Psychiatric Bulletin (2008) 32: 139-142. doi: 10.1192/pb.bp.107.015263
© 2008 The Royal College of Psychiatrists
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A ‘dual diagnosis’ community psychiatric nurse service in Lanarkshire: service innovation

Shay Griffin, Consultant Psychiatrist

Addiction, Monklands Hospital, Airdrie, Lanarkshire ML6 0JS, email: shay.griffin{at}lanarkshire.scot.nhs.uk

Andy Campbell, Community Psychiatric Nurse

Community Mental Health Team, Cumbernauld, Lanarkshire

Hazel McCaldin, Community Psychiatric Nurse

Community Mental Health Team, Hamilton, Lanarkshire

Declaration of interest

None.

AIMS AND METHOD

We established two ‘dual diagnosis’ community psychiatric nurse posts within community mental health teams in Lanarkshire to improve the service care for individuals with comorbidity. A questionnaire-based evaluation of the service over a 2-year period was conducted.

RESULTS

Comorbidity was under-reported by community mental health teams and under-referred to specialist addiction services. The presence of new specialist nurses enhanced the detection of comorbidity, improved staff perceptions of working with patients that misuse substances, and was associated with a clinical and functional improvement in patients over 2 years.

CLINICAL IMPLICATIONS

Our findings support the recent trend to provide integrated care for comorbid service users within main-stream mental health services, and suggest a model of service delivery that might be more widely developed to address the concern that such users ‘fall through the gaps’ between services.