Interprofessional relationships in dual diagnosis discourse in an Australian State: are we respecting each other yet?

Roberts, Bridget

doi:10.1080/17523281.2011.618995

Cited by 6 publications

(10 citation statements)

References 18 publications

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“…Many sectors of care aspire to provide client-centred care [37], and so client-centred care can be a common point of consensus from which agency and worker relationships are developed.…”

Section: Level 2: Organisationalmentioning

confidence: 99%

“…Indeed, one of the major barriers to integration is professional boundaries and territorialism [37], compounded by competitiveness between agencies.…”

Section: Level 3: Service Deliverymentioning

confidence: 99%

“…The development of networks and joint events around shared interests are examples that Roberts [37] and Lee et al [30] identified as ways of overcoming professional boundaries, and providing opportunities to share knowledge. Participants in Roberts’ [37] study recalled how groups advocating for better care for clients with AOD and mental health issues (dual diagnosis) and dual diagnosis projects (such as organising training, conferences, and lobbying) arose from the ground-up by interested clinicians, consumers and carers networking around a common purpose.…”

Section: Level 3: Service Deliverymentioning

confidence: 99%

“…Participants in Roberts’ [37] study recalled how groups advocating for better care for clients with AOD and mental health issues (dual diagnosis) and dual diagnosis projects (such as organising training, conferences, and lobbying) arose from the ground-up by interested clinicians, consumers and carers networking around a common purpose. However, the challenge with informal relationships developed between staff that do not materialise into formal relationships, is that they are sensitive to staff movements and departures.…”

Section: Level 3: Service Deliverymentioning

confidence: 99%

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Strategies to facilitate integrated care for people with alcohol and other drug problems: a systematic review

Savic

Best

Manning

et al. 2017

Subst Abuse Treat Prev Policy

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BackgroundThere is a growing body of research highlighting the potential benefits of integrated care as a way of addressing the needs of people with alcohol and other drug (AOD) problems, given the broad range of other issues clients often experience. However, there has been little academic attention on the strategies that treatment systems, agencies and clinicians could implement to facilitate integrated care.MethodsWe synthesised the existing evidence on strategies to improve integrated care in an AOD treatment context by conducting a systematic review of the literature. We searched major academic databases for peer-reviewed articles that evaluated strategies that contribute to integrated care in an AOD context between 1990 and 2014. Over 2600 articles were identified, of which 14 met the study inclusion criteria of reporting on an empirical study to evaluate the implementation of integrated care strategies. The types of strategies utilised in included articles were then synthesised.ResultsWe identified a number of interconnected strategies at the funding, organisational, service delivery and clinical levels. Ensuring that integrated care is included within service specifications of commissioning bodies and is adequately funded was found to be critical in effective integration. Cultivating positive inter-agency relationships underpinned and enabled the implementation of most strategies identified. Staff training in identifying and responding to needs beyond clinicians’ primary area of expertise was considered important at a service level. However, some studies highlight the need to move beyond discrete training events and towards longer term coaching-type activities focussed on implementation and capacity building. Sharing of client information (subject to informed consent) was critical for most integrated care strategies. Case-management was found to be a particularly good approach to responding to the needs of clients with multiple and complex needs. At the clinical level, screening in areas beyond a clinician's primary area of practice was a common strategy for facilitating referral and integrated care, as was joint care planning.ConclusionDespite considerable limitations and gaps in the literature in terms of the evaluation of integrated care strategies, particularly between AOD services, our review highlights several strategies that could be useful at multiple levels. Given the interconnectedness of integrated care strategies identified, implementation of multi-level strategies rather than single strategies is likely to be preferable.Electronic supplementary materialThe online version of this article (doi:10.1186/s13011-017-0104-7) contains supplementary material, which is available to authorized users.

