Improving care pathways for adults with substance use and mental health problems
Tackling dual diagnosis: improving joined-up care through research
Substance use and mental health problems commonly coexist in adults, and the relationship between them is complex.
In comparison with adults presenting with a single disorder, those with both have a heightened risk of additional health problems and premature death, including increased risks of self-harm and suicide.
There is uncertainty about the level of unmet needs of people attending emergency departments with substance use and mental health problems. People with these problems are usually offered fragmented care that is ineffective and leads to poor outcomes.
Through this research, we are working with service-users and key stakeholders to involve them in developing and implementing our research activities. Together, we will use existing evidence to identify, co-produce, and refine care models that could be delivered within existing services.
'Place of Safety'
Under Section 136 (S136) of the UK Mental Health Act, people who experience a mental health emergency may be detained by the police and conveyed to a 'Place of Safety' for an urgent assessment of their needs.
It is recommended that integrated treatment in the UK be delivered by existing mental health services, following training and with support from substance misuse services.
We know there is a high prevalence of those with substance use disorder and mental health problems presenting to a ‘Place of Safety’.
Previous studies have identified that alcohol has a disproportionate impact on emergency departments and is associated with half of all presentations involving self-harm, overdoses and poisonings.
Optimised care
We are working with key stakeholders, including service-users, professionals and commissioners, we are bringing together evidence to co-produce and trial optimised models of care that could be delivered within existing services.
We are defining the population, reviewing routine data from current pathways and exploring experiences of care to find the gap in care needs for adults with co-existing substance use disorders and mental health problems.
This research will take place across six localities: the East Riding of Yorkshire, Hull, North-East Lincolnshire, North Lincolnshire, North Yorkshire, and York.
Patient and public involvement and stakeholder engagement
Our patient and public involvement advisory groups consist of adults with lived experience of substance use disorders and mental health problems who either present to 'Places of Safety' and emergency departments or are signposted into the research by carer organisations offering support services.
The groups are made up of people across the six integrated care board local authorities.
Our key stakeholder group is made up of representatives from key services, including addiction, adult mental health, psychiatric liaison services, hospital settings for example emergency departments and S136 suites, police and criminal justice teams, carer organisations, clinicians, voluntary, community and social enterprise services, commissioners, and policymakers.
This diverse group provides insights into care and care pathways and provides key data sources.
Work packages
Core team
| Name | Role |
|---|---|
| Professor Thomas Philips | Professor of Nursing in Addictions and Director, Centre for Addiction and Mental Health Research, University of Hull (Theme Lead) |
| Dr Tyler Mills | Research Fellow, Centre for Addiction and Mental Health Research, University of Hull (Theme Coordinator) |
| Dr Jo Bell | Reader in Mental Health, Suicide Prevention, Trauma and Loss, University of Hull |
| Sarah Capes | Patient and Public Involvement and Engagement Coordinator, Centre for Addiction and Mental Health Research, University of Hull |
| Professor Judith Cohen | Director, Hull Health Trials Unit and Co-director, Centre for Addiction and Mental Health Research, University of Hull |
| Professor Simon Coulton | Professor of Health Services Research, University of Kent |
| Professor Colin Drummond | Professor of Addiction Psychiatry, King’s College London |
| Alison Sharpe | Public Co-applicant, University of Hull |
| Dr Laura Voss | Consultant Liaison Psychiatrist and HYMS Honorary Senior Lecturer, Humber Teaching NHS Foundation Trust |
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