The recent scoping study was phase 1 of a larger study led by Professor Charlotte de Crespigny and Professor Cherrie Galletly from the University of Adelaide, and involved a large multi-disciplinary research team.
Professor de Crespigny, from the University’s School of Nursing, says the key issue with these services in the northern suburbs is that they are ill-equipped to provide the significant proportion of their consumers, experiencing combined mental health and substance problems (known as comorbidity), with the comprehensive treatments they need to recover.
“People with comorbidity most commonly have depression or anxiety, along with problems with alcohol, sedatives, cannabis, stimulants or other drugs. International research indicates that 70-90% of people accessing mental health or drug and alcohol support services have some form of comorbidity,” Professor de Crespigny says.
“People’s comorbidity is typically missed or undertreated by current services or programs nationwide, which leads to even worse mental health and substance dependence, and this is very apparent in northern Adelaide.
“This is happening because the local services may only treat one problem rather than holistically caring for a patient. This is a serious policy, funding, service and treatment model, clinical practice and education issue,” she says.
Professor de Crespigny says Adelaide northern suburbs are considered one of the most disadvantaged metropolitan regions in Australia, and consumers and caregivers are extremely frustrated with the local services.
“Patients, carers, local service providers, clinicians, workers and community leaders alike indicated during the scoping study that they were frustrated and concerned that so few mental health and drug and alcohol services are offered locally in such a large and impoverished region,” Professor de Crespigny says.
“While eventually locating some government and non-government mental health and only alcohol and drug services or programs, it took extensive internet searching and phone or personal contact to find them. And of those found, very few indicated they accepted or addressed both mental health and substance abuse issues,” she says.
Professor de Crespigny says disjointed policy and disruptive government services re-structuring, and current competitive funding and procurement arrangements, prevent collaboration between services and workers.
“Services and teams need to work together to build capacity, confidence and competence in providing comorbidity care as their core business,” Professor de Crespigny says.
“There is also a need for a unified, accessible database to inform the various service managers, clinicians and consumers about available local mental health and drug and alcohol services, and comorbidity care” she says.
This research has been a scoping study within a larger study funded by the Australian Research Council – Industry Linkage program co-funded by SA Mental Health (Northern Adelaide Mental Health), called Stopping the Run-around: Comorbidity Action in the North (CAN).