It ’ s been wonderful to see the partnership between specialist substance misuse and mental health services grow and develop through regular forums , events , training , and open communication across the locality . We still have high aspirations about what we can achieve in North Yorkshire and York , and this work is our pledge going forward .

As part of this we identified that , while the process of collective learning in dual diagnosis is a

priority , there is a continuing need for colleagues from different services to have shared spaces to talk , connect and learn together . The hope is that joint and collaborative working comes from not just service-level agreements and policy , but through relational connection and understanding of each other ’ s roles , culture , and values .

The Dual Diagnosis Network offers a shared space to support collaborative thinking and reflection from multi-agency partners such as mental health , drug and alcohol services , police , probation , third sector providers , housing , social care , advocacy providers and education . However , there ’ s an identified need for shared , focused learning events to support skills development across the region .

Training and supporting professionals to learn and develop their skills is essential and ensures individuals feel competent in what they do , which in turn supports improved clinical outcomes for service users . The implementation of any training strategy is , however , often fraught with complexity –

as there are challenges around consistency , cost , application of learning and the return on investment . While tackling all these complexities and challenges is outside the work we ’ ve done , our approach to shared learning has supported people to learn and develop , fulfilling our overarching aim of helping clinicians from different services to come together and learn together to build better relationships . The aim is to model and support collaborative working on a clinician-to-clinician level .

As an example of the learning together approach , for the last few years we ’ ve held an annual dual diagnosis conference . This has been hosted online and is open to all in the region , with a focus on developing understanding and knowledge for those both experienced and less experienced in working with service users with co-existing needs . One of the main aims of the Dual Diagnosis Network and conference is to engage people from mental health and drug and alcohol services in a way of working and learning that will benefit the people we work with .

The dual diagnosis webinar focused on several clinical areas including developments in prescribing , lived experience perspectives on dual diagnosis and recovery and trauma-informed care , as well as break-out room

discussions on partnership working for better outcomes and how we can develop a greater sense of collaborative connectedness for services and service users .

Using live engagement software , we were able to collect data throughout the conference about who was in the room , their insights and their feedback . The data revealed that we had a varied mix of professionals , from more than 25 organisations and services . Results on the day showed us that , overall , attendees came away having learnt a lot about the shared topics , with individuals sharing service pathways with each other as well as concerns with commissioners and senior staff that they might otherwise have found hard to express .

The Dual Diagnosis Network , and more specifically the annual conference , has allowed for spaces where passionate people working in the mental health sector , drug and alcohol support and wider services come together to interrogate and co-create shared ways of learning . What has also developed , however , is a process of better service connection . This way of connecting and its growth has supported us all to begin creating a shared professional movement to facilitate change in a steady and meaningful way . By being more systemically connected we support our service users together – and better .

Dolly Cook is area manager and cochair of the Dual Diagnosis Network , Changing Lives .

Dr Stephen Donaldson is clinical psychologist and co-chair of the Dual Diagnosis Network – Tees , Esk and Wear Valleys NHS Foundation Trust .

Kate McLaven is digital inclusion coordinator at Changing Lives , York Drug & Alcohol Service

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