Problematic substance use in two mental health NGOs, and staff, client and general public attitudes towards problematic substance use amongst people with mental illness

Abstract

A significant proportion of people with mental illness are thought to have co-occurring problematic substance use but there is little published information available and that which is published can be contradictory and vary according to a number of factors. Additionally, the stigma surrounding co-occurrence is little understood and an exploration of attitudes would benefit mental health service design and delivery. The study aimed to measure the rates of concurrent problematic substance use in community-based health services and to compare attitudes of staff, clients and the public towards people with this population. Create an exploratory model of attitudes. Surveys distributed to staff and clients of two mental health non-government organisations (NGOs) and to a comparison sample of members of the general public. Eighty-two staff, 333 clients and 545 members of the public were surveyed. Rates of alcohol and substance use amongst service clients were similar to levels previously reported of 25% and 39%, respectively. Staff were shown to have better attitudes towards people with mental health and problematic substance use issues compared with service clients and the general public. The rates of problematic substance use in community-based psychosocial support services are consistent with high levels found in other studies of mental health services. Workers hold less stigmatising attitudes than either the public or service clients. An exploratory model of attitudes suggests that personal responsibility may not be an important component of the stigma surrounding co-occurring mental illness and problematic substance use.

Keywords:

• substance misuse
• mental illness
• comorbidity
• stigma
• attitudes

Acknowledgements

The authors would like to acknowledge the Mental Health Coordinating Council, Network of Alcohol and Drug Agencies and the NSW Ministry of Health for funding the research, and the staff and clients of the services who generously gave their time and effort.