Home > Model of care for people with mental disorder and co-existing substance use disorder (dual diagnosis).

National Working Group for Dual Diagnosis. (2023) Model of care for people with mental disorder and co-existing substance use disorder (dual diagnosis). Dublin: Health Service Executive.

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The definition of Dual Diagnosis for this Model of Care is: ‘the co-morbid disorders due to substance use and/ or addictive behaviours along with the presence of mental disorder(s)’. The disorders of substance use include disorders of alcohol use.

 

Dual Diagnosis teams will primarily provide services to those with severe mental illness and co-morbid mild, moderate or severe disorders due to substance misuse and disorders due to addictive behaviours. However, those with a Dual Diagnosis involving less severe co-morbid disorders of mental illness will also be assessed if necessary by the Dual Diagnosis services for the purpose of a second opinion or if the diagnosis is unclear after assessment by the HSE Community Mental Health Teams (CMHTs) and HSE addiction services.

 

For the purpose of service provision, the service delivery will occur in two phases. In Phase 1, the Dual Diagnosis teams will provide services for those without a disorder due to addictive behaviour (which will include gambling and gaming disorder). Phase 2 of the Dual Diagnosis which will be implemented in the future will include disorders due to addictive behaviours. Phase 2 will depend on resources being provided to develop services in both HSE addiction services and Dual Diagnosis services for those presenting with gambling and gaming disorders. Exploration and discussion is needed at interdepartmental levels to consider the possibility of service provision for the prison population with the simultaneous development of adequate mental health and addiction services across the prison services.

 

The provision of care will follow pathways as described in this Model of Care and service users will have access to inpatient acute psychiatric unit beds on a planned basis. This Model of Care also recommends the establishment of a National Dual Diagnosis Rehabilitation Unit, preferably in Dublin, and the provision of continued funding for appropriately funded inpatient rehabilitation beds through both the HSE addiction and Dual Diagnosis services.

 

Provision of training for service providers under two tiers will also be an integral part of the Dual Diagnosis National Clinical Programme. This will be delivered in partnership by the Dual Diagnosis services with the HSE addiction services, the National Office for Suicide Prevention (Connecting for Life) and HSE CMHTs.

Item Type
Report
Publication Type
Irish-related, Guideline
Drug Type
All substances
Intervention Type
Treatment method
Date
23 May 2023
Pages
141 p.
Publisher
Health Service Executive
Corporate Creators
National Working Group for Dual Diagnosis
Place of Publication
Dublin
ISBN
978-1-78602-225-7
EndNote
Subjects
A Substance use and dependence > Personal history of substance use (pathway) > Recovery
B Substances > Cannabis / Marijuana
B Substances > Alcohol
B Substances > Sedatives, hypnotics or tranquillisers (CNS depressants) > Benzodiazepine
B Substances > Cocaine
B Substances > Opioids (opiates)
B Substances > New (novel) psychoactive substances > Gabapentinoids GABA (Pregabalin / Gabapentin)
F Concepts in psychology > Process / behavioural / non-substance disorder > Gambling
F Concepts in psychology > Process / behavioural / non-substance disorder > Gaming / Internet / Phone related disorder
G Health and disease > Substance use disorder > Drug use disorder > Drug intoxication > Poisoning (overdose)
G Health and disease > Substance related disorder > Substance related mental health disorder > Dual diagnosis
HJ Treatment or recovery method > Substance disorder treatment method
HJ Treatment or recovery method > Substance disorder treatment method > Substance replacement method (substitution) > Opioid agonist treatment (methadone maintenance / buprenorphine)
HJ Treatment or recovery method > Substance disorder treatment method > Detoxification
J Health care, prevention, harm reduction and treatment > Health care delivery
J Health care, prevention, harm reduction and treatment > Health care programme, service or facility > Substance use project or service
MA-ML Social science, culture and community > Sociocultural discrimination > Minority group (racial / ethnic group, immigrant, Traveller)
MP-MR Policy, planning, economics, work and social services > Organisational development / co-operation > Workforce / staff skills and training
T Demographic characteristics > Adolescent / youth (teenager / young person)
T Demographic characteristics > Substance or health care worker / provider
T Demographic characteristics > Prison Inmate (prisoner)
T Demographic characteristics > Affected family members / concerned persons
VA Geographic area > Europe > Ireland

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