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“…Many sectors of care aspire to provide client-centred care [37], and so client-centred care can be a common point of consensus from which agency and worker relationships are developed.…”

Section: Level 2: Organisationalmentioning

confidence: 99%

“…Indeed, one of the major barriers to integration is professional boundaries and territorialism [37], compounded by competitiveness between agencies.…”

Section: Level 3: Service Deliverymentioning

confidence: 99%

Section: Level 3: Service Deliverymentioning

confidence: 99%

Section: Level 3: Service Deliverymentioning

confidence: 99%

See 2 more Smart Citations

Strategies to facilitate integrated care for people with alcohol and other drug problems: a systematic review

Savic

Best

Manning

et al. 2017

Subst Abuse Treat Prev Policy

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“…This can be explained by the fact that substance-use disorder care is less related to medical treatment than other health problems [52]. The entrenched stigmatisation of individuals with substance-use disorders [6263] also explains why few resources are invested in programmes for this population.…”

Section: Discussionmentioning

confidence: 99%

Implementing Key Strategies for Successful Network Integration in the Quebec Substance-Use Disorders Programme

Fleury

Perreault

Grenier

et al. 2016

International Journal of Integrated Care

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Background: Fragmentation and lack of coordination often occur among organisations offering treatment for individuals with substance-use disorders. Better integration from a system perspective within a network of organisations offering substance-use disorder services can be developed using various integration strategies at the administrative and clinical levels.This study aims to identify integration strategies implemented in Quebec substance-use disorder networks and to assess their strengths and limitations.Methods: A total of 105 stakeholders representing two regions and four local substance-use disorder networks participated in focus groups or individual interviews. Thematic qualitative and descriptive quantitative analyses were conducted.Results: Six types of service integration strategies have been implemented to varying degrees in substance-use disorder networks. They are: 1) coordination activities-governance, 2) primary-care consolidation models, 3) information and monitoring management tools, 4) service coordination strategies, 5) clinical evaluation tools and 6) training activities.Conclusion: Important investments have been made in Quebec for the training and assessment of individuals with substance-use disorders, particularly in terms of support for emergency room liaison teams and the introduction of standardised clinical evaluation tools. However, the development of integration strategies was insufficient to ensure the implementation of successful networks. Planning, consolidation of primary care for substance-use disorders and systematic implementation of various clinical and administrative integration strategies are needed in order to ensure a better continuum of care for individuals with substance-use disorders.

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Reflections on capacity‐building initiatives in an Australian state

Roberts

Maybery²,

Jones

2013

Advances in Dual Diagnosis

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Purpose: The integration of health or social services is an enduring challenge and especially so in relation to the people experiencing 'dual diagnosis', the co-occurrence of mental health and substance use problems. The emergence of the 'dual diagnosis' concept has highlighted the tension between specialist treatment for single problems and complex, individualised care. This paper examines the evolving nature of dual diagnosis initiatives in an Australian state during recent decades. Approach: Interpretive, case study analysis of policy documents and key informant interviews (19) illuminates the experience of dual diagnosis initiatives. Findings: In the case of Victoria, dual diagnosis responsiveness has evolved slowly over the last 20 years, delayed by the inherent difficulty of practice change, a weak perception of need, interprofessional tensions and shortcomings in data collection, coordination and resources. Key enablers have been champions and leaders in policy, management and clinical practice, directive government policy and targeted funding. Achieving a wrap-around service system entails investment in interpersonal relationship-building and stigma reduction as well as technical or structural changes. Value: A unique and independent view of a twenty year period indicates progress in attitudinal change that merits wider acknowledgement and application to other settings throughout health and social care.

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Interprofessional relationships in dual diagnosis discourse in an Australian State: are we respecting each other yet?

Cited by 6 publications

References 18 publications

Strategies to facilitate integrated care for people with alcohol and other drug problems: a systematic review

Strategies to facilitate integrated care for people with alcohol and other drug problems: a systematic review

Implementing Key Strategies for Successful Network Integration in the Quebec Substance-Use Disorders Programme

Reflections on capacity‐building initiatives in an Australian state

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