Transcript Session 6 - Specific Population Groups.ppt

Co-occurring Alcohol and Other Drug and
Mental Health Conditions in Alcohol and
other Drug Treatment Settings
Session 6:
Specific Population
Groups
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Comorbidity Guidelines
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Refer to:
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Chapter 10
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Focus of this Session
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Indigenous Australians
Culturally and linguistically diverse groups
Gay, lesbian, bisexual and transgendered
Rural/remote
Homeless persons
Specific gender issues
Coerced clients
Youth
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Meeting Specific Needs
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Treatments and services for AOD and
comorbidity have arisen from research on
dominant culture of city-dwelling westernised
adults
Can work for clients from different
backgrounds, but approaches may need to be
adapted depending on individual clients’
characteristics
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Cultural and Contextual
Factors
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Cultural background
Age
Gender
Sexual orientation
Stability of accommodation
Remote location
Level of coercion into treatment
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Indigenous Australians
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Over-representation in mental health and
AOD services
High prevalence of comorbidity
Increased risk of poor treatment outcomes
Mainstream models may not be appropriate
with some Indigenous Australians
NB: not a homogenous group
Refer to IRIS, Appendix P in Guidelines
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CALD
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Little research on CALD groups in AOD
services (let alone comorbidity!)
Under-represented in AOD treatment services
Multiple barriers to AOD and MH treatment
which need to be addressed
Consider use of Trauma Screening
Questionnaire, Appendix N in Guidelines
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GLBT
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Minimal research on GLBT and comorbidity;
trends towards higher prevalence of higher
distress and higher AOD use than general
population
Younger clients may be at greater risk of
suicide
Engagement and confidentiality are
fundamental
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Rural/Remote
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Social, economic, geographic and community
barriers to treatment
May contribute to higher rates of suicide
Limited specialist services
Anonymity a challenge
Alternatives need to be considered, such as
on-line, self-guided and telephone services
(eg: Moodgym)
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Homeless Persons
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Higher rates of comorbidity
Up to 3 x more likely to have mental disorder
Reduced access to services and resources
Inconsistent involvement with services
Lower levels of literacy
Need to meet immediate needs
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Gender
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Patterns of comorbidity and needs of men
and women differ
Issues of stigma, DV and childcare with
women
Men less forthcoming in seeking treatment
May need gender specific services,
particularly family-oriented for women
Men may need more concrete, actionoriented approach
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Coerced Clients
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Sources and level of coercion vary – family,
judicial, employer, child protection
Do not assume treatment will be less
effective; can be important opportunity
Requires high level of engagement and
“rolling with reluctance”
Confidentiality may be limited and needs to
be clarified from start
Harm reduction goal more realistic
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Youth
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Studies identify adolescents and young adults
at particular risk of comorbidity
High levels of mood and anxiety disorders
among substance-abusing youth
Time when first signs of psychosis may
appear
Need for “youth friendly”, flexible services
Issues of confidentiality for minors
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In sum…
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Consider range of specific needs of individuals
in assessment and treatment of co-existing
AOD and MH issues
Need for programs to be flexible to meet
range of needs
See Chapter 10 in Guidelines for further
information
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