Dual Diagnosis
A
space
to
listen
Dual Diagnosis
Anonymous is a
new peer-led
resource for people
with co-existing
mental health and
addiction problems,
as Dr Raffaella Milani
explains
C
oexisting substance misuse and mental health disorders (dual diagnosis)
are the norm, rather than the exception. A report commissioned by the
Department of Health and NTA in 2002 found that 75 per cent of users of
drug services and 85 per cent of users of alcohol services were
experiencing mental health problems, and 44 per cent of mental health
service users either reported drug use or had used alcohol at hazardous or harmful
levels in the past year (Weaver et al, 2002).
The Prison Reform Trust’s 2010 Bromley Briefing reported that 75 per cent of all
prisoners had a dual diagnosis, yet Lord Bradley’s 2009 review of people with mental
health problems or learning disabilities in the criminal justice system stated that
those needing to access services for both mental health and substance
misuse/alcohol problems were disadvantaged by the system. Furthermore, the 2016
national confidential inquiry into suicide and homicide by people with mental
illness found that over the last 20 years, alcohol/drug misuse and isolation have
become increasingly common factors as antecedents of suicide; more than half of
the patients who died by suicide had a history of alcohol or drug misuse, but only a
minority of patients were in contact with substance misuse services.
Despite the high prevalence of people with dual diagnosis and the associated
negative consequences on the physical, psychological and social domains, there is a
clear gap in the service delivery for these clients. Recovery is a long-term process,
and for people with comorbidity it is a lifelong commitment. Non-judgmental
attitude, integrated care, and a social network that supports abstinence are three
key elements of successful and sustainable recovery. Mutual aid groups such as AA
have been playing an important role in supporting individuals in achieving and
maintaining abstinence in the UK and around the world, and are an invaluable
source of social capital for those who are most at risk of isolation.
Since August 2016, a new peer-led resource has been made available in west
London. It provides a non-judgmental, empathetic and welcoming environment
16 | drinkanddrugsnews | July/August 2017
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