Skip to main content

Mental Health Services

Volume 470: debated on Tuesday 15 January 2008

To ask the Secretary of State for Health what assessment he has made of the level of demand for NHS services for dual-diagnosis patients who abuse substances and have a mental illness; what assessment he has made of whether that demand is being met; and what plans he has for future provision of services. (179175)

The Department has undertaken a substantial programme of work to ensure that the needs of this group are met. The implementation of this has been supported by substantial increases in funding across the NHS over the past 10 years and specific funding increases for substance misuse services through the introduction of the pooled drug treatment budget, which has tripled in size since it was introduced in 2001 (£129 million to £398 million in 2007-08).

Examples of work undertaken to support improvements in this area include:

In the “Mental Health Policy Implementation Guide: Dual Diagnosis Good Practice Guide” (Department of Health, 2002) it was made clear that people who have both drugs misuse and mental health problems need high quality, patient focused and integrated care, which should be delivered within mental health services. It charged local implementation teams in partnership with drug action teams with implementing the policy requirements.

The 2002 Good Practice guide alongside guidance published in 2006, “Dual diagnosis in inpatient and day hospital settings” represents a summary of current Government policy on this issue. The key message is the need for mainstreaming—the recognition that substance misuse is usual rather than exceptional among people with mental health problems, and that the relationship between the two is complex.

The updated “Drug Misuse and dependence - UK guidelines on clinical management” (the ‘clinical guidelines’), published in September 2007 identifies that patients in drug treatment services with common mental illness problems additional to their drug misuse are often treated in drug treatment services, although clarity on competencies and shared care models is important. For all those with mental health problems, it is important that competent practitioners make adequate assessment and appropriate treatment be organised.

Proper assessment is the key to establishing a comprehensive care plan for dual diagnosis. Adequate risk assessment of mental health should be undertaken at initiation of treatment and at appropriate times during management. Specific psychological management in line with appropriate guidance, such as National Institute for Health and Clinical Excellence and other psychiatric and drug misuse guidelines can then be provided.