Youth dual diagnosis clients and the systemic barriers they face

Studies have shown that more than half of individuals with a mental health condition are also using drugs and alcohol. Anna Brockman says it’s crucial to work holistically with both concerns at an early stage.

Clients with alcohol, other drugs and mental health issues often face significant complexities and limitations in accessing appropriate services. In fact clients with these dual diagnoses are more susceptible in experiencing reduced functionality in their lives, including issues with housing, legal, employment, isolation and poor physical health.

Several studies have attempted to highlight the intrinsic link between drug and alcohol and mental health in Australia, stating that 65-98% of individuals with a mental health condition are also using drugs and alcohol. However the Department of Health (2012) has shown that over half of clients with comorbidities who are accessing appropriate services are only being treated for one area of concern. When this client group is left untreated, many develop long-term disabilities and are left homeless, jailed or are forced into using acute services for support.

How does this affect youth? The life of an adolescent is significant to the formation of an adult self. This point in an individual’s development show significantly high rates of increased mental health concerns and experimental substance use. Working holistically with both concerns at this stage of life could prevent long-term problematic issues relating to dual diagnosis. More so working with a preventive framework instead of treating solely symptomology at an acute level is both beneficial financially and for the community. This is reflected in some of the work that headspace are providing for Australian young people.

There has been legislative improvement in the systemic barriers that have prevented individuals from accessing services over the last several years. Although, many would argue that the provided funding and demand on the mental health systems have prevented these policies filtering down into direct service provision. Lack of funding and resources are hugely impacting role in treating this complex client group.

Other areas that have a significant impact on young clients with dual diagnosis, is the stigma and community attitudes towards mental health and drugs and alcohol. The importance of social inclusion for young people helps individuals find self-identity. This may reduce young people to engage in help seeking behaviour and/or increase substance use to fit in. young people also may have limited access to transportation or income. Therefore funding services to engage in local schools, and provide free online face-to-face, telephone and online support is vital in providing information and access for clients.

Most importantly, the fragmentation of current mental health and drug and alcohol services show to be the most significant barrier for clients seeking help. Lack of staff training and integrative support between organisations tend to lead to inadequate provision of treatment. Integrated models of care within an organization or collaboratively ensures holistic support to address complexities of the needs of each individual.  I contend that change will require a shared definition and goal of effective practice across both sectors.

To create long-term change in dual diagnosis clients, it is important to provide integrative support in the earlier stages of concern. Providing young people with accessible and flexible services as well as staff who are dual diagnosis trained can show a significant improvement in our community.

headspace is the National Youth Mental Health Foundation providing early intervention mental health services to 12-25 year olds, along with assistance in promoting young peoples’ wellbeing. This covers four core areas: mental health, physical health, work and study support and alcohol and other drug services. The services can be accessed through headspace centres, online counselling service eheadspace, and postvention suicide support program headspace School Support.