Cleary Michelle, Hunt Glenn E, Matheson Sandra, Walter Garry
Research Unit, Sydney South West Area Health Service at Concord Centre for Mental Health, Concord Hospital, Hospital Road, Concord, NSW 2139, Australia.
Drug Alcohol Rev. 2009 Mar;28(2):122-8. doi: 10.1111/j.1465-3362.2008.00041.x.
Substance misuse by people with a serious mental illness may exacerbate psychiatric symptoms and contribute to relapse. The aim of the study was to ascertain the views of a wide range of Australian mental health service providers on staff education and training, client contact and management, assessment, and treatment effectiveness and service delivery.
A survey was sent to a sample of 171 mental health stakeholders in Australia identified through internet searches, state and territory mental health departments and professional organisations.
Of the 66 respondents (39% response rate), the substances identified to be most problematic were alcohol and cannabis. Integrated service models of treatment were identified as the most preferable and effective. Barriers to treatment included client motivation to reduce substance use, poor communication and coordination between treatment services, and lack of specific services for dual diagnosis clients. Almost all indicated a need for further training in the area of dual diagnosis.
Dual diagnosis is common and the reality is that this vulnerable clientele will continue to challenge service providers and treatment approaches into the foreseeable future. Issues include the organization and delivery of treatment services, education and training, resource allocation, collaboration between treatment agencies and clinically relevant research evaluating the effectiveness of practice. It is thus surprising that with so much investment in this area the majority of stakeholders are still dissatisfied with access to and the level of care for dual diagnosis clients.
患有严重精神疾病的人群滥用药物可能会加剧精神症状并导致病情复发。本研究的目的是确定澳大利亚各类心理健康服务提供者对员工教育与培训、与客户的接触和管理、评估以及治疗效果和服务提供的看法。
通过互联网搜索、州和领地心理健康部门以及专业组织，向澳大利亚171名心理健康利益相关者样本发送了一份调查问卷。
在66名受访者中（回复率为39%），被认为问题最大的物质是酒精和大麻。综合治疗服务模式被认为是最可取和最有效的。治疗障碍包括客户减少药物使用的动机、治疗服务之间沟通与协调不畅以及缺乏针对双重诊断客户的特定服务。几乎所有人都表示需要在双重诊断领域接受进一步培训。
双重诊断很常见，现实情况是，在可预见的未来，这类弱势客户群体将继续给服务提供者和治疗方法带来挑战。问题包括治疗服务的组织与提供、教育与培训、资源分配、治疗机构之间的合作以及评估实践效果的临床相关研究。因此，令人惊讶的是，尽管在这一领域投入了大量资金，但大多数利益相关者仍然对双重诊断客户获得的服务和护理水平不满意。
