Background: Little is known about typical service contact profiles and associated factors among clients with co-occuring mental health and substance use problems. Aim: Findings are reported from a 12-month audit of clients presenting to regional (NSW, Australia) adult community mental health and drug and alchohol services. Method: Raw data for this service evaluation project were extracted from an electronic clinical information database, comprising 61,062 community-based service contacts by 3344 clients (average age, 38.7 years; 49.8% male). Results: Several broad care pathways were identified. Substance use problems were experienced by 25.1%, with higher rates among males and younger clients. This group accounted for 35.4% of annual community-based server contacts, with substantially higher rates among clients with opiate dependence (133 contacts per client) and those with comoroid psychosis (44 per client), compared to the typical dual diagnosis client (18 per client). Clients actively engaged with a specialised dual diagnosis service had half the rate of service contacts (9 per client), reflecting a mixture of client characteristics, group-based treatment programmes, and enhanced engagement strategies. Conclusions: Comorbidity and service contact profiles are highly variable across treatment settings, reinforcing the value routine of audits for identifying typical care pathways and targeting shared interventions.
Mental Health and Substance Use Vol. 3, Issue 1, p. 10-24