Learning from lived experience: towards recovery
Leroy Simpson, Person with lived experience, Specialist Committee Member, Coexisting severe mental illness and substance misuse, NICE
In 2005 Leroy was diagnosed with severe depression, personality disorder with agoraphobic, paranoid and psychotic features. He has been through the criminal justice and mental health systems, experienced homelessness and lived in supported housing. Since 2006 Leroy has been heavily involved in client Involvement. He is a member of four clients’ groups, sits on two advisory committees and a steering group. He was a member of a four NICE guideline development Groups (GDG).
"NICE have researchers, we can’t just say ‘we want this, we want that’, we have to prove it. It’s not about a quick fix, it’s about developing the conversation. With regards to alcohol, it’s a question that needs to be asked, not a case of the information being given to you. Psychiatrists say please get your alcohol problem sorted first, then we’ll sort this [mental health]"
Early Identification and Prevention: Improving wellbeing and resilience
Dr Phil Cooper MBE, Consultant Nurse Dual Diagnosis / Clinical Transformation, North West Boroughs Healthcare NHS Foundation Trust. Deputy Chair, Progress: National Nurse Consultants Consortium Dual Diagnosis
The presentation will highlight how North West Boroughs Healthcare NHS Foundation Trust routinely screen for substance misuse in all new assessments completed in assessment, accident and emergency psychiatric liaison services and early intervention in psychosis teams. The process to continue the assessment in community mental health recovery teams is discussed and the prevalence of substance misuse in all mental health teams. Finally, an example of how liaison with a charity that harnesses the power of sport can be used to attract men to access help and support for mental health and substance misuse issues.
"I don’t think that men are difficult to attract to services, I think that sometimes our services are not attractive to men… I don’t think that addicts are difficult to attract to services, I think that sometimes our services are not attractive to addicts. Taking mental health and disguising it as mental fitness is a really good way to engage men."
Breaking barriers: challenging attitude and stigmatisation of individuals with co-existing mental and addictive disorders
Dr Raffaella Margherita Milani, Course Leader, Substance Use and Misuse Studies, University of West London
Mental health and addiction are highly debilitating and stigmatising conditions, as a consequence people who suffer from both disorders (dual diagnosis) experience therefore often experience serious life challenges, discrimination and isolation (Laudet, et al., 2000). Studies have shown that health professionals in many cases have negative and counterproductive attitudes towards dual diagnosis patients (Van Boekel et al., 2015), which can have drastic effects on the therapeutic alliance and treatment outcomes (Adams, 2008). In addition, negative attitude and prejudices can contribute to the exclusion of vulnerable individuals from the services they need (MEAM coalition, 2015, NICE, 2016). This presentation explores the impact of stigma and stereotyping on people with dual diagnosis and the role that training can have in challenging and changing negative attitudes towards these clients. Data from international research as well as from training evaluations carried out at the University of West London will be presented.
"What can we do to improve attitude towards these clients? Can patients make a difference to the effectiveness of training? How is knowledge translated in actual service practice, what is the impact on users? It is difficult to measure attitude, how can we measure that attitudes have changed? Better education can improve attitudes and reduce stigma"
Coexisting severe mental illness and substance misuse in Older People: Challenges for Policy and Practice
Dr Tony Rao, Old Age Psychiatry representative, Faculty of Addictions, Royal College of Psychiatrists, Consultant Old Age Psychiatrist and Visiting Researcher, Institute of Psychiatry, Clinical Academic Group Lead for Dual Diagnosis, South London and Maudsley NHS Foundation Trust
Substance use and misuse is growing rapidly in older people of the ‘baby boomer’ generation. In people with mental disorders, the complexity of presentations and problems offers opportunities for new ways of working within mental health services. This requires a different approach to assessment, intervention and care that incorporates age-specific programmes. This presentation address these challenges, with aim of improving health and social outcomes through an integrated approach to the care of older people with dual diagnosis.
"There’s always this fight between substance abuse and mental health services about who these patients ‘belong’ to, and they’re always batted around services. Addiction is very much like other chronic illnesses, it is relapsing and remitting, we need long term support, not ending up in A&E and crisis services, we end up with patients in crisis which is not what we want"