Evaluation of a treatment programme for serious mental illness and substance use in an inner city area

Abstract

People with co-occurring drug and alcohol problems and mental disorders often fail to access treatment or are poorly treated by the current health systems. In 1994 an inner city community mental health service in Sydney attempted to address this problem by establishing a treatment programme targeting patients with a serious mental illness and substance use. The treatment programme employed 3.5 fulltime clinical staff and was called the Gemini Project. A quasi-experimental design was used to assess the efficacy of this service. Eighty-three patients were assessed for treatment, 67 received treatment and 37 were followed-up at 12 months. A revised version of the Opiate Treatment Index and the Nursing Modification version of the Brief Psychiatric Rating Scale were used to measure drug taking, social functioning, HIV risk-taking behaviour, and psychiatric symptoms before and after intervention. One-year follow-ups detected no significant changes in patient outcomes. A major problem in implementing this programme was the failure to maintain patients' engagement in treatment.