A model for improved dual diagnosis treatment
Many individuals with substance use problems also experience concurrent mental
health problems (75% of drug service users and 85% of alcohol service users
experience a mental health problem (Weaver et al, 2002)), and this dual diagnosis
often results in these individuals experiencing more severe issues in other areas;
worse physical health, greater levels of disability, lower quality of life. (Strathdee et
al, 2002). It can also make access to the necessary treatment more challenging, with
many individuals in drug and alcohol services not meeting the threshold to access
secondary mental health treatment. As Weaver et al (2002) state; only 38% of drug
users with a psychiatric disorder receive mental health treatment.
Addressing the needs of individuals with dual diagnosis is complex and challenging,
however, the, current commissioning of a North Somerset substance misuse service
(due to commence in April 2015) has provided the opportunity to improve the
delivery of dual diagnosis treatment, and your input is essential.
The 6 sections relate to the delivery of dual diagnosis treatment within the North
Somerset substance misuse service. You are kindly requested to give your thoughts
and comments below in each of the sections.
1. Requirements:
The Provider will be required to:






Deliver concurrent substance misuse and mental health treatment (for low to
moderate mental health problems), including the prescribing of appropriate
medication.
Deliver substance misuse training for local mental health services.
Conduct dual diagnosis treatment from both a static location and from
outreach/satellite services.
Employ staff with formal mental health qualifications.
Have the necessary governance structures in place to ensure mental health
interventions are delivered safely and effectively.
Develop the skills of all service staff in recognising and responding to mental
health problems.
Do you agree with these proposed requirements?
Yes
No
Please suggest any amendments or additions to these requirements.
2. Outcomes:
The outcomes to be achieved from the dual diagnosis treatment are:




Improved retention in substance misuse treatment for individuals with
concurrent mental health problems.
Improved substance misuse treatment outcomes for individuals with
concurrent mental health problems.
Improved joint working between substance misuse services and mental health
services.
Improved experience of service delivery by individuals with dual diagnosis.
Do you agree with these proposed requirements?
Yes
No
Please suggest any amendments or additions to these requirements.
3. Dual diagnosis treatment definition:
The Provider, through their bid, will be expected to clearly describe a dual diagnosis
treatment package.
Do you agree that the Provider should be required to explicitly describe a
package of dual diagnosis treatment?
Yes
No
Do you agree that the responsibility for specifying and developing the dual
diagnosis treatment should remain with the Provider?
Yes
No
If no, please suggest how the dual diagnosis treatment should be described in
the service specification.
4. Defining the mental health issues addressed by the Provider:
As stated above, the Provider will be required to address low to moderate mental
health issues, these will include: self harm, depression, anxiety, sleep disorders and
eating disorders.
Do you agree that the service specification should explicitly state a series of
mental health conditions that the Provider should address?
Yes
No
If yes, please suggest any amendments or additions to the list of conditions
stated above.
5. Handover to primary care or specialist mental health services.
There will clearly be a need for the Provider to, at certain times, hand the treatment
of mental health conditions over to primary care and/or specialist mental health
services. It is suggested that the criteria for handover will be: when the mental health
issues exceed the definition of low to moderate, or when the individual is no longer
experiencing problematic substance use.
Do you agree that handover criteria should be defined in the service
specification?
Yes
No
If yes, please suggest any amendments or additions to the suggested criteria
for handover outlined above.
6. Dual diagnosis mutual aid.
The Provider will be required to develop and support local dual diagnosis mutual aid
programmes.
Do you agree with this requirement?
Yes
No
If yes, please suggest any amendments or additions you would make.
If no, please explain why.
Please give details on any existing dual diagnosis mutual aid groups which
would be useful to include in the service specification.
Please return this form to Ted Sherman, Substance Misuse Manager, North
Somerset Council, at ted.sherman@n-somerset.gov.uk by Thursday 31 July.