Dual Diagnosis

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What is the impact of complex health needs on the individual and mental health services?

This essay aims to discuss the impact of complex mental health needs on an individual; it talks about the impact on mental health services on an individual Dual diagnosis refers to a condition whereby an individual suffers from an enduring mental illness and at the same time struggles with a co-existing drug or alcohol dependency issues (DoH 2009). Rassool (2002) describes dual diagnosis as a complex mental health problem which is a broad expression characterized by the presence of two inter-reliant disorders. The substances which are most commonly used by those with enduring mental illness are alcohol, cannabis and stimulants. People with dual diagnosis not only have two major struggles, however they also experience other complex issues such as homelessness, poor engagement with services, finances and legal issues which, results in the exacerbation of their mental state (DoH, 2002). This account aims to focus upon the impact of a complex mental health need and the services involved.

The DOH (2002) acknowledges that providing services for someone both a mental health and a drug and/or alcohol problems is a very difficult task for frontline mental health services. The department reiterates that due to the complexity of the issues involved in the caring process, putting the service users at a high risk of suicide, relapse and consequently readmission to hospital. The involvement of multi- agencies in the provision of care though useful, tends to create gaps in the service provision if without effective coordination (Dorling 2003). DOH (2008) (refocus CPA) - paved the way for a policy to clarify how care for individuals with a wide range of needs are ought to receive a high level of care coordination. The policy also clarifies that only this group of individuals will be subject to a CPA. Care plans and assessments will be used to address the various needs encountered by the concerned individuals. Care coordinators were identified as being very vital to ensure the care coordination process is person centred. Care coordinators will undergo nationally recognised training according to a national competences framework. (Fisher et al 2004) supports that the treatment of individuals a dual diagnosis requires an effective integration of skills from both the mental health and chemical dependency fields. They also identify that due to the high mortality and morbidity of this group of clients, it is absolutely essential to provide the services in an integrated model. Research also shows that providing services separately to treat individuals with dual diagnoses is ineffective compared to the integrated services model (Graham et al 2003). Evidential proof has shown that suggests that people with dual diagnosis are more likely to suffer frequent relapses, hospital readmissions, and high incidences of suicide attempts, family problems, homelessness, and disruptive behaviour including violence (Drake 2005). The collaboration between social support and treatment agencies should clearly be effective and provide realistic treatment goals, taking into consideration that the services are scarce. The collaboration should be at all levels in order to cater for the varied and changing needs for the individuals with dual diagnoses (Bhui 2004). In 1998, the government developed a 10 year strategy to deal with drugs problem facing Britain. The government acknowledged that this was a serious problem posing a threat to the communities through drug related crimes. In the same report, the anti-drugs coordinator identified that the emphasis had just been put on tackling illegal drugs and he proposed that the misuse of legally obtainable substances such as alcohol and tobacco without medical intervention, was also closely related to illegal drugs problems and therefore needed addressing. In 2010, the government reviewed its strategy, and this time the strategy...
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