Policies and Reports

This section is where you can find National policies and reports.

This page will show you those specific to co-occurring mental health, alcohol and drug difficulties

Coexisting severe mental illness and substance misuse Quality standard [QS188] Published date: 20 August 2019

This quality standard covers the assessment, management and care provided for people aged 14 and over who have coexisting severe mental illness and substance misuse. It describes high-quality care in priority areas for improvement www.nice.org.uk

Coexisting severe mental illness and substance misuse: community health and social care services NICE guideline [NG58] Published date: 30 November 2016

This guideline covers how to improve services for people aged 14 and above who have been diagnosed as having coexisting severe mental illness and substance misuse. The aim is to provide a range of coordinated services that address people’s wider health and social care needs, as well as other issues such as employment and housing.
www.nice.org.uk

Coexisting severe mental illness (psychosis) and substance misuse: assessment and management in healthcare settings Clinical guideline [CG120] Published date: 23 March 2011


This guideline covers assessing and managing people aged 14 years and over with coexisting severe mental illness (psychosis) and substance misuse. It aims to help healthcare professionals guide people with psychosis with coexisting substance misuse to stabilise, reduce or stop their substance misuse, to improve treatment adherence and outcomes, and to enhance their lives. www.nice.org.uk


Capability Framework: Working effectively with people with co-occurring mental health and alcohol/drug use conditions

This capability framework has been developed to support the implementation of Better care for people with co-occurring mental health and alcohol/drug use conditions:a guide for commissioners and service providers. The guidance, published in 2017, was developed through Public Health England (PHE) by an expert panel to provide an up-to-date guide for commissioners and service providers www.clinks.org

This capability framework has been developed to support the implementation of Better care for people with cooccurring mental health and alcohol/drug use conditions: a guide for commissioners and service providers. The guidance, published in 2017, was developed through Public Health England (PHE) by an expert panel to provide an up-to-date guide for commissioners and service providers www.gov.uk

Older Adults Our Invisible Addicts 2018

The publication of Our Invisible Addicts in 2011 represented an important landmark in recognising the extent of substance-related health problems amongst older people and that the special service needs to deal with the complexity of such problems, which often involve co-morbid mental and physical health problems, polypharmacy and psychosocial adversity.

Since then, our knowledge concerning the clinical and public mental health aspects of substance misuse in older people has continued to advance but substance misuse amongst older people continues to grow as the population of “baby boomers” ages, increasing both the number of older people and the percentage of the older population with experience of substance misuse.

Given the further experience and knowledge we now have and the growing need, it is now timely to readdress the issue and to review and revise the original report and build on its recommendations. With this revision, we seek to build on the progress made over the past six years and to emphasise anew that including older people with substance problems in national policies is imperative and that there is a need for organisational reform to tackle this burgeoning issue.

The complex constellation of risks that older people with addictions face and create can result in presentation to a variety of services such as older people’s mental health, addictions, primary care, acute hospital settings, social care, housing, criminal justice and the voluntary sector. In many cases the staff in these settings have little specialist knowledge of how to deal with such complexity.

As a result, in this revision we consider and advocate the further development of a clinical workforce with the appropriate knowledge, skills and attitudes to provide identification, assessment, treatment, and assist in recovery and referral for substance misuse in an older population. In particular, we see a need to reverse the loss of multi-professional specialist training in addictions that has taken place in recent years.

We also explain how the problem can be best addressed though an approach that is multi-professional, involving psychiatry, nursing, pharmacy, occupational therapy, psychology, social work and the voluntary sector (including peer support).

This report also addresses the important public mental health aspect. The public is poorly informed about the relationship between drinking and health risks in older people. There is also a need to improve knowledge and awareness around the increasing use of illicit and prescription drugs, as well as the harm caused by novel psychoactive substances, substances acquired using the internet, and other addictions accompanying substance misuse such as gambling.

Improving health and social outcomes for older people with substance-related disorders requires a rigorous approach and this report collates the most up-to-date information relevant to practising psychiatrists, their teams and other colleagues.

There is a need for best practice to be implemented and extended to all relevant settings including the criminal justice system and end of life care. As we do so, we should continue to research the effectiveness of the different approaches taken, using both qualitative and quantitative measures to evaluate this.

This report, which has been developed with representation from a patient, the Royal College of Psychiatrists, the Royal College of General Practitioners and the British Geriatrics Society, provides the latest milestone on the journey towards developing the best possible response to this important problem.

Click on the link here for the 2018 report www.rcpsych.ac.uk

Progress - National Consortium of Consultant Nurses in Dual Diagnosis & Substance Use