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Dual Diagnosis

News from today’s conference; ‘A Practical Guide to improving the Management of severe mental illness & substance misuse: Dual Diagnosis’, chaired by Professor Alan Maryon-Davis Chair of the NICE Guideline Development Group.

Chairman’s Introduction: Implementing the new NICE Guideline for severe mental illness and substance misuse (Dual Diagnosis).
NICE Guideline available here.  

In his presentation Professor Maryon-Davis discussed:

Who the Guideline is for?

  • Commissioners and providers including those working in primary care
  • Staff working in all services who come into contact with this group
  • The criminal justice system
  • Voluntary and community sector organisations
  • People aged 14 and above diagnosed as having coexisting severe mental illness and substance misuse and who live in the community, their families and carers

Key messages:

  • Much wider recognition that this group of people, despite their complexities, have as much right to dedicated care and support as anyone else
  • Non-judgmental, empathetic, person-centred approach
  • Creative, responsive engagement and involvement
  • Mutual respect and trust
  • Strong leadership in mental health, substance misuse, primary care, social care, housing, employment, benefits, criminal justice and the voluntary sector in addressing the needs of this client group
  • Good communication across the system
  • Effective coordination of services and delivery
  • Making the most of existing services and community assets for the benefit of this group of vulnerable people

Promoting better outcomes and supporting people with dual diagnosis
Lord Victor Adebowale CBE
, Chief Executive, Turning Point

In his presentation Lord Adebowale stated:

"70% in drug treatment services and 86% in alcohol services experience mental health problems"

"22-44% of adult psychiatric inpatients also have a substance misuse problem"

"There has to be much wider acknowledgement that people with a dual diagnosis, who often ‘fall through the gaps’, have as much right to support as anyone else"

"The most vulnerable in our society face the biggest barriers in accessing services"

"Recognising issues early on prevents problems escalating"

"Outcomes based commissioning would deliver more integrated, responsive services for people with dual diagnosis"

Pre-Conference Abstract: Promoting better outcomes and supporting people with dual diagnosis
Turning Point has long campaigned for better services for people with a dual diagnosis. We know that this group remains at the sharp end of the inverse care law. The most vulnerable face the biggest barriers in accessing services. Yet, dual diagnosis has, for too long, been a low priority for policy makers. Too often, fragmented services means that people with co-existing mental health problems and drug/alcohol problems fall through the gaps between services. 

The ability to meet the needs of people with dual diagnosis should be the mark of quality for any service. Services need to be flexible and person-centred. This is achieved by involving people we support and their networks in the design and delivery of services.   However, we must recognise that the challenges for service providers are considerable, working as they are within a fragmented commissioning environment.  

In his presentation Victor will use the case study of the Hertfordshire Complex Needs service – a service run by Turning Point in partnership with Herts Young Homeless and Hertfordshire MIND network - to illustrate how services can be more inclusive and deliver better outcomes and support for people with a dual diagnosis.  Key in this is: taking a person centred approach, transparent risk assessment which involves the service user, sharing expertise with mainstream services and supporting people to build bridges with services where the relationship may have broken down in the past, using crisis as an opportunity to intervene quickly to break the cycle, intervening early to prevent problems escalating and moving away from a traditional appointments based model in order to help people better engage with services.   

Full presentation

Implementing the NICE Guidance in practice: what needs to change?
Dr Jane Marshall, Consultant Psychiatrist, South London & Maudsley NHS Trust, and Member, Guideline Development Group, Severe mental illness and substance misuse (dual diagnosis) – community health and social care services, NICE

In her presentation Dr Marshall stated:

"The aim of the guideline is to provide a range of coordinated services that addresses people’s wider heath and social care needs as well as other issues such as housing and employment"

"Individuals may be able to respond to recommendations more quickly than organisations"

"Guideline will be updated in 2020"

"Raise awareness locally through routine communication channels"

Pre-Conference Abstract:
In this talk I shall be exploring the implementation of NICE guideline CG58: Coexisting severe mental illness and substance misuse: community health and social care services. I shall focus on undertaking a baseline assessment against the recommendations.

Full presentation 

Supporting families and children
Dr Mike Shaw
, Co-Director, The Family Drug and Alcohol Court National Unit, and Consultant Child & Adolescent Psychiatrist, Tavistock Clinic

Full presentation

Future events of interest: 

Transforming Mental Health Services for Children & Young Adults
Monday 30 January 2017 
De Vere West One, London

Towards Zero Suicide: Preventing Suicide, Saving Lives
Thursday 23 February 2017 
The Studio, Birmingham

Psychosis & Schizophrenia: Early interventions & successful pathways
Friday 24 February 2017 
De Vere West One Conference Centre, London

Psychological Therapies in the NHS
Wednesday 15 March 2017 — Thursday 16 March 
Millenium Conference Centre, London

Improving the Physical Health of Adults with Severe Mental Illness
Friday 24 March 2017 
De Vere West One Conference Centre, London

Achieving Better Access for Mental Health Crisis Care
Friday 28 April 2017 
De Vere West One Conference Centre. London

23 January 2017

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