What are the Implications for Clinical Management and Service Development of Prevalent Comorbidity in U.K. Mental Health and Substance Misuse Treatment Populations?

• NCJ Number: 207129
• Journal: Drugs: Education, Prevention and Policy Volume: 11 Issue: 4 Dated: August 2004 Pages: 329-348
• Author(s): Tim Weaver; Gerry Stimson; Peter Tyrer; Thomas Barnes; Adrian Renton
• Date Published: August 2004
• Length: 20 pages
• Publication Format: Article
• Publication Type: Report (Study/Research)
• Language: English
• Country: United Kingdom

Annotation

This study examined the prevalence of mental health and substance misuse comorbidity in the United Kingdom and analyzed the health and social care needs of this population.

Abstract

In the United Kingdom, scant evidence exists concerning the prevalence and clinical management of patients with mental illness and substance misuse comorbidity, hampering service to this population. As part of the Department of Health’s Drug Misuse Research Initiative, the current study assessed the prevalence of comorbidty among patients of Community Mental Health Teams (CMHT’s) and drug and alcohol services in four urban centers in the United Kingdom. Research methods involved obtaining brief patient data from key workers and a patient interview administered in random samples drawn from substance misuse and CMHT census populations; interviews with 400 CMHT and 353 substance misuse patients were used in the analysis. The health and social care needs of patients were examined through the use of the Camberwell Assessment of Need (CAN). The results revealed that 44 percent of CMHT patients reported past year problem drug or alcohol use. A full 74.5 percent of drug patients and 80.6 percent of alcohol patients suffered a past year psychiatric disorder. The presence of multiple disorders was common among the comorbid patients, as was a greater need for community care. Treatment approaches for this population are not currently restricted based on comorbid status, but there is little joint management between services for comorbid patients. The findings indicate that resources need to be targeted toward evidence-based interventions that focus on the comorbid population. The emerging consensus is that comorbid patients are currently most appropriately served by mainstream mental health services; practitioners in these mental health services should gain core knowledge about comorbidity and learn the skills associated with taking a detailed drug and alcohol history. Tables, figures, note, references