Mental health among clients of the Sydney Medically Supervised Injecting Centre (MSIC)

Abstract

The Sydney Medically Supervised Injecting Centre (MSIC) is a supervised injecting facility (SIF) where people who inject drugs (PWID) can do so legally, under health professional supervision. The majority of clients have low levels of education and employment, high rates of incarceration and unstable housing and poor social networks, and 70 % do not access local health services. These factors increase the risk of poor mental health, and it has been documented that PWID have elevated rates of mood, anxiety, personality and psychotic disorders; post-traumatic stress disorder (PTSD); and higher rates of trauma exposure, suicidality and self-harm. The current study is the first to investigate the mental health among clients of a SIF. Validated instruments to examine clients’ mental health, social networks and trauma histories were administered to 50 frequently attending clients by a mental health nurse. The majority of respondents were unemployed, homeless and had a history of incarceration, and 82 % report they had been diagnosed with a mental health problem, but only 24 % report they were receiving treatment. Respondents had poor social networks, had poorer mental health symptoms compared to US inpatients and had experienced multiple traumatic events, and a high number of respondents had scores indicative of PTSD. These results highlight the need for mental health clinicians to be employed in SIFs and other drug consumption rooms (DCRs) to assist clients to address their mental health and psychosocial needs, particularly in light of the fact that these services are often the only places these PWID engage with in an ongoing way.

Drug consumption rooms: A systematic review of evaluation methodologies

“…The majority of the evaluation papers were published between 2005 and 2011 (Figure ) and most were from Canada (Figure ). Since 2006, more papers described DCR/SIF clients or service operation . Also, after 2006, papers using qualitative methods have spiked including those focused on DCR clients or staff , and on other stakeholders .…”

Common mental disorders and resilience in homeless persons

“…Resilience means the ability to recover from life adverse situations (10) , and it is expressed in the presence of risk factors; there will be no resilience without risk. Risk has the potential to predispose people and populations to negative results, and may be present in both individual and environmental characteristics.…”

How to overcome political and legal barriers to the implementation of a drug consumption room: an application of the policy agenda framework to the Belgian situation

“…For this group, DCRs aim to reduce the risk of transmission of blood-borne infections, to reduce the likelihood of morbidity and mortality resulting from overdose, and to help PWUD avoid other harms associated with drug consumption under unhygienic or unsafe conditions [4, 5, 7, 10]. DCRs also aim to reach and maintain contact with socially marginalised groups and to facilitate access to health and social services, including addiction treatment programmes [11–16]. In terms of public safety, DCRs aim to contribute to a reduction in drug use in public places and in the presence of discarded needles and other related public order problems linked with open drug scenes [7, 17].…”