Government initiatives to establish integrated treatment experiences for young people with co-occurring mental health issues and problematic alcohol and other drug (AOD) use have made slow progress, with broad government strategies lacking the detail and funding commitment essential to improve care, a new Orygen report has found.
Integrated treatment means providing young people with services that address AOD use problems and mental ill-health at the same time.
Developed in partnership with Turning Point the report, titled Seamless support: toward an integrated treatment experience for young people with co-occurring alcohol and other drug use and mental ill-health, found that although people working to support young people were frustrated by the lack of improvement in this area there was widespread commitment to advancing an integrated treatment approach for this group of young people.
Associate Professor Gill Bedi, head of substance use research at Orygen and co-author of the report, said mental ill-health and AOD use disorders co-occur at high rates in young people.
“There can be a lot of variation in the complexity of their illness, as well as the range of psychosocial challenges they face, such as remaining engaged with school or maintaining housing tenancy,” Associate Professor Bedi said.
“Implemented appropriately, an integrated approach to treatment can provide a tailored mix of supports for the young person.
“There are different ways in which health professionals and services can be structured or how they collaborate to deliver integrated treatment. Whichever approach is taken, the most important thing is that a young person experiences continuity of support.
“If one health issue is treated first, or in isolation, there is the potential for other health issues to worsen or limit the effectiveness of the treatment being provided. Integrated treatment aims to provide the best outcome for a young person,” Associate Professor Bedi said.
Turning Point Executive Clinical Director Professor Dan Lubman said young people were significantly more likely to have acute substance use or chronic substance use disorders as risk factors for suicide.
“We also know that integrated treatment, care and support is essential to improving outcomes for people with co-occurring substance use or addiction and mental illness,” Professor Lubman said.
"We need greater investment in alcohol and other drug services to support an integrated model of care that provides wraparound support to address the social determinants of health, and that enables collaborative care by multidisciplinary teams of specialists to meet the varied needs of individuals.”
The report has developed the following key policy solutions for delivering an integrated treatment experience for young people with co-occurring problematic AOD use and mental ill-health across a range of severity levels:
- identify opportunities to trial new initiatives for expanded service integration;
- support collaboration and develop workforce capacity to implement integrated treatment; and
- drive improvement in service design, treatment delivery and workforce practice.
Four principles underpinned the development of policy solutions: harm reduction; early intervention; de-stigmatisation; and developmentally-informed care, which recognises the needs of a young person at their age and level of maturity.
Associate Professor Bedi said the principles were aimed at supporting help-seeking, minimising the impact of illness on a young person and providing treatment appropriate to their context.
David Baker, policy manager at Orygen, said that although examples of integrated treatment have been implemented, the policy challenge is to expand the delivery of these services to reach more young people.
“We need to harness the findings of this report to develop the targeted policy solutions we’ve identified and support the robust development and implementation of integrated treatment services for young people with mental ill-health and problematic AOD use,” Mr Baker said.
You can download the report on the Orygen website.