People living with mental health challenges and co-occurring substance use issues often cannot find streamlined, integrated and patient-centred care that addresses both needs. 

Integrated care is the gold standard for addressing the complex needs of individuals with co-occurring mental health and substance use disorders. It acknowledges the interconnected nature of these conditions and aims to provide comprehensive, coordinated, and seamless support to individuals, ensuring they receive the most effective and efficient treatment.  

Effective treatment approaches focus on comprehensive assessment, personalised treatment planning, and a combination of evidence-based therapies, medication management, and psychosocial support.  

Ben Steele, a lived experience advocate, details his experiences here: Lived experience advocate Ben Steele talks about his advisory role with drug and alcohol services (youtube.com) 

About the project

The research team was a unique collaboration of clinicians, people with lived experience of mental health and drug and alcohol issues, and health service managers who have come together to identify ideas to improve the responses of services to people with co-occurring conditions. The group developed four initiatives to address the gaps and barriers in service provision and deliver co-ordinated care to improve people’s experiences and health outcomes: 

• Mental health and alcohol and other drugs resource package 

The project team, with a clinical reference group including people with lived experience, developed a directory of online and telephone resources (local and national) for people experiencing co-occurring mental health and drug and alcohol conditions. Targeted at clinicians, the directory gives fast reference for information or services for people with less severe mental health and drug and alcohol conditions. 

• Health Pathways 

This project developed clinical pathways for GPs to support people who have both mental health and drug and alcohol conditions, ensuring they can access services and information at the appropriate time. This ‘no wrong door’ approach is intended to integrate patient journeys between general practice, specialist mental health and drug and alcohol services, and physical health clinics within the community, hospital and non-profit service sectors. 

• Electronic Medical Record 

Appropriate use of electronic medical records means clients do not have to repeat their story to multiple services, and can improve the quality of referrals and the patient journey through the system. This collaboration looked at what is required to do this effectively, including workforce issues, clinical pathways, clinical information systems and approaches to cross-disciplinary team communication. 

• Multidisciplinary shared care plans 

This initiative addressed how GPs can share patient care with SESLHD mental health services for complex mental health conditions. It involved an electronic shared care plan between GPs and the health district clozapine clinic for supporting these patients, some of whom also have alcohol and other drug issues.