1. Module 15: Multi-agency Working and Service Delivery

2. Objectives To be able to critically appraise current service provision To be aware of the roles and responsibilities of each service To be able to navigate service users through the system (case-study)

3. Dual Diagnosis Capabilities Help people access care from other services: To have local knowledge of services appropriate to meeting needs of people with combined mental health and substance use; their eligibility criteria; to know how to refer to such agencies, and to support the service user whilst the referral is being processed. Dual Diagnosis Capability 15 level 2 Multi-agency/professional working: To understand the roles and responsibilities of the range of professionals and service providers, and to share care, and work in partnership with them. Dual Diagnosis Capability 16, level 2

4. Parallel Model of Service Provision Multi-agency approach, with substance use and mental health services working in –parallel (providing care at the same time), or –sequentially (one service provides care, then the other takes over). The parallel arrangement can work well if: –There’s good communication –Clear roles and responsibilities –Everyone is clear about what the plan of care entails. If it doesn’t work well then the service user falls between the services Sequential care is problematic as it can be very difficult to work on one problem before moving on to working on the others as they are usually intertwinned.

5. Integrated Treatment Integrated treatment of substance use and mental health provided by the same individual or team. Comprise of: –Staged interventions –Assertive Outreach –Motivational interventions –Social support interventions –Long term perspective –Comprehensiveness –Cultural sensitivity and competence But integrated teams are:- –Expensive to run –Get saturated quickly –All expertise restricted to the DD team

6. UK Service Model (DH, 2002) Integration of approaches to substance use and mental health Care provided in mainstream services Primary mental health problem- mental health has main responsibility Primary substance use problem- substance use has main responsibility Mental health and substance use services should support and advise each other Workers require skills and knowledge to integrate approaches. Multi-agency working essential for many people with dual diagnosis