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  • Title: Co-morbid drug and alcohol and mental health issues in a rural New South Wales Area Health Service.
    Author: Hoolahan B, Kelly B, Stain HJ, Killen D.
    Journal: Aust J Rural Health; 2006 Aug; 14(4):148-53. PubMed ID: 16911163.
    Abstract:
    OBJECTIVE: In 2003 the New South Wales (NSW) Centre for Rural and Remote Mental Health (CRRMH) conducted an analysis of co-morbid drug and alcohol (D&A) and mental health issues for service providers and consumers in a rural NSW Area Health Service. This paper will discuss concerns raised by rural service providers and consumers regarding the care of people with co-morbid D&A and mental health disorders. DESIGN: Current literature on co-morbidity was reviewed, and local area clinical data were examined to estimate the prevalence of D&A disorders within the mental health service. Focus groups were held with service providers and consumer support groups regarding strengths and gaps in service provision. SETTING: A rural Area Health Service in NSW. PARTICIPANTS: Rural health and welfare service providers, consumers with co-morbid D&A and mental health disorders. RESULTS: Data for the rural area showed that 43% of inpatient and 20% of ambulatory mental health admissions had problem drinking or drug-taking. Information gathered from the focus groups indicated a reasonable level of awareness of co-morbidity, and change underway to better meet client needs; however, the results indicated a lack of formalised care coordination, unclear treatment pathways, and a lack of specialist care and resources. DISCUSSION: Significant gaps in the provision of appropriate care for people with co-morbid D&A and mental health disorders were identified. Allocation of service responsibly for these clients was unclear. It is recommended that D&A, mental health and primary care services collaborate to address the needs of clients so that a coordinated and systematic approach to co-morbid care can be provided.
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