The NHS Confederation has called for greater joined-up delivery in the treatment of people with dual diagnoses of mental health and substance misuse problems.
It has published a briefing paper that identifies key issues around dual diagnosis, explains existing policy and makes recommendations on what mental health providers and commissioners should be doing in this area.
Dual diagnosis is the term used to describe people who have concurrent mental health and drug misuse or alcohol problems. It affects a third of mental health service users, half of substance misuse service users and 70% of prisoners.
Among key recommendations, the paper highlights the need for staff training in substance misuse management in all mental health trusts, and the need to strengthen the capacity for effective joint working and commissioning between drug and alcohol services and community mental health services.
It points out that mainstreaming dual diagnosis can only work if local services develop and agree focused definitions of the term.
The paper stresses the need to raise awareness of dual diagnosis in primary care and outreach services with increasing numbers of people being seen within primary care settings with common mental disorders, such as mild to moderate levels of anxiety.
Care Programme Approach
It also says the Care Programme Approach, the system for managing the care of people in mental health services, should be applied to people with a dual diagnosis, and there should be greater emphasis on listening to service users.
It also refers to the need for best practice for dual diagnosis patients being applied in prisons. This issue was also picked up in Lord Bradley’s report on prisoners with mental health problems or learning disabilities in the criminal justice system, which said improved services for prisoners with dual diagnosis should be urgently developed.
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