Hattie Catherine Ann Moyes, Lana MacNaboe and Kate Townsend
This paper aims to understand the current scale of substance misuse in psychiatric intensive care units (PICUs), identify how substance misuse affects members of staff, patients…
Abstract
Purpose
This paper aims to understand the current scale of substance misuse in psychiatric intensive care units (PICUs), identify how substance misuse affects members of staff, patients and the running of wards and explore with staff what resources would be most useful to more effectively manage substance misuse and dual diagnosis on PICUs.
Design/methodology/approach
The paper used a mixed-methods approach, using a quantitative survey to determine the extent of substance use in PICUs and a co-design workshop to understand the impact of substance misuse on PICU wards, staff and patients.
Findings
The estimated rate of substance misuse in PICUs over a 12-month period is 67%, with cannabis the most frequently used substance. Despite the range of problems experienced on PICUs because of substance misuse, the availability of training and resources for staff was mixed.
Research limitations/implications
The findings may not be fully generalisable as research participants were members of a national quality improvement programme, and therefore, may not be representative of all PICUs. Data was collected from clinicians only; if patients were included, they might have provided another perspective on substance misuse on PICUs.
Practical implications
This paper emphasises the importance of substance misuse training for PICU staff to adequately respond to patients who misuse substances, improve the ward environment, staff well-being and patient outcomes.
Originality/value
This paper provides an updated estimation of rates of substance misuse in PICUs over a 12-month period and make suggestions for a training programme that can better support staff to address substance misuse on PICUs.
Details
Keywords
Hattie Catherine Ann Moyes, Joshua James Heath and Lucy Victoria Dean
The purpose of this paper is to review the literature on offenders with a dual diagnosis and discuss how prison-based services can improve to better meet the needs of prisoners…
Abstract
Purpose
The purpose of this paper is to review the literature on offenders with a dual diagnosis and discuss how prison-based services can improve to better meet the needs of prisoners with co-occurring substance misuse and mental health disorders.
Design/methodology/approach
A comprehensive literature search of PsycINFO, JSTOR, PubMed and Google Scholar, reviewing international studies on dual diagnosis amongst offender and community samples spanning the last three decades, supplemented by international policy, guidance papers and reports was conducted to explore how services can be improved.
Findings
It was found that research into dual diagnosis amongst prisoners internationally was scarce. However, from the evidence available, several consistent factors emerged that led to the following recommendations: integrated treatment needs to be coordinated and holistic, staged and gender-responsive; increased availability of “low level”, flexible interventions; transitional support and continuity of care upon release with the utilisation of peer mentors; comprehensive assessments in conducive settings; mandatory dual diagnosis training for staff; and increased funding for female/gender-responsive services.
Practical implications
The recommendations can inform commissioners, funders and service providers of areas where support must be improved to address the needs of prisoners with a dual diagnosis.
Social implications
Improved outcomes for prisoners with a dual diagnosis would likely have a positive effect on society, with improvements in mental health and substance misuse treatment impacting on rates of reoffending.
Originality/value
This paper brings originality and value to the sector because it reviews relevant research on dual diagnosis and translates it into practical implications for policy makers.