Double or Nothing? - Responding to co-morbidity in South Australia

This study investigated the views of health workers in South Australia about how to respond to patients who have substance use disorders and other mental illnesses.In 1999, an initial meeting of stakeholders which was representative of workers and consumers in the area resulted in the formation of a working group. The group developed an array of typical case scenarios based on actual patients with co-morbidity problems. The scenarios included how patients were managed that were then re-worked into what was thought would be “best practice” management. Case scenarios included the major psychiatric disorders and a range of substance use disorders. Examples of the scenarios will be given during the presentation.The scenarios were then examined together to identify the main themes, which indicated problems and solutions in helping this group of patients. The themes settled into areas of: assessment of patients,training of staff, co-operation and collaboration between institutions,knowledge of what are best practices, and facilities and resources.Once these themes were identified the larger group was reconvened to examine the scenarios and findings. Further refinements lead to a series of policy recommendations. Although the outcomes (the policies) have proven to be of value, the process by which this took place was extremely productive in many ways.