Co-morbid drug and alcohol and mental health issues in a rural New South Wales Area Health Service

• Published in: The Australian journal of rural health 2006-08, Vol.14 (4), p.148-153
• Main Authors: Hoolahan, Bryan, Kelly, Brian, Stain, Helen J., Killen, Didi
• Format: Article
• Language: English
• Subjects: co-morbidity; Comorbidity; consumer; Delivery of Health Care - organization & administration; Drug abuse - Australia; drug and alcohol; Female; Focus Groups; Health Care Surveys; Health planning - Australia - New South Wales, Australia; Humans; Male; Medical services; Mental Disorders - epidemiology; Mental Disorders - therapy; Mental health; Mental health services - Australia; New South Wales; New South Wales - epidemiology; Prevalence; Quality Assurance, Health Care - methods; rural; Rural areas; Rural Health Services - organization & administration; Rural Population - statistics & numerical data; service provider; Sex Distribution; Substance-Related Disorders - epidemiology; Substance-Related Disorders - therapy; Treatment
• ISSN: 1038-5282; 1440-1584
• DOI: 10.1111/j.1440-1584.2006.00792.x

Objective:  In 2003 the New South Wales (NSW) Centre for Rural and Remote Mental Health (CRRMH) conducted an analysis of co‐morbid drug and alcohol (D&A) and mental health issues for service providers and consumers in a rural NSW Area Health Service. This paper will discuss concerns raised by rural service providers and consumers regarding the care of people with co‐morbid D&A and mental health disorders. Design:  Current literature on co‐morbidity was reviewed, and local area clinical data were examined to estimate the prevalence of D&A disorders within the mental health service. Focus groups were held with service providers and consumer support groups regarding strengths and gaps in service provision. Setting:  A rural Area Health Service in NSW. Participants:  Rural health and welfare service providers, consumers with co‐morbid D&A and mental health disorders. Results:  Data for the rural area showed that 43% of inpatient and 20% of ambulatory mental health admissions had problem drinking or drug‐taking. Information gathered from the focus groups indicated a reasonable level of awareness of co‐morbidity, and change underway to better meet client needs; however, the results indicated a lack of formalised care coordination, unclear treatment pathways, and a lack of specialist care and resources. Discussion:  Significant gaps in the provision of appropriate care for people with co‐morbid D&A and mental health disorders were identified. Allocation of service responsibly for these clients was unclear. It is recommended that D&A, mental health and primary care services collaborate to address the needs of clients so that a coordinated and systematic approach to co‐morbid care can be provided.