Translating Evidence-Based Practice for Managing Comorbid Substance Use and Mental Illness Using a Multimodal Training Package

ABSTRACT

Objective: Comorbid mental health and substance use problems are highly prevalent in substance use treatment settings and generally lead to poorer treatment outcomes. Pathways to Comorbidity Care (PCC) is a multimodal training program developed to encourage an integrated service approach to improve clinicians capacity to identify and manage comorbid substance use and mental health outcomes within public drug and alcohol treatment settings.

Methods: In this paper we describe the concepts underlying the PCC package and the use of implementation science to assess and overcome potential barriers, including clinicians preferences, knowledge about best practice, and professional culture.

Results: The training components include didactic seminars, group workshops run by a local clinical champion on relevant subjects such as motivational interviewing and cognitive behavioral therapy, individual clinical consultation, and feedback with a senior clinical psychologist. The PCC also includes an online portal containing comorbidity resources including manuals, guidelines, and booster webinars. Finally, we describe the evaluation of PCC implementation.

Conclusions: Drug and alcohol services need to be equipped to treat the majority of comorbid mental health conditions in their clients. We anticipate that this multimodal training package, which applies the principles of implementation science, will facilitate effective and integrated care for these vulnerable clients.

KEYWORDS:

• Comorbidity
• substance use
• mental illness
• translation

Disclosures

None of the authors report any conflict of interest. Professor Teesson is director of Climate Schools Pty Ltd., which is a company established to distribute evidence-based drug and alcohol resources to schools.

Acknowledgments

The authors are grateful to Associate Professor Katherine Mills, Dr. Christine Marel, Associate Professor Francis Kay-Lambkin, Dr. Sally Hunt, and Dr. Emma Barrett for their contributions to the training material.

Additional information

Funding

This project is funded by the New South Wales (NSW) Health Translational Research Grant Scheme with contributions from the National Health and Medical Research Council (NHMRC) Centre for Research Excellence in Mental Health and Substance Use and an NSW Health Translational Research Fellowship (KM).