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The British experience of dual diagnosis in the national health service

Published online by Cambridge University Press:  24 June 2014

A. L. Lowe*
Affiliation:
St Ann's Hospital
M. T. Abou-Saleh
Affiliation:
St George's Hospital Medical School, University of London, London, UK
*
Alison L. Lowe, MBC ChB, MRCPsych, Consultant Psychiatrist, St Ann's Hospital, St Ann's Road, London N15 3TH, UK. Tel: +44 (0)20 8442 6113;Fax: +44 (0)20 8442 6447; E-mail: alison.lowe@hpt.nhs.uk

Abstract

The co-occurrence of substance misuse and other psychiatric disorder (dual diagnosis) has been increasingly recognized in the UK. Clinical studies of patients with severe mental disorders showed high rates of substance misuse with poor clinical and social outcome. These patients often fall ‘between the cracks’ of the separate general psychiatric and addiction services. This has necessitated the development of a national policy advocating the provision of integrated care within mainstream psychiatric services. There are emergent models of good practice that require evaluation of effectiveness and cost effectiveness.

Type
Research Article
Copyright
Copyright © 2004 Blackwell Munksgaard

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References

Duke, PJ, Pantelis, C, McPhillips, MA, Barnes, TRE. Comorbid substance misuse among people with schizophrenia in the community: An epidemiological study in Central London. Br J Psychiatry 2001;179: 501513. CrossRefGoogle ScholarPubMed
Drake, RE, Bartels, SJ, Teague, GB, Noordsy, DL, Clarke, RE. Treatment of in substance abuse in severely mentally ill patients. J Nerv Ment Dis 1993;181: 606611.CrossRefGoogle ScholarPubMed
Menezes, PR, Johnson, S, Thornicroft, Get al. Drug and Alcohol Problems among Individuals with Severe Mental Illness in South London. Br J Psychiatry 1996;168: 612619.CrossRefGoogle ScholarPubMed
Cuffell, BJ, Heithoff, KA, Lawson, W. Correlates of patterns of substance misuse among patients with schizophrenia. Hosp Comm Psychiatry 1993;44: 247251. Google Scholar
Safety First. Five-Year Report of the National Confidential Enquiry Into Suicide and Homicide by People with Mental Illness. London, UK: Department of Health, 2001. Google Scholar
Department of Health. Mental Health Policy Implementation Guide – Dual Diagnosis Good Practice Guide. London, UK: DH, 2002. Google Scholar
The Department of Health Guidance on Models of Care. Models of care, National Treatment Agency for Substance Misuse, London, UK, 2002. Google ScholarPubMed
National Minimum Standards For General Adult Services In Psychiatric Intensive Care Units (PICU) and Low Secure Environments. London, UK: Department of Health, 2002. Google Scholar
Pillar to post. A video produced by Croydon Mind. Available through http://.www.indincroydon.org.uk.Google Scholar
Department of Health. Personality Disorder: No Longer a Diagnosis of Exclusion. London, UK: DH.Google ScholarPubMed
Abou-Saleh, MT. Substance misuse and comorbid psychiatric disorders. CPD Bull Psychiatry 2003 2000; 2: 6167. Google Scholar
Johnson, S. Dual diagnosis of severe mental illness and substance misuse: a case for specialist services? Br J Psychiatry 1997;171: 205208.CrossRefGoogle ScholarPubMed
Marshall, F, Keating, A, Annan, Jet al. The Substance Misuse (Drugs and Alcohol) Review to support the development of the London Health Strategy. St George's Hospital Medical School, Addictions Resource Agency for Commissioners.Google Scholar