Register      Login
Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
RESEARCH ARTICLE

Towards holistic dual diagnosis care: physical health screening in a Victorian community-based alcohol and drug treatment service

Lara Jackson A D , Boyce Felstead A , Jahar Bhowmik B , Rachel Avery A C and Rhonda Nelson-Hearity A
+ Author Affiliations
- Author Affiliations

A Banyule Community Health, 21 Alamein Road, West Heidelberg, Vic. 3018, Australia.

B Department of Statistics, Data Science and Epidemiology, Swinburne University of Technology, Hawthorn Campus, Vic. 3122, Australia.

C Swinburne University of Technology, Hawthorn Campus, Vic., Australia.

D Corresponding author. Email: lara.jackson@bchs.org.au

Australian Journal of Primary Health 22(2) 81-85 https://doi.org/10.1071/PY15097
Submitted: 22 June 2015  Accepted: 20 September 2015   Published: 30 November 2015

Abstract

The poorer health outcomes experienced by people with mental illness have led to new directions in policy for routine physical health screening of service users. By contrast, little attention has been paid to the physical health needs of consumers of alcohol and other drug (AOD) services, despite a similar disparity in physical health outcomes compared with the general population. The majority of people with problematic AOD use have comorbid mental illness, known as a dual diagnosis, likely to exacerbate their vulnerability to poor physical health. With the potential for physical health screening to improve health outcomes for AOD clients, a need exists for systematic identification and management of common health conditions. Within the current health service system, those with a dual diagnosis are more likely to have their physical health surveyed and responded to if they present for treatment in the mental health system. In this study, a physical health screening tool was administered to clients attending a community-based AOD service. The tool was administered by a counsellor during the initial phase of treatment, and referrals to health professionals were made as appropriate. Findings are discussed in terms of prevalence, types of problems identified and subsequent rates of referral. The results corroborate the known link between mental and physical ill health, and contribute to developing evidence that AOD clients present with equally concerning physical ill health to that of mental health clients and should equally be screened for such when presenting for AOD treatment.

Additional keywords: mental health, service integration.


References

Australian Bureau of Statistics (2008) ‘National Health Survey.’ (Commonwealth of Australia) Available at http://www.abs.gov.au/AUSSTATS/abs@.nsf/mf/4364.0/ [Verified 22 June 2015]

Australian Commission on Safety and Quality in Health Care (2014) ‘Health literacy: Taking action to improve safety and quality.’ (ACSQHC) Available at http://www.safetyandquality.gov.au/wp-content/uploads/2014/08/Health-Literacy-Taking-action-to-improve-safety-and-quality.pdf [Verified 23 September 2015]

Australian Government (2010a) ‘National standards for mental health services 2010.’ (Commonwealth of Australia) Available at http:// www.health.gov.au/internet/main/publishing.nsf/Content/mental-pubs-n-servst10 [Verified 23 September 2015]

Australian Government (2010b) ‘Sixth national HIV strategy 2010–2011.’ (Commonwealth of Australia) Available at http://www.health.gov.au/internet/main/publishing.nsf/Content/ohp-national-strategies-2010-hiv/$File/hiv.pdf [Verified 23 September 2015]

Australian Institute of Health and Welfare (2010) Trends in access to dental care among Australian adults. Research report series no. 47. Commonwealth of Australia, Canberra.

Australian Institute of Health and Welfare (2014) Tobacco smoking. Commonwealth of Australia, Canberra.

van Boekel LC, Brouwers EMP, Weeghel J, Garretsen HFL (2013) Stigma among health professionals towards patients with substance use disorders and its consequence for healthcare delivery: Systematic Review. Drug and Alcohol Dependence 131, 23–35.
Stigma among health professionals towards patients with substance use disorders and its consequence for healthcare delivery: Systematic Review.Crossref | GoogleScholarGoogle Scholar | 23490450PubMed |

Cancer Council Tobacco Control Unit (2008) The reciprocal relationship between social disadvantage, financial stress and smoking: what does the research tell us? What can community service organisations do?’ Cancer Council NSW, Sydney.

Chapman S, Barratt A, Stockler M (2010) ‘Let sleeping dogs lie? What men should know before getting tested for prostate cancer.’ (Sydney University Press: Sydney)

Coglan R, Lawrence D, Holman D, Jablensky A (2001) ‘Duty to care: physical illness in people with mental illness.’ Department of Public Health and Department of Psychiatry and Behavioural Science, University of Western Australia, Perth.

