Dual diagnosis is the term used to describe the presence of one or more disorders or diseases in addition to a primary disease or disorder. For example, a person who is suffering from a mental illness and substance abuse would be considered to have dual diagnosis. It can be difficult to diagnose as alcohol and drugs often induce psychiatric symptoms. It is therefore important to differentiate between substance induced symptoms and those of a pre-existing mental illness. Experts therefore suggest that diagnosis cannot be made until a period of abstinence has been achieved to allow for substance induced symptoms to dissipate.

Why do I need residential treatment for dual diagnosis?

Treatment should be offered in a setting that recognises that intervention needs to be centred on treating both disorders together. It is important to seek advice and find a treatment centre that is able to manage needs and care of a person with a dual diagnosis. Staff will need to be experienced, and there should be a collaborative decision making process between the client and the treatment team.

Prior to admission to a detox & rehab centre

A psychiatric assessment may be required and a multi-disciplinary report compiled. This allows the chosen clinic to have an overview of needs and to be able to assure that the clients’ needs can be met.

On admission to a detox & rehab centre

The client will undergo further assessment. This will be foundation of the care offered and subject to regular reviews and change. Clients will be allocated a keyworker who is the main source of support during the client’s stay, and will establish positive relationships with the client and his or her family and friends. A care plan will be created, evidencing the clients’ needs and choices. Risk assessments will also be created to ensure the safety and well-being of all parties.

Treatment for dual diagnosis

Throughout the treatment duration, a multi-disciplinary approach will ensure that the clients’ needs are constantly considered and assessed so that the appropriate treatment is provided. It is likely that the treatment programme will be longer and approached more systematically than for most addictions.

Medication will be prescribed to address the symptoms of mental illness. This allows the client to stabilise and prepare themselves psychologically for the treatment to address their addiction.
Life-long maintenance drugs to prevent addiction relapse may also be considered in order to reduce the risk of further mental health symptoms and their negative impact on daily living. Alongside this, there should be an intensive, challenging psychological programme which offers therapeutic interventions. This encourages the client to challenge the reasons behind their addiction, the trigger points to their behaviours and the ways they will manage them in the future. These therapies can focus on the 12 step programme and also incorporate cognitive behavioural therapy, motivational interviewing, one to one and group counselling and other recognised interventions. Holistic therapies will also be utilised in support of this.