Within mental health services dual diagnosis is recognised as one of the most challenging yet least resourced areas of mental health. We brought together mental health services and substance misuse services to ensure patients received a joint service and improved access and outcomes for an excluded group of patients.
Within mental health services dual diagnosis is recognised as one of the most challenging yet least resourced areas of mental health. We brought together mental health services and substance misuse services to ensure patients received a joint service and improved access and outcomes for an excluded group of patients.
This innovation provided access to substance misuse through two routes self-referral and staff referral, access through various mediums and reduced paper work needed to access a service which can lead to referrals not being made based on time constraints. we did this by sharing training skills, offering training on mental health to substance services.
By working jointly one afternoon a week voluntary agency turning point provide a substance worker joins dual diagnosis lead in trust to assess all clients who would like to access substance treatment, they can self- refer or be identified by staff. assessments are done within the mental health setting.
We also offer a drop in once a week in our involvement centre so clients can self-refer or just have a chat about their use.
Once a week a addictions consultant visits the trust to offer advice on prescribing to consultant psychiatrists and offers training. It is different because we offer drop ins for confidentiality, it joins up prescribing so that people are not discharged without methadone prescriptions and have a substance worker before discharge, we offer advice on mental health to substance workers and clients have less chance of falling through the net of services. Workers from each service communicate better and share the work load. We teach in the recovery college to service users to ensure they know what services are available and how to access
Commissioning around substance misuse has seen the change in providers of service every 3 years, this has been challenging for mental health clients and staff in constantly working with new providers, we started to work with turning point as soon as the contract was signed to ensure continuity and access for mental health clients. By operating on the mental health premises has seen an uptake of referrals and by offering drop ins has also allowed clients to self-refer or seek advice that is the starting point.
We work closely with turning point and social care substance misuse and mental health services to maintain a seemless service. We work with the recovery college to teach dual diagnosis to service users and make them aware of services and access routes
Feedback is obtained via face to face contacts and surveys in both areas. lessons learnt from how it can be delivered in a more effective way.
Challenges are the constant commissioning framework and seeking a resolution to 3 year cycles would be an advantage we cannot control this but work with staff to ensure if the service changes our input does not. More negotiation with commissioning to identify needs of dual diagnosis clients and to have obtained direct funding.
It is embedded and agreed by both organisations on need. It is not funded but seen as a positive role and built into staff contracts. So if the individual moves on it stays in the job descriptions for the next person.
It will be formally evaluated to demonstrate effectiveness.
Although we are only 9 months in informal evaluation has taken place that has shown an increase in referrals and uptake of services, verbal feedback from clients has demonstrated a need. the training has been evaluated by the recovery college and excellent reviews means we continue to do this 3 times a year.
access to services have been improved
substance use being seen by staff as important and referrals being made
open door policy and drop in encourage clients to self-refer or seek advice with no barriers
increased uptake of services and outcomes.
we share through national forums and presentations within our organisations, at the end of the first year we will write a paper for publication
This service has not been funded but still been successful, dual diagnosis affects the majority of patients yet is underfunded, any change in a persons substance misuse makes a major impact on improving their lives so small steps build a brighter future for the whole family not just the individual.
