Battle to help ‘dual diagnosis’ victims

Sydney
25 August 2002

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Battle to help ‘dual diagnosis’ victims

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Battle to help ‘dual diagnosis’ victims

Sr Myree Harris … we’re lagging behind

By Kathleen Carmody

Dual diagnosis – substance abuse and mental illness – is “one of the most intractable issues” in the mental health spectrum, “one which is not effectively being addressed”, says Sr Myree Harris.

It is not uncommon for sufferers of a mental illness like schizophrenia or manic depression (bi-polar disorder), or a disorder such as anorexia or depression, to try to ease their symptoms with illicit drugs or excessive consumption of alcohol.

Indeed, a high proportion of people with a mental illness have a corresponding drug or alcohol dependency (around 35 per cent, according to recent statistics). It is even higher among the homeless and psychiatric patients.

Dual diagnosis has been very poorly addressed in Australia.

Sufferers generally have found themselves shunted between mental health and drug and alcohol services, with either claiming the problem is the other’s responsibility.

Now the State Government is getting serious about the issue, says Myree.

“It’s a very big problem,” she says. It affects law and order; people with personality disorders and substance abuse problems often become violent and they may harm police or members of the community, or they may be a danger to other patients.

“It’s a huge health issue also.” Sr Myree, president of the St Vincent de Paul Society advisory committee on care of the mentally ill, has been appointed to a new advisory committee appointed by the Government to oversee the development of proposals to meet the needs of people with a dual disorder.

She says it is still feeling its way.

“The two services have not been talking to each other and working with each other very well,” she says.

“There will have to be a lot of ongoing work; within the profession there has to be a lot more dialogue.” The ideal outcome of the committee, says Myree, would be to have mental health and drug and alcohol services working effectively together to treat people with dual diagnosis, addressing the specific needs of various target groups – particularly the homeless.

“It’s not just a medical problem, but also a social one.” Statistics suggest that 30 per cent of homeless people in NSW with a mental illness also have substance abuse problems (in Victoria, the figure is closer to 50 per cent).

For this group, Myree proposes the establishment of a residential treatment rehabilitation unit.

“As well as needing to be treated for two disorders (these people) need to be helped to regain a place in society,” she says.

“They have to be helped to learn living skills; they can’t do that in a six-week treatment program.

“People need to be helped with budgeting, shopping and cooking, they need to be helped to find their way back into education or job placement, and they need to be placed in housing with appropriate levels of support – individuals will differ.” Myree cites the program at Charles O’Neill House, a St Vincent de Paul Society-run hostel for homeless who have shown the potential to live independently in the community, as a good example (see Replacing the void).

Last month Myree was awarded a Churchill Fellowship to investigate models of treatment and rehabilitation for people with dual diagnosis. She will spend six weeks next year studying research programs and strategies being implemented in Britain, Canada and the US.

“Canada has a comprehensive national program,” she says. “I would like to see something like that developed here.

“We’re certainly lagging behind. I’m picking up a reaction that we have the answers here already and I would argue against that quite vigorously.

“We do need to learn from the rest of the world, especially countries similar to ourselves.”