Mentally ill with addictions ‘need more help’

THE health system is failing to treat vulnerable drug addicts who also suffer mental health problems, with studies suggesting many are falling between the cracks.

Up to half of all those with mental health problems may also be addicted to drugs or alcohol, according to international surveys.

They are more likely to be violent, to attempt suicide, to be homeless and to be infected with HIV or other illnesses. Yet those mentally ill and addicted are not being treated for both across the country.

Changes to the way mental health and addiction services are co-ordinated have been recommended by the National Advisory Committee on Drugs (NACD).

A report, by a team of researchers from Dublin City University, revealed that only one fifth of services catered for those who are mentally ill and addicted to drugs. This is despite the international surveys that suggest between a quarter and a half of all those suffering from poor mental health also have addiction problems.

“Access to services is limited because of exclusion criteria which are applied to people with a dual diagnosis in both addiction (58%) and mental health services (43%),” the report said.

Dr Eamon Keenan, a consultant psychiatrist and member of the NACD, cited the example of an individual on a drug programme who is not regarded as drug free while still on anti-depressants.

Some mental institutions have no methadone programmes so that a patient sometimes has to leave a facility to go to a clinic.

Addicts with mental health problems can find themselves without any service if substance abuse is the primary disorder, if violent behaviour is present or if it is thought a person is unable to cope with the rigours of treatment, because of either mental stress or addiction.

Launching the report, junior minister Noel Ahern, who has responsibility for drug strategy, said: “Prevalence can range from as many as one in two to one in four people with a mental health disorder who can also have a substance abuse disorder. There is obviously reason for concern.”

The NACD recommends the establishment of a committee to develop guidelines for dual diagnosis, that psychiatric patients on methadone should be allowed to continue on that prescription and that there be improved training and education.