![Sample our Health and Social Care journals, sign in here to start your FREE access for 14 days]({"type":"image" , "src" : "/sda/5938/TOC-Subject-Sample-2021-Health-Social-Care.jpg"})
Abstract
The current literature acknowledges that substance use amongst those with severe mental health problems is common, and recent prevalence estimates suggest that up to 56% of psychiatric inpatients are using alcohol or drugs problematically. It has also been shown that substance use can play a significant role in leading to an acute admission, and that inpatients who use substances have poorer hospital-related outcomes than non-users. Despite this knowledge, there appears to be a level of uncertainty amongst academics, clinicians and policy-makers alike with regards to what works for this client group. The research in this field is limited and often reports mixed or inconclusive findings, which in turn leads to guidelines that fail to recommend any specific interventions or combination of interventions for inpatients who are using substances. Furthermore, the common existing barriers to implementation of evidence-based approaches into routine care make the challenge even more difficult, with the day-to-day reality suggesting that even providing the evidence and recommending interventions within guidelines may not be sufficient to promote integration into practice. Despite the challenges, an inpatient admission may present a ‘window of opportunity’ to address substance use amongst those with severe mental-health problems, which may in turn contribute to reduced readmissions and lower healthcare costs. In addition, positive outcomes may potentially increase the clients' connections to their family, community and support networks by keeping them in the community. Finally, it is argued that there is potential to enhance the knowledge, confidence and skills of inpatient staff to address this complex and challenging need.