Dual Diagnosis Program: The Difficulties of Implementing a Dual Diagnosis Program

Recovery from substance misuse is difficult for any users trying to get their lives back on track but for those people who suffer from dual diagnosis issues, the journey back to normality – or as near to normality as possible in terms of their underlying illness – is compounded by a number of underlying issues. One of these is the constant confrontation of everyday medication for their underlying illness. Another is their sense of underlying self-worth. Still another concern is a perception problem: this includes perception of other people and, more fundamental, a problem of low self-esteem in their perception of themselves as valued members of society. While substance misuse is of increasing concern world-wide, the recognition, in its own right, of problems associated with dual diagnosis has been rather overlooked. Despite dual diagnosis having been with us for many years, it is really only comparatively recently that resources have been made available to tackle the problem and institute a dual diagnosis programme in its own right.

The scale is huge and the matter is a multifarious one, although appropriate care is now being delivered through the instigation of a number of dual diagnosis programmes. It has been recognised that the appropriateness of this care centres on a holistic approach so integrating suitable healthcare teams has been of prime concern when setting up a dual diagnosis programme. All human beings need to be considered to have an active role to contribute to society and, despite psychiatric illness, this is no less important to sufferers taking part in a dual diagnosis programme. Recognition of this is fundamental to a co-ordinated approach to a personalised treatment plan because dual diagnosis sufferers have social needs in equal proportion to medical needs and, for long-term success, both aspirations need to be accommodated in an individualised dual diagnosis programme.

It is only fairly recently that a suitable definition of dual diagnosis has become accepted: this is centred on the co-existence of problems which cover both a problem with substance misuse while also taking into account a pre-existing mental health illness. For sufferers, themselves, this is still the tip of the iceberg and it is a recognised factor that dual diagnosis is pretty multifaceted when it comes to recognising the needs of those with dual diagnosis. Many professionals believe that the definition should be more specific – which mental illness should be included and which should not? Is one more profound and more deserving to be treated than another? All these need to be considered in terms of funding and employing the appropriate healthcare profession in accordance with the illness being considered.

Shocking figures from the Office of National Statistics indicates that, in the UK, a moderate dependency problem exists in approximately 10% of male remand prisoners whilst 40% had a severe dependency and a huge 79% showed to have two mental disorders plus a drug dependency problem. A number of factors have been shown to exacerbate a tendency towards the development of dual diagnosis such as behaviour, a person’s response to their environment and genetic make up. These, however, a just a few of the problems leading to the requirement for a dual diagnosis programme to be set up. Drugs such as cannabis tend to exacerbate what might initially have been a minor psychiatric problem and other drugs could act as triggers to set off a dormant mental health problem. As such problems are so intricate, models of care need to be considered by Care Delivery Teams to ensure that a social and medical underclass are not allowed to develop whereby dual diagnosis sufferers are not considered to be sufficiently ‘needy’ to be accepted onto a dual diagnosis programme.

 

 

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Filed under: dual diagnosis program

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