S75: Dual Diagnosis in Regional Victoria: Bridging the Silos

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By September 12, 2019 No Comments

Authors: Remi Briody, Ivan Thorne, Sylvia Alberti

Year: 2019

Event: 2019 TheMHS Conference

Subject: Dual Diagnosis in Regional Victoria: Bridging the Silos

Type of resource: Conference Presentations and Papers



Remi Briody is a registered senior Clinical Psychologist at Uniting Ballarat with 10 years experience in working in mental health in regional and rural Victoria.
Due to a strong background working in clinical services, Remi has a passion for appropriate process and policy development to support clients and their clinicians.

Ivan Thorne has worked in the Community/Health sector for 34 years, across New Zealand and Australia. He joined the Community Service sector 20 years ago in leadership roles within Community Mental Health, Victims of Crime, Disability Services, Youth Mental Health and Youth Withdrawal. This included teaching the Certificate and Diploma for AOD and Mental Health. Ivan’s interest in Dual Diagnosis work, and how this applies in youth services, has led him to present several papers on the effects of substance misuse on young people with the belief that this cohort of client needs a holistic approach to treatment. Ivan’s current role as Manager of Wellbeing Services for Uniting Ballarat oversees a Dual Diagnosis Clinic, Youth Withdrawal Service and other AOD and MH residence- and community-based treatment services.

The health services system is typically structured to respond to specific singular needs. This is problematic for individuals with co-morbid substance misuse and mental health conditions, particularly in regional/rural areas. Often people with dual diagnosis concerns face fragmented responses and have slipped between the gaps of mainstream health systems and AOD services with different parts of the system focusing on addressing each issue in isolation.

This negatively impacts client wellbeing as well as impacting treatment effectiveness. It’s further complicated in regional areas as tertiary mental health services are not required to treat AOD issues, however, are often the primary point of contact for many service users.

This challenging set of circumstances provided the impetus for the development of the Dual Diagnosis Clinic at Uniting in Ballarat. We determined that there was a significant need to establish a clear service whose primary function is to actively address both mental health and substance use issues concurrently within a multidisciplinary team.

Uniting has established the first clinic which has a Dual AOD /MH focus as the core specialisation under a bulk billing service.

Learning Objectives
Learning Objective 1: This paper aims to discuss the successes and challenges of setting up a Dual Diagnosis Clinic in regional Victoria; providing an insight into how to establish in other rural remote catchments
Learning Objective 2: The issue of comorbid health conditions is prevalent topic across healthcare & is particularly relevant for mental health- whereby issues are often addressed in isolation.
Additionally, many clients who present with comorbid conditions often have multiple clinicians involved in their care- which can be confusing and not therapeutically beneficial.
The development of the Dual diagnosis, bulk billing clinic within Uniting Ballarat aims to address comorbid conditions concurrently, thereby reducing the burden on accessing services to the client.

Staiger, P.K; Thomas, A.C; Ricciardelli, L.A; Mccabe, M.P.; Cross, W.; & Young, G. (2011). Improving services for individuals with a dual diagnosis: A qualitative study reporting on the views of service users. Addiction Research and Theory, 19(1): 47–55.
Barnes, L. & Rudge, T. (2003). Co-operation and co-morbidity: Managing dual diagnosis in rural South Australia. Collegian Vol 10 (2)

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