RCPsych report shows people with substance use & mental health disorders suffering harm after being excluded from care.
A new report, developed by the Royal College of Psychiatrists’ working group on co-occurring substance use and mental health disorders (CoSUM), shows that people with substance use and mental health disorders are being failed by a system that is not designed or equipped to meet their complex needs.
The working group, which includes a number of South London and Maudsley representatives, including Chief Medical Officer, Professor Derek Tracy, Clinical Director of the Addictions Clinical Advisory Group, Dr Emily Finch, and Dr Jenny Drife who is also a co-author of the report and is consultant in charge of the Trust’s homelessness service, found that people with CoSUM experience poorer health, poorer engagement with work, and higher mortality and suicide rates than those who have an individual mental illness or substance use disorder.
Dr Emily Finch, who co-authored the report and is also the Chair of the Royal College of Psychiatrists Addictions Faculty, said: “Anyone can develop an addiction, but no one chooses to. It’s vital that we shift from a culture of blame to one of compassion.
“People who struggle with alcohol and drug misuse often have underlying trauma and suffering that makes it difficult to cope with their thoughts and emotions. This can be connected to a range of experiences from bullying and abuse to poverty, discrimination and loneliness and lead to mental health problems.
“It takes tremendous courage to seek help and accessing services should not be a barrier to care. I’ve seen firsthand how beneficial joined up support can be, and we must ensure nobody is excluded from the care they need.”
The report looks at the relationship between different patterns and types of substance use and mental health issues and focuses on severity as a way of understanding where individuals may be best able to access the right interventions for them.
The College is also calling on all health and local authority commissioners to ensure the number of people with CoSUM disorders, and their outcomes, are routinely monitored. This will help improve understanding the scale of the issue while supporting better resource allocation and strategic planning.
Clinical Director of the Forensic Services at the Trust and President of the Royal College of Psychiatry, Dr Lade Smith CBE, said: “People with substance use issues often have a co-existing mental illness and it is not uncommon for people with mental illness to have a problem with alcohol or substance use.
“A person might have an addiction to alcohol or ketamine that is linked to post-traumatic stress disorder. They are often bounced from one service to another, only being offered support for one condition at a time, as most services lack the specialist skills and resources needed to treat all their illnesses together. The consequence is that people only get sicker which is why we need trained and experienced staff who can provide care and treatment in one place.”
The report is aimed at helping the general public, healthcare professionals and commissioners to better understand CoSUM and has recommendations for how people can be better cared for. It includes detailed information about these illnesses, how they can be treated and shares accounts from people who have personally experienced them.
South London and Maudsley NHS Foundation Trust has a number of services to support dual diagnosis work including our Naloxone service, our ketamine clinic and our cannabis clinic.
