- The document discusses dual diagnosis, which is when a person has both a substance misuse issue and a mental health disorder. It is common for the causes and symptoms to overlap. - Dual diagnosis is a major issue, with around 3/4 of prisoners and 75-80% of drug/alcohol service users also experiencing mental health problems. Only 62% of drug users with mental health issues receive treatment. - Having both a substance use disorder and mental illness leads to worse health outcomes and difficulties accessing care. The document advocates for services to better coordinate and meet people's full range of needs.

1. - Ellie Gordon -
Mental Health
Substance Misuse
&

2. Work in a specialist
Drug & Alcohol
service
Often long standing issues
for a number of years
Often background of
significant childhood trauma
People seen usually require some
form of medication to help with
their substance use issues
Commonly see people
with high levels of
dependence
Dual Diagnosis a
common
area of concern
The Context

3. What isDualDiagnosis?
Drug use may cause users to
experience one or more symptoms
of a mental health disorder, either
or triggering an underlying long-
term mental disorder
Both the substance use problem and
the mental health disorder may be
caused by overlapping factors: brain
deficits, genetic vulnerability and
early exposure to stress or trauma
Mental disorders may lead
to drug use to alleviate the
symptoms of a mental
disorder.

4. Which camefirst?
Common sticking
point for services
Can lead to lack of
treatment options due to
exclusion criteria
Dual Diagnosis people can
often fall between services –
and not get needs met
Does it really matter?

5. Why should this worry us?
The combination of substance use and mental health
disorders often results in serious social, psychological
and physical complications.
Psychiatric co-morbidity makes up a substantial
contribution to the burden of diseases worldwide,
especially among vulnerable population groups.
The occurrence of a substance use or a mental health
disorder is often reciprocally interlinked, with one
condition leading to or exacerbating the other.
Psychiatric co-morbidity particularly
affects vulnerable groups, such as
young people, people from ethnic
minorities, sex workers and
especially prisoners.
People with co-morbid
disorders have poorer
diagnosis, lower access to
care and poorer compliance
with treatment.

6. Scale of the problem
Approx ¾ of the prison
population estimated having a
substance misuse issue
It is estimated that 80% of people with a serious
Mental illness have a substance misuse issue
Approx 75% of users of drug services and 85%
per cent of users of alcohol services were
experiencing mental health problems
38 per cent of drug users with a psychiatric
disorder were receiving no treatment for their
mental health problem
30 per cent of the drug treatment population and
over 50 per cent of those in treatment for alcohol
problems had ‘multiple morbidity
Recent statics estimate that between 43 to 120 individuals per 100,000
population meet the criteria for a diagnosis of psychiatric co-morbidity.
Stats from the Co-
morbidity of Substance
Misuse and Mental Illness
Collaborative study or
COSMIC1 (2002)

7. How can you help?
Make every
contact count!
Help the person = improve their health and well being =
reduce public health issues = reduce costs to the NHS overall
Commission services to
work together to meet
needs.
Use Brief
interventions – they
can work
Less restrictive
inclusion/exclusion
criteria
Simple forms of
support can make a
big difference
Commission services to
meet needs where the
person presents.
Develop operationally
responsive services
Maintain strategic focus
to meet local demand

8. Whydo we needto change?
If we help people to overcome
prejudice, challenge
stereotypes and stigma, we will
focus on supporting the whole
person.
If we can better meet need
we will improve the health
and well being of the people
support .
Who doesn’t want that?

9. Thankyou for Listening
Any Questions?
Contact: elliegordon@nhs.net