It ’ s time to overcome the barriers to both use of psychedelics in mental health treatment and access to treatment for people with coexisting mental health and substance issues , heard the RCGP and Addiction Professionals Managing drug and alcohol problems in primary care conference
As far back as 2002 , research was showing that 70 per cent of people in drug services and 86 per cent in alcohol services had described or reported severe mental health problems in the previous year , said Dr Hauwa Onifade , a forensic psychologist at Turning Point involved in developing services with an integrated approach to coexisting mental health difficulties and substance use . Far too many in this client group were still failing to access the support they needed , she said .
Despite efforts to integrate services , there were ongoing barriers to bridging the gap . In many services there was ‘ sequential delivery ’, with clients told to address their substance issues before they could access mental health support , or parallel delivery – clients accessing both , but with difficulties in joining them up . Years of diminishing investment had taken its toll , while the transfer of public health functions to local authorities had also led to an ‘ accountability gap ’ across substance and mental health providers . ‘ And of course COVID hasn ’ t made any of this any easier .’
HIGH RISK Turning Point had developed a substance use and mental health ( SUMH ) toolkit for professionals , condensing research and guidelines from PHE , NICE and elsewhere , she said . The organisation had also been working in Leicester , Leicestershire and Rutland on developing an integrated team , with a pilot launching during the COVID period following an audit of more than 3,000 clients . This had identified two significant groups where there were gaps in accessing treatment – populations involved in injecting drug use who were ‘ frequent flyers ’ at local hospitals and also presented with high levels of risk around mental health , including self-harm and suicide , and longer-term clients who , although there was little risk of self-harm or suicide , were in high levels of distress and unable to make changes in their substance use as a result .
‘ We tend to focus on highrisk populations , almost to the detriment of the other group ,’ she said . ‘ And even with the high-risk populations we ’ re not necessarily working with them long-term , so they tend to fall into that pattern of re-presenting to services . A lot of services were involved in their care and a lot of people were aware of their difficulties , but they weren ’ t necessarily in treatment for very long .’
NO WRONG DOOR Turning Point ’ s integrated team had tried to implement the ‘ no wrong door ’ concept – that all services should have a fully open-door policy – along with a ‘ huge focus on engagement and retention ’, she told the seminar . There was also a need to focus on client needs rather
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