on how to tackle a difficult issue.

"If we are going to get this right then there needs to be training for staff in drug, alcohol and outreach teams so they can deal with dual diagnosis. There also needs to be effective commissioning and joint working between mental health trusts, primary care trusts (PCTs) and local authorities.

"Primary care and outreach services are becoming actively aware of dual diagnosis issues, and there also needs to be a focus on dual diagnosis in prisons, as well as meaningful service user involvement in the design and implementation of services."

Notes

-- Dual diagnosis affects:
- 1/3 service users
- 1/2 substance misuse service users
- 70 per cent of prisoners.

-- 9.3 per cent of men and 3.6 per cent of women in the UK are classified as dependent on alcohol

-- 3.4 per cent of adults showed signs of dependence on drugs in the past year (2.5 per cent on cannabis and 0.9 on other drugs)

-- Rates of drug dependency have almost doubled in the last 15 years.

-- The proportion if the English population meeting the criteria for one common mental disorder has increased from 15.5 per cent in 1993 to 17.6 per cent in 2007

-- The NHS Confederation represents more than 95% of the organisations that make up the NHS. Its members include the majority of NHS acute trusts, ambulance trusts, foundation trusts, mental health trusts, primary care trusts, independent providers of NHS services, special health authorities and strategic health authorities in England; trusts and local health boards in Wales; and health and social service trusts and boards in Northern Ireland.

-- The National Mental Health Development Unit (NMHDU) is the agency charged with supporting the implementation of mental health policy in England by the Department of Health in collaboration with the NHS, Local Authorities and other major stakeholders.

-- The Unit was launched in April of this year, and is made up of a number of programmes including the National Dual Diagnosis Programme. The Dual Diagnosis Programme leads are Ann Gorry ( ann.gorry@nmhdu.org.uk ) and Tom Dodd ( tom.dodd@nmhdu.org.uk ). More information is available at http://www.nmhdu.org.uk.

Source
The NHS Confederation

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