Council of Australian Governments (2012) ‘Roadmap for national mental health reform 2012–2022.’ (Commonwealth of Australia) Available at https://www.coag.gov.au/sites/default/files/The%20Roadmap%20for%20National%20Mental%20Health%20Reform%202012-2022.pdf.pdf [Verified 23 September 2015]

Crewe J (2013) ‘Physical health matters too project report.’ (North East Primary Care Partnership) Available at http://www.nepcp.org.au/resources/physical-health-matters-too-project-report [Verified 22 June 2015]

Croton G (2011) ‘Potential: Australia’s evolving responses to co-occurring MH and substance use disorders.’ Submission to Senate Community Affairs Committee – Commonwealth Funding and Administration of MH Services Inquiry. (Northeast Health Wangaratta: Victoria)

Deloitte Access Economics (2011) ‘Re-awakening Australia: the economic cost of sleep disorders in Australia.’ (Sleep Health Foundation: Canberra)

Department of Health (2009) ‘Community health priority tools.’ (Department of Health: Melbourne, Vic.)

Department of Health (2012) ‘Victorian population health survey 2010.’ (State Government of Victoria: Melbourne, Vic.)

Department of Human Services (2005) ‘Victorian burden of disease study: mortality and morbidity in 2001.’ (Public Health Group, Department of Human Services) Available at https://www2.health.vic.gov.au/getfile/?sc_itemid=%7bF84D614F-47FC-4027-BD0B-777AA49070A7%7d&title=Victorian%20Burden%20of%20Disease%20Study [Verified 23 September 2015]

Department of Human Services (2008) Because mental health matters: a new focus for mental health and wellbeing in Victoria: consultation paper. Department of Human Services, Melbourne, Vic.

Drake E, O’Neal E, Hobbs M (2008) A systematic review of psychosocial research on psychosocial interventions for people with co-occurring severe mental and substance use disorders. Journal of Substance Abuse Treatment 34, 123–138.
A systematic review of psychosocial research on psychosocial interventions for people with co-occurring severe mental and substance use disorders.Crossref | GoogleScholarGoogle Scholar |

Hayes RD, Change C, Fernandes A, Broadbent M, Lee W, Hotopf M, Stewart R (2011) Associations between substance use disorder sub-groups, life expectancy and all-cause mortality in a large British specialist mental healthcare service. Drug and Alcohol Dependence 118, 56–61.
Associations between substance use disorder sub-groups, life expectancy and all-cause mortality in a large British specialist mental healthcare service.Crossref | GoogleScholarGoogle Scholar | 21440382PubMed |

NSW Health (2009) ‘Physical Health Care of Mental Health Consumers Guidelines’ (NSW Department of Health) Available at http://www0.health.nsw.gov.au/policies/gl/2009/GL2009_007.html [Verified 23 September 2015]

Keaney F, Gossop M, Dimech A, Guerrini I, Butterworth M, Al-Hassani H, Morinan A (2011) Physical health problems among patients seeking treatment for substance use disorders: a comparison of drug dependent and alcohol dependent persons. Journal of Substance Use 16, 27–37.
Physical health problems among patients seeking treatment for substance use disorders: a comparison of drug dependent and alcohol dependent persons.Crossref | GoogleScholarGoogle Scholar |

Mitchell L (2011) ‘Domestic violence in Australia: an overview of the issues.’ (Parliament of Australia) Available at http://www.aph.gov.au/About_Parliament/Parliamentary_Departments/Parliamentary_Library/pubs/BN/2011-2012/DVAustralia [Verified 23 September 2015]

Petry NM, Stinson FS, Grant BF (2005) Comorbidity of DSM-IV pathological gambling and other psychiatric disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions. The Journal of Clinical Psychiatry 66, 564–574.
Comorbidity of DSM-IV pathological gambling and other psychiatric disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions.Crossref | GoogleScholarGoogle Scholar | 15889941PubMed |

Stein JA, Zane JI, Grella CE (2012) Impact of abstinence self-efficacy and treatment services on physical health related behaviours and problems among dually diagnosed patients. Journal of Dual Diagnosis 8, 64–73.
Impact of abstinence self-efficacy and treatment services on physical health related behaviours and problems among dually diagnosed patients.Crossref | GoogleScholarGoogle Scholar | 22707922PubMed |

Tripp JC, Skidmore JR, Cui R, Tate SR (2013) Impact of physical health on treatment for co-occurring depression and substance dependence. Journal of Dual Diagnosis 9, 239–248.
Impact of physical health on treatment for co-occurring depression and substance dependence.Crossref | GoogleScholarGoogle Scholar |