Dual Diagnosis in the U.K

Smith, Jeffery A.; Frazer, Sheila; Boer, Harm; Donovan, Martin

doi:10.1176/ps.45.3.280

Cited by 6 publications

(4 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…One British study of a forensic psychiatric service in south‐west England provided preliminary, and therefore limited, data. Smith et al (1994) investigated all patients (33 total, 29 men, 4 women) who were admitted to the Devon and Cornwall medium secure unit during 1991 for a history of drug/alcohol use. A substance misuse or dependency history was found in 18 of the patients, or 54.5%.…”

Section: Forensic Psychiatric Datamentioning

confidence: 99%

Substance misuse, offending and mental illness: a review

Phillips

2000

Psychiatric Ment Health Nurs

View full text Add to dashboard Cite

The literature concerning the associations between violence, mental disorder, comorbidity and substance misuse are discussed in this review, which focuses on the findings of several international studies that demonstrate significantly higher rates of violence in substance misuse and dual diagnosis (when compared with 'single' diagnosis groups). The need for the development of an effective psychiatric nursing response in terms of assessment, liaison and joint clinical management approaches to those with a dual diagnosis is discussed in the context of United Kingdom Government legislation and policy in both forensic mental health services, and in statutory substance misuse services.

show abstract

Section: Forensic Psychiatric Datamentioning

confidence: 99%

Substance misuse, offending and mental illness: a review

Phillips

2000

Psychiatric Ment Health Nurs

View full text Add to dashboard Cite

show abstract

“…Prevalence studies of comorbidity (concurrent psychiatric disorder and substance abuse disorder) in the psychiatric population have found varying results from 29% substance misuse in patients with depression (Grant, 1995) to over 65% in patients with schizophrenia (Mueser et al, 1990). A study of patients in a medium secure unit found just over 50% of patients with a history of alcohol or drug abuse (Smith et al, 1994). Alternatively, Singleton et al (1998) found an alcohol abuse prevalence rate of 58% in male remand prisoners and of 63% in male sentenced prisoners.…”

Section: Discussionmentioning

confidence: 99%

The Detection and Treatment of Substance Abuse in Offenders with Major Mental Illness: An intervention study

et al. 2004

View full text Add to dashboard Cite

Previous research demonstrated that alcohol and drug misuse prior to admission to special (high and medium) security psychiatric care in Scotland was high. Evidence from clinical practice subsequently suggested that the situation was worsening. In response, a three-pronged strategy was implemented: staff were trained in alcohol and drug issues in mentally disordered offenders, an admission screening programme was introduced to detect those at risk, and specific interventions were developed. This paper presents data on the admission screening programme and on a specific intervention. Study 1 describes the admission data on 86 male patients admitted to the State Hospital, Carstairs. It confirmed that alcohol (81%) and drug (75%) misuse were rising in this population. Combined drug and alcohol abuse was common resulting in the development of joint treatment interventions. Study 2 describes an eight-week drug and alcohol education and awareness programme. An evaluation of this intervention showed that subjects' knowledge of alcohol and drug issues rose significantly pre to post-intervention. However no difference was found in the stage of change or locus of control measures. A number of possible explanations for this finding are discussed, including the validity of the instruments and the effect of detainment in a high security psychiatric environment on the opportunity to change. In spite of the limitations of the environment, the prevalence of alcohol and drug misuse and its association with violence emphasise the need for specific programmes.

show abstract

“…There is clear evidence that substance (alcohol or illicit drug) misuse is a major risk factor for violence in individuals with mental disorder (Lindqvist and Allebeck, 1989;Swanson, Holzer, Ganju and Jono, 1990;Hodgins, 1992;Swanson, 1993;Smith, Frazer, Boer and Donovan, 1994;Swanson, 1994;Eronen, Tiihonen and Hakola, 1996;Fulwiler, Grossman, Forbes and Ruthazer, 1997;Tiihonen, Isohanni, Rasenen, Koiranen and Moring, 1997;Scott et al, 1998;Steadman et al, 1998;Wheatley, 1998;Soyka, 2000;Monahan et al, 2001). Despite this, until recently, there was a dearth of research on substance misuse in high security hospital patients.…”

Section: Introductionmentioning

confidence: 99%

Substance misuse in a high security hospital: Three years of urine drug testing at the State Hospital, Carstairs

MacIntyre

McNamara²,

Irwin³

et al. 2004

Journal of Forensic Psychiatry & Psychology

View full text Add to dashboard Cite

With the increasing evidence for the significant contribution to violence made by alcohol and drug misuse in people with mental disorder, there is emerging evidence of the importance and increasing prevalence of substance misuse problems in patients admitted to high security hospitals in the UK. Recorded routine voluntary urine drug screening of patients at the State Hospital, the high security hospital for Scotland and Northern Ireland, started in 1998. Results of urinalysis over the 3 years from 1 January 1999 to 31 December 2001 were examined. Out of 7,069 samples sent from 421 patients there were 712 (10.1%) positive results. The majority were false positives (672; 9.5%) due to prescribed medication, with only 40 (0.6%) true positives. All the true positive results in the admission unit were related to substance misuse prior to admission, the remaining true positive results were all within the continuing care wards, with no true positives in the rehabilitation wards. Even though the testing was not truly random, it is likely that the findings reflect extremely low levels of substance misuse within the hospital in contrast with findings from UK prisons. Whether urine testing contributes to the prevention of drug misuse within the hospital is unclear, and there are potential ethical and legal concerns about the urine testing process. It is important that high security hospitals are virtually drug free, to enable the uncontaminated assessment and treatment of mentally disordered offenders.

show abstract

Dual Diagnosis in the U.K

Cited by 6 publications

References 2 publications

Substance misuse, offending and mental illness: a review

Substance misuse, offending and mental illness: a review

The Detection and Treatment of Substance Abuse in Offenders with Major Mental Illness: An intervention study

Substance misuse in a high security hospital: Three years of urine drug testing at the State Hospital, Carstairs

Contact Info

Product

Resources

About