TY - JOUR
T1 - Care planning and nonpharmacological interventions in a metropolitan inpatient dual diagnosis service
T2 - A retrospective exploratory study
AU - MacLeay, Euan
AU - Fry, Margaret
AU - Roche, Michael Anthony
AU - Montilla, Tim
N1 - Funding Information:
The researchers would like to acknowledge the support of managers, staff, and colleagues throughout the Mental Health Drug and Alcohol Directorate and Northern Sydney Local Health District. The work required for the study was conducted in salaried time. Their generosity with their time in sharing their experience and knowledge was invaluable.
Publisher Copyright:
© 2020 Australian College of Mental Health Nurses Inc.
PY - 2020/10/1
Y1 - 2020/10/1
N2 - In Australia, the terms dual diagnosis and comorbidity are commonly used, often interchangeably, to describe the experience of consumers with both mental health difficulties and difficulties with alcohol and other drug use. Consumers with comorbidity often have complex needs that require comprehensive assessment, multidisciplinary team support, and trauma-focused management. More information about the demographics of consumers admitted with comorbidity, and the documented assessed needs, care, and interventions provided, would provide the foundations for working towards improved quality and continuity of care. Therefore, the aim of this study was to explore the documentation of inpatient assessment, care, and interventions provided to people with comorbidity. The research design was a retrospective exploratory study, and data collection involved a 12-month healthcare record audit. Forty-one records were screened, and 36 consumer healthcare records were identified as eligible for inclusion in the study. Most consumers (n = 34, 94%) were admitted on an involuntary basis, and 8 (22.2%) were female. Consumers had a median length of stay of almost six months. In most healthcare records, there was no documented evidence of care planning involvement by consumers or the multidisciplinary team. There was great variance in the delivery of nonpharmacological interventions. Most consumers did not receive trauma-focused assessment or intervention, and assessment tools were often incomplete with outcome measures poorly documented. This study has demonstrated significant gaps in consumer and multidisciplinary engagement with care planning and goal setting. There was poor documentation of comprehensive assessment and nonpharmacological interventions.
AB - In Australia, the terms dual diagnosis and comorbidity are commonly used, often interchangeably, to describe the experience of consumers with both mental health difficulties and difficulties with alcohol and other drug use. Consumers with comorbidity often have complex needs that require comprehensive assessment, multidisciplinary team support, and trauma-focused management. More information about the demographics of consumers admitted with comorbidity, and the documented assessed needs, care, and interventions provided, would provide the foundations for working towards improved quality and continuity of care. Therefore, the aim of this study was to explore the documentation of inpatient assessment, care, and interventions provided to people with comorbidity. The research design was a retrospective exploratory study, and data collection involved a 12-month healthcare record audit. Forty-one records were screened, and 36 consumer healthcare records were identified as eligible for inclusion in the study. Most consumers (n = 34, 94%) were admitted on an involuntary basis, and 8 (22.2%) were female. Consumers had a median length of stay of almost six months. In most healthcare records, there was no documented evidence of care planning involvement by consumers or the multidisciplinary team. There was great variance in the delivery of nonpharmacological interventions. Most consumers did not receive trauma-focused assessment or intervention, and assessment tools were often incomplete with outcome measures poorly documented. This study has demonstrated significant gaps in consumer and multidisciplinary engagement with care planning and goal setting. There was poor documentation of comprehensive assessment and nonpharmacological interventions.
KW - adult
KW - comorbidity
KW - dual diagnosis
KW - mental health
KW - substance-related disorders
UR - http://www.scopus.com/inward/record.url?scp=85082928463&partnerID=8YFLogxK
U2 - 10.1111/inm.12719
DO - 10.1111/inm.12719
M3 - Article
C2 - 32243035
AN - SCOPUS:85082928463
SN - 1445-8330
VL - 29
SP - 856
EP - 867
JO - International Journal of Mental Health Nursing
JF - International Journal of Mental Health Nursing
IS - 5
ER -