According to research by The University of Glasgow, mental health patients who miss their GP appointments face a significantly increased risk of death. The study involved 274,547 patients with a mental illness in Scotland. People who missed two or more GP appointments in a year were eight times more likely to die in the subsequent 18 months – as compared to those who missed none. Of those who died, the average age was just 49. Almost a third of mental health patients who missed GP appointments were also addicted to alcohol and drugs.
In this blog, we’ll look at some of the healthcare needs of patients with mental illness and addiction. Diagnosis of a co-occurring mental illness and addiction can be a difficult or complex process. Even with the correct diagnosis, still so many people miss vital check-ups with their GP – so how can primary healthcare services adapt? And why is publicly funded residential treatment so critical for people with a dual diagnosis?
Mental Illness and Addiction – The Difficulties of Diagnosis
Diagnosing a co-occurring mental illness and addiction requires a detailed knowledge of the patient’s medical history and background, regular interventions by qualified health professionals and sometimes multi-agency working. Where patients struggle to communicate effectively with their doctor, or they miss GP appointments, diagnosis is often delayed or overlooked entirely. So it’s possible that the numbers affected by mental illness and addiction are much higher than the figures recorded by GPs.
Even when doctors make correct diagnoses of mental illness and addiction, unravelling the conditions and providing effective treatment isn’t always straightforward. Take the example of alcohol addiction and depression – initially, there are many more questions than answers, including:
- Does depression lead to alcohol abuse in certain patients, as a form of self-medication?
- Or are depressive symptoms just an inevitable biological response to excessive drinking? Will your depression be cured, therefore, once you give up alcohol?
- Where do the treatments of alcohol addiction and depression overlap? And where must they be treated as separate illnesses?
- Can depression ever be treated effectively if a patient drinks too much alcohol? Are patients always asked about their alcohol use before they are prescribed anti-depressants, for example?
These are just a few examples of why it’s challenging to identify and treat co-occurring mental illness and addiction.
Missed GP Appointments Highlight a Healthcare Need
Rather than view patients who miss GP appointments as lazy or inconsiderate, it’s vital that services adapt. When a patient has a mental illness and addiction, missing health appointments may indicate relapse – where their symptoms have become so overwhelming, and it’s hard to function in everyday life.
Take the example of a patient who is addicted to alcohol and has clinical depression. She is likely to go through phases where she finds it hard to meet her basic needs – such as eating nutritious food, drinking enough water or getting enough sleep. Without adequate nutrition or good quality rest, her ability to make and remember GP appointments will be affected. Alcohol alters judgment and affects memory. Depression often affects motivation, including the ability to leave the house.
Some innovative GP surgeries do recognise and adapt to the healthcare needs of people with mental illness and addiction. Two effective measures are having mental health therapists in primary care services and increasing access to on-the-day GP appointments. These adaptations can reduce waiting times for specialist help, as well as increasing choice and flexibility for patients who struggle to keep their appointments.
Residential Treatment for Mental Illness and Addiction
Often the most effective treatment for mental illness and addiction takes place in residential settings. The intensive nature of residential rehab programmes means that the correct diagnoses can be established quickly. Personalised treatment plans and holistic therapies offer patients the most appropriate care. In residential rehabs, treatment plans are monitored very closely and adapted where necessary – this is particularly important in the early weeks or months of recovery.
As a result of intensive residential treatment, patients typically gain incredible insights into their illness and learn important recovery strategies in a shorter space of time than it would take in non-residential programmes.
Residential treatment programmes for mental illness and addiction are very flexible too. They always include thorough assessments – but following on from that can be any combination of detoxification, rehabilitation, secondary care and aftercare. The treatment programme can be continuously adapted to the needs of the patients, as they achieve essential milestones in their recovery.
UKAT have called on local authorities nationwide to ensure fair access to addiction treatment. This is particularly important for people who suffer from a mental illness and addiction, to give them the best chance of recovery.
If you or a relative suffers from mental illness and addiction, please contact UKAT for a confidential assessment and treatment options for dual diagnosis.