Assessing and responding to hazardous and risky alcohol and other drug use: The practice, knowledge and attitudes of staff working in mental health services

Abstract

Introduction: Comorbidity of mental illness and alcohol and other drugs (AOD) raises workforce challenges in terms of appropriate knowledge, skills and attitudes required for delivering best care. Aim: (1) To assess the knowledge, skills and attitudes of mental health staff in relation to AOD use and (2) to inform development of training to provide effective screening and interventions for people with both mental health and AOD problems (co-morbidity). Method: Quantitative survey of knowledge, skills and attitudes regarding AOD issues completed by multidisciplinary mental health staff (n ¼ 104/218) working across acute and community settings. Results: A 47.7% response rate was achieved. Generally staff held positive attitudes and motivation towards working with people with comorbidity, but there was an absence of formal training, experience or knowledge. Most staff believed they could deal with AOD issues; however, confidence was higher with assessment over AOD-related interventions (brief interventions, motivational approaches and goal setting) and only 24% of staff correctly identified standard drinks. Most staff recognized that AOD assessment and intervention is part of their role and access to training would facilitate their ability to improve service to mental health consumers. Conclusion: Integrated care for people with comorbidity requires mental health service providers to address identified gaps in clinician's knowledge, skills and attitudes with training in relation to AOD. To ensure effective training uptake and implementation, workforce leaders need to target identified barriers with initiatives such as support, mentoring and appropriate tools in relation to AOD.

A Narrative Analysis of the Experiences of Barangay Officials Involved in Community-Based Drug Rehabilitation

“…In addition, their interactions with clients made them less judgmental of drug users. This finding is consistent with studies that show that health workers who have received training and worked with recovering users have more positive attitudes in dealing with problematic substance use (Wheeler, Crozier, Robinson, Pawlow, & Mihala, 2014). Moreover, this reinforces the value of CBDR not just in helping clients, but also in helping community members understand the complexities of substance use.…”

Impact of a videoconferencing educational programme for the management of concurrent disorders on nurses’ competency development and clinical practice: protocol for a convergent mixed methods study

“…15 However, nurses' difficulties in caring for patients with MH problems who also problematically use alcohol or drugs have been highlighted in numerous studies. [16][17][18] For example, Wener and Woodgate 19 reported that feelings of ambivalence, frustration and powerlessness are common among Canadian primary care nurses who encounter individuals living with CDs. This situation is further exacerbated in rural and remote areas, 20 whereas many nurses frequently feel ill-equipped and emotionally exhausted in addressing the care needs of complex and severe cases of patients with CDs.…”

Mental Health Nurses’ Attitudes towards Consumers with co-Existing Mental Health and Drug and Alcohol Problems: A Scoping Review

“…In mental health settings, the problematic use of drugs and alcohol has frequently been observed as a complicating factor which escalates decline in consumer's wellbeing and results in a relapse of mental health problems (Graham, 2004). A rise in the number of consumers with a dual diagnosis in mental health settings can influence the quality of treatment provided (Wheeler et al, 2014). Pinderup (2018) stated that mental health clinicians' inadequate knowledge of dual diagnosis treatment and their inefficiency in assessing and treating dual diagnosis can hinder the outcome (Pinderup, 2018).…”

“…This review report that clinicians' therapeutic attitudes can predict the efficiency of consumer engagement. However, mental health clinicians attribute lower status to working with consumers who use illicit substance than supporting other consumer groups (Wheeler et al, 2014). Foster and Onyeukwu (2003) reported attitudes towards consumers with substance abuse to have a direct impact on the relationship clinicians have with consumers and the quality of care they deliver.…”

“…Ralley, Allott, Hare, and Wittkowski (2009) stated clinicians' negative attitudes could affect the care and hinder the consumer's recovery from the illness. Moreover, clinicians' stigmatising attitudes towards consumers with substance use illnesses result in negligible care offered to the consumers (Wheeler et al, 2014), and these negative attitudes can be passed on to novice clinicians (Foster & Onyeukwu 2003).…”