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Launch of HRB evidence review on dual diagnosis treatment services

The Minister of State with responsibility for Health Promotion and the National Drugs Strategy, Catherine Byrne TD, and the Minister of State with responsibility for Mental Health and Older People, Jim Daly TD will today launch the Health Research Board (HRB) evidence review, Treatment services for people with co-occurring substance use and mental health problems: a rapid realist synthesis. This report is part of the HRB Drug and Alcohol Evidence Review series and was undertaken by a team from the Georgia Health Policy Center in the United States.  

There is good evidence that greater integration of mental health and addiction services leads to improved treatment outcomes, but that this integration is difficult to implement. Integration is not a single concept related to a specific treatment or relationship among providers, but rather a complex, multifaceted portfolio of interrelated parts of a system.  The purpose of the HRB review was to understand what aspects of the integrative process made it more likely that better treatment outcomes would be achieved.

Speaking at the launch, Minister Byrne said;

I am delighted to launch this evidence review on dual diagnosis with my colleague Minister Jim Daly. Our National Drugs Strategy commits to improving outcomes for people with co-occurring mental illness and substance misuse problems.  Treating people with a dual diagnosis requires integration between addiction and mental health services. We are working together to ensure that patients with a dual diagnosis will receive an assessment, an onward referral and timely access to appropriate treatment.

This evidence review is particularly important as it will give us a greater understanding of what works so that we can deliver better integrated mental health and addiction services leading to better outcomes for people with a dual diagnosis. The Department of Health has allocated funding of €1.5million funding for dual diagnosis services in 2019.

The HRB asked the review team to take a realist approach to studying the literature on the topic. This means that they sought to identify the characteristics, or mechanisms, that are more likely to result in successful implementation of evidence-based treatments and the contexts in which this change occurs.

The findings of the review are grouped into outcome areas of integration, access, and individual and family treatment outcomes.  The study describes a four-level framework for integration that is co-produced by policymakers, providers, and clients at the policy, organisation or provider, treatment, and individual levels. Policies and resources need to be aligned to create incentives for providing integrated care, while a knowledgeable, coordinated workforce keeps the individual at the centre.

Minister Daly added

I am delighted to be here today to help launch the HRB's new report on dual diagnosis, and continue the conversation on this important issue. People presenting with both addiction and mental health problems are often among the most vulnerable in society. We need to ensure that the treatment given to these individuals is based on a strong evidence base, and drawn from best practice. This report contributes to our increasing understanding of the complexities of dual diagnosis. The HSE is continuing to develop its service provision on dual diagnosis, and I hope to see progress in this area in the coming months.