The Forgotten Dual Diagnosis Acquired Brain Injury & Mental Illness

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By May 14, 2015 No Comments

Authors: Hopwood M., Cox, C., Johnson, K.

Year: 2002

Event: 2002 TheMHS Conference

Subject: book of proceedings Dual disorders, Austin & Repatriation Medical Centre, Brain Disorders Program., comorbidity,

Type of resource: Conference Presentations and Papers

Abstract: Acquired brain injury (ABI) is a common cause of disability in our community severely affecting over 160,000 Australians (Australian Institute of Health and Welfare, 1999). Recent research indicates that individuals with a history of ABI are at greater risk of developing mental illness and are at increased risk of suicide attempts than those people without ABI (Silver et al., 2001). Clinical experience also supports these findings, suggesting co-morbidities such as depression, psychosis, personality change, substance abuse and impulse control difficulties are common after ABI and add dramatically to overall impairment of quality of life. Consequently, people with mental illness and ABI represent a significant and frequent clinical and service delivery challenge to mental health services and traditional non-psychiatric rehabilitation services. The Brain Disorders Program (BDP) at the Austin and Repatriation Medical Centre (A&RMC) specialises in providing medium to long-term neuropsychiatric rehabilitation for people with ABI and mental health problems in a range of treatment settings including an inpatient service. The team approach is interdisciplinary, including medical, nursing and allied health staff (neuropsychology, occupational therapy, social work). The aim of the service is to complete a thorough and broad assessment, diagnose and stabilise any acute medical or psychiatric component to the person’s presentation and to then put strategies in place to manage ongoing behavioural, cognitive and mental health problems. The end goal is to ensure successful community placement, whether at home, in community housing or some other form of supported accommodation. Given the common occurrence of this often forgotten dual disability, gaining an understanding of the impact of ABI on a person’s mental health and presentation when they are mentally unwell is crucial for professionals in all sectors. This paper provides an outline of the BDP and gives a case example to illustrate the way the components of the service fit together. The case example further highlights some of the service delivery issues, and the way that an individual with an ABI can develop a significant mental health problem.

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