Maturing out, natural recovery, and dual diagnosis: What are the implications for older adult mental health services?

Searby, Adam; Maude, Phil; McGrath, Ian

doi:10.1111/inm.12143

Cited by 3 publications

(2 citation statements)

References 41 publications

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“…The mean drinking per day reported was 8.5 drinks, so many people may quit by switching to alcohol, even though 35% reported that alcohol was a trigger (Toneatto et al, 1999). One study suggests that many older, dually diagnosed adults do not recover without treatment (Searby et al, 2015).…”

Section: Cocainementioning

confidence: 99%

Self-guided Change: The most common form of long-term, maintained health behavior change

Bishop

2018

Health Psychology Open

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Millions of people change risky, health-related behaviors and maintain those changes. However, they often take years to change, and their unhealthy behaviors may harm themselves and others and constitute a significant cost to society. A review—similar in nature to a scoping review—was done of the literature related to long-term health behavior change in six areas: alcohol, cocaine and heroin misuse, gambling, smoking, and overeating. Based on the limited research available, reasons for change and strategies for changing and for maintaining change were also reviewed. Fifty years of research clearly indicate that as people age, in the case of alcohol, heroin and cocaine misuse, smoking, and gambling, 80–90 percent moderate or stop their unhealthy behaviors. The one exception is overeating; only 20 percent maintain their weight loss. Most of these changes, when they occur, appear to be the result of self-guided change. More ways to accelerate self-guided, health-related behavior change need to be developed and disseminated.

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Section: Cocainementioning

confidence: 99%

Self-guided Change: The most common form of long-term, maintained health behavior change

Bishop

2018

Health Psychology Open

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“…Despite these findings, little research explores dual diagnosis in the older adult (65 years and over) population. Older adults pose substantial challenges in respect of screening and assessment of alcohol and other drug (AOD) use, and have been labelled the “invisible addicts” as their presentations may differ markedly from their younger counterparts (Crome et al ; Searby et al ).…”

Section: Introductionmentioning

confidence: 99%

Prevalence of co‐occurring alcohol and other drug use in an Australian older adult mental health service

Searby

Maude

McGrath

2016

Int J Mental Health Nurs

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Co-occurring mental illness and substance use disorder, known as dual diagnosis, is a significant challenge to mental health services. Few older adult specific alcohol and other drug treatment services exist, meaning older adult mental health services may become the default treatment option for many. Evidence suggests that dual diagnosis leads to substandard treatment outcomes, including higher rates of psychiatric relapse, higher costs of care and poorer treatment engagement. This paper explores the prevalence of co-occurring alcohol and other drug (AOD) use in an older adult community mental health service in inner Melbourne, Australia. This aim was accomplished by using a retrospective file audit of clinical intake assessments (n = 593) performed on consumers presenting to the service over a two-year period, June 2012-2014. Of consumers presenting to the service, 15.5% (n = 92) were assessed by clinicians as having co-occurring AOD use. Depression predominated in the dual diagnosis group as the primary mental health disorder. Dual diagnosis consumers in this sample were statistically more likely to be male and younger than their non-dual diagnosis counterparts. A limitation of this audit was the lack of implementation of screening tools, leaving assessment to clinical judgement or the interest of the clinician. This may also explain the discrepancy between the results of this study and previous work. Although appearing to be a relatively small percentage of assessments, the results accounted for 92 individuals with complex mental health, AOD and medical issues. Poor screening procedures in a population that is traditionally difficult to assess need to be rectified to meet the future challenges inherent in the ageing baby boomer generation, changing drug use trends and extended lifespans through harm reduction initiatives and medical advancements.

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The Experiences of Clinicians Caring for Older Adults with Dual Diagnosis: An Exploratory Study

Searby

Maude

McGrath

2017

Issues in Mental Health Nursing

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Dual diagnosis has been identified as a significant challenge to mental health services, resulting in higher rates of psychiatric relapse and greater illness severity. Much research explores dual diagnosis in the adult mental health cohort, however little research attention has been paid to older adults with dual diagnosis. Far from being a trivial issue, preliminary studies have shown that dual diagnosis in older adults is under diagnosed and poorly identified by clinicians with few specific treatment options available. In addition, studies of the ageing baby boomer cohort demonstrate a potential for dual diagnosis presentations to increase in the coming years. This article explores the experiences of a clinical team providing care to older adults with dual diagnosis in Melbourne, Australia, through a semi-structured interview process. The participants described a number of systemic barriers to providing care to the older adults with dual diagnosis presenting to the mental health service, in addition to feeling poorly prepared and expressing a degree of clinical helplessness. Additionally, the participants described service improvement, which included a strong dual diagnosis culture in the leadership team of the mental health service and role modelling dual diagnosis competent practice among clinicians.

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Maturing out, natural recovery, and dual diagnosis: What are the implications for older adult mental health services?

Cited by 3 publications

References 41 publications

Self-guided Change: The most common form of long-term, maintained health behavior change

Self-guided Change: The most common form of long-term, maintained health behavior change

Prevalence of co‐occurring alcohol and other drug use in an Australian older adult mental health service

The Experiences of Clinicians Caring for Older Adults with Dual Diagnosis: An Exploratory Study

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