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Personalised care is vital when dealing with complex mental health needs in rehab , says Dr Arun Dhandayudham
At WDP we ’ re always learning from our residents , each other and cuttingedge best practice – we strive to provide the very best care . But what has become clear over time , however , is that the complexity of our residents ’ mental and physical needs has increased dramatically . This has brought new challenges that we ’ re enthusiastically responding to . Why are we seeing more complex cases ? Well , the people who are being referred are getting older , which can mean other mental and physical complications from prolonged substance use and age-related medical conditions . People are also using a broader combination of drugs , and there ’ s an increasing
recognition of over-the-counter addictions and dependence on prescription medications .
There ’ s also been the past decrease in funding for substance misuse services meaning only the most complex people were getting referred and people were waiting longer for a placement . This can mean they ’ re more ill when they do come to us .
Several detox units have also closed in recent years – there ’ s now no dedicated inpatient detox service within the M25 , apart from the beds at Guy ’ s and St Thomas ’ NHS Foundation Trust . This has put significant pressure on the few specialist detox facilities that remain , like WDP ’ s Passmores House .
During the height of the pandemic , this stayed open but reduced our capacity to keep people as safe as possible – at one point we had almost 300 people on our waiting list . But now waiting lists are back to normal and we can usually get people in for a detox within six weeks of referral – and faster when needed .
Our team has a well-deserved reputation for managing complex detoxes for people in complex situations and with complex co-morbidities . Working closely with referrers to craft bespoke treatment and support plans means we do this really well – we support pregnant patients and support onward rehab placements post detox , and we can also take people waiting for liver transplants .
We manage a significant number of alcohol detoxes as well as a range of opiate stabilisations and detoxes . We also offer detoxes from many other substances
The need for more detox spaces and being able to provide bespoke care for diverse groups inspired us to take action . We ’ ve obtained land next to Passmores House and are planning to develop it to increase capacity . including GBL , ketamine , kratom , loperamide , stimulants and benzos .
We can do this because we have nurses on site 24 / 7 and a medical presence every day of the week including weekends , with support from myself – as a consultant in addiction psychiatry – general psychiatrists and GPs , as well as psychology input . The wellbeing of our staff is also really important to us . One example is that we have recently sourced bespoke trauma-informed care approaches training specifically for our managers .
Understanding trauma and its effects is crucial , but being able to give our managers dedicated training on identifying vicarious / secondary trauma within their team has felt like a really powerful addition to our learning and development offer . This sits alongside other new and important training developments around gender-informed approaches , learning difficulties and autism .
The need for more detox spaces and being able to provide bespoke care for diverse groups inspired us to take action . We ’ ve obtained land next to Passmores House and are planning to develop it to increase capacity in this space . We ’ re also collaborating with The Nelson Trust to set up a women ’ s only detox in Gloucestershire , the only one of its kind in the UK – more news about this soon !
Dr Arun Dhandayudham is executive medical director at WDP
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