Dual Diagnosis

New toolkit for individuals with dual diagnosis/ Co-occurring for mental health and substance misuse conditions.

In May 2021 a toolkit was created by Adfam for professionals working with individuals with dual diagnosis (mental health and substance misuse conditions). Adfam works with individuals who are affected by alcohol or drug use, gambling on family members and friends. Adfam and families with lived experience have been involved in the creation of this toolkit. The toolkit has been created for professionals working with this client group.

Carers can face many challenges when supporting a loved one who has a dual diagnosis including stigma, lack of understanding from professionals and strain on services which can all have a detrimental impact on their mental and physical health. This toolkit has been created to provide simple and effective tools in order to help families cope with these barriers.

Dual diagnosis – what does it mean?

This term has been used to describe substance misuse and mental health conditions. Families described that this term often does not adequately cover the conditions as it can often exceed having a dual diagnosis and may extend to relationships, employment, financial and housing and social isolation problems. This cohort of people may face difficulties due to research indicating them having chaotic lifestyles. Sometimes a diagnosis may not be forthcoming with these challenges. Co-occurring for mental health and substance misuse conditions rather than dual diagnosis

Section 1 - Understanding how services can respond to co-occurring conditions.

This is underpinned by NICE clinical guidelines including Psychosis with coexisting substance misuse – 2011 and coexisting severe mental illness and substance misuses – 2016 and PHE / NHSE – better care for people with co-occurring mental health and alcohol and drug use conditions – 2017. The aim of these documents is to contribute towards making informed decisions about their care and treatment alongside healthcare professionals. If consent is granted then it is important for carers and families to be involved in decisions about their treatment and care. It is vital to build rapport with individuals who have or may have psychosis and coexisting substance misuse which is trusting, respectful and non-judgemental. Where necessary the mental health act may be utilised with the Care Act 2014, Mental Capacity Act 2005 and the Mental Health Act 1983/ 2007 being important guidelines.

Section 2 – Helping family members deal with specific challenges associated with co-occurring conditions.

Individuals with co-occurring conditions are likely to pose a risk to themselves or be at risk of harm from other people as well as being a risk to other people. Therefore, it is important to remain alert to the potential risks, if you feel unsafe; move away from danger, don’t put yourself at risk by staying with a person who is violent. If necessary, call the police is the advice outlined by the toolkit.

The toolkit provides a range of factors to consider which will be helpful in the management of the condition.

Section 3 – Supporting family members who are caring for someone with a co-occurring condition.

There are a range of factors again to help with this area. It is important that a carer’s health is considered by completing a carers assessment. Caring for others can impact on a carers physical and mental health and the toolkit provides a variety of resources to help.