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Published in Berry Beaumont, David Haslam, Care of Drug Users in General Practice, 2021
‘Dual diagnosis’ is the term used to describe the status of drug users who have a concomitant mental health problem. There may be a causal, consequent or coincidental relationship between psychiatric morbidity and drug use. These patients are challenging to manage in psychiatric units, often because of behavioural problems. It may be difficult to get them admitted and for their drug use to be appropriately addressed when in hospital. They have low rates of compliance with aftercare. There is considerable interest in the psychiatric and drug addiction field in drawing up protocols for management of these patients. Correct diagnosis can often only be achieved after inpatient observation in a psychiatric unit. A local psychiatrist with an interest in drug addiction is an essential requirement but may not be available in all areas.
Cognitive behavioural integrated treatment (C-BIT)
Published in David B Cooper, Care in Mental Health—Substance Use, 2019
Working with people who experience mental health–substance use problems can pose challenges for professionals due to the often complex needs of these individuals. The UK Dual Diagnosis Good Practice Guide advocates mainstreaming/ integrated treatment where individuals have their mental health and substance use needs addressed concurrently.1 It can be difficult for professionals to provide integrated services if they have not received appropriate training to enhance their confidence and skills. Integrated treatment advocates a stage-wise treatment approach, which matches interventions to the individual’s stage of engagement.2, 3 The effective implementation of integrated treatment is, therefore, dependent on professionals having the skills to deliver a range of interventions that are tailored to the needs of the individual. This chapter describes the development and implementation of cognitive behavioural integrated treatment (C-BIT) within Birmingham and Solihull Mental Health Foundation Trust (BSMHFT), UK.
Serious mental illness and dual diagnosis
Published in April Russello, Severe Mental Illness in Primary Care, 2018
There is substantial evidence that treating substance use, especially opiate use, with the appropriate pharmacological and psychological interventions, helps improve outcome in a number of domains, including continued illicit use, criminal behaviour and social functioning. The National Treatment Outcome Research Study has estimated that every £1 spent on treatment saves £3 in criminal justice costs. The treatment of patients with dual diagnosis is of course complicated by the additional mental health problems, though there is no reason why the same treatment approaches as those used in those without a co-morbid problem cannot be used. However, practitioners need to have a realistic and long-term view of treatment and it is important that they are aware of the different approaches that may be necessary during different stages of treatment.
Alcohol, Substance Use Disorders and Mental Health: Resources for U.S. Veterans
Published in Alcoholism Treatment Quarterly, 2022
PTSD is related to alcohol misuse and either can appear first. Being diagnosed with a substance use disorder and a mental illness at the same time is also known as “co-occurring disorders” or a “dual diagnosis” (Iqbal, Levin, & Frances, 2019; SAMHSA, 2022). According to the U.S. Department of Veterans Affairs (2022), “women who have PTSD at some point in their lives are 2.5 times more likely to also have alcohol abuse or dependence than women who never have PTSD. Men are 2.0 times more likely to have alcohol problems if they have PTSD than men who never do not have PTSD.” It also reports that between 60% and 80% of Vietnam veterans seeking PTSD treatment have alcohol misuse problems and war veterans with both mental illnesses tend to binge drink, or 4–5 or more drinks in 1–2 hours It can also increase some PTSD symptoms (USDVA, 2022).
Positive psychology in dual diagnosis recovery: a mixed methods study with drug and alcohol workers
Published in Journal of Substance Use, 2020
Katalin Ujhelyi Gomez, Jerome Carson, Gill Brown, Mark Holland
In traditional psychotherapy, clients discuss weaknesses and deficits and therapy rarely focuses on the positives (Seligman et al., 2006). Similarly, the primary aim of dual diagnosis (DD) treatment is to attend to the substance use problem and tackle the mental health issues with limited focus on clients’ strengths. This deficit-based approach, however, may bring about an ignorance of clients’ potentials. Positive psychology (PP) is concerned with repairing weakness and deficit, but also with nurturing character strengths, promoting excellence, as well as exploring and developing conditions and processes that make life worth living (Seligman et al., 2004). A strengths-based PP approach may help achieve a more balanced outlook (Bird et al., 2012) enabling substance use practitioners to gain a more positive view of their clients. This, in turn, may help them be more effective in providing support through guiding clients toward flourishing and have a greater sense of accomplishment buffering against burnout (Rashid, 2015).
Mental Health Nurses’ Attitudes towards Consumers with co-Existing Mental Health and Drug and Alcohol Problems: A Scoping Review
Published in Issues in Mental Health Nursing, 2020
Roopalal Anandan, Wendy Cross, Michael Olasoji
In mental health settings, dual diagnosis is a term applied to define co-existing mental health and alcohol/drug problems (co-morbidities) that can occur in the same person simultaneously (WHO, 2010). Dual diagnosis encompasses organic and mental illness, social and spiritual concerns (Russell et al., 2017). Consumers with a dual diagnosis have complex needs (Brener et al., 2010; Ortega & Ventura, 2013) and associated higher social and health risks including homelessness, behavioural issues, suicide, homicide and violent criminal activity (Brener et al., 2010). Social discrimination, negative attitudes and stigma of consumers with dual diagnosis still exists among mental health clinicians (Rassool, 2006), and these consumers are more stigmatised than those with any other health issue (Livingston et al., 2012). These prejudices can have long-term consequences for consumers, such as hindering their life objectives, lessening societal involvement, hampering community relations and support (Lucksted & Drapalski, 2015). Consumers with a dual diagnosis do not receive adequate or comprehensive care in Australia, and there are barriers to best service delivery (Canaway & Merkes, 2010). These consumers are at risk of deterioration of their mental health symptoms, and they pose a challenging concern to service providers and traditional treatment approaches (Brener et al., 2010).