Dual Diagnosis Capability Framework

1
Dual Diagnosis Capability Framework

• Dr Liz Hughes
• Senior Lecturer, Mental Health and Addictions
  Research Group

2
Aim of presentation

• Give an overview of developments in DD
• Discuss the development and implementation of the
  Capabilities Framework
• To discuss workforce development issues and
  Leeds-specific needs

3
The development

• 2006 commissioned as part of CSIP National Dual
  Diagnosis Programme
• On the back of the surge in competence and
  capabilities in both mental health and substance
  misuse (skills for health DANOS and MH NOS KSF,
  Capable Practitioner Framework, The 10 Essential
  Shared Capabilities
• However,nothing existed that described the core
  capabilities required to work with dual diagnosis
• I was commissioned to do this at University of
  Lincoln

4
Team

• Anne Gorry and Tom Dodd- CSIP DD leads
• Ian Hamilton
• Mandy Barrett
• Dr Tara ONeill
• Sharon Walker
• Tabitha Lewis
• David Manley
• Sean McDaid

• Service user and carers consultation meeting
  asked what they thought was most important skills
  and attitudes for people working with dual
  diagnosis

5
Levels

• Core- everyone, everywhere
• Generic- post qualification staff/key workers in
  mental health and substance misuse services
• Specialist- those with lead responsibility for
  service and workforce development for DD

6
The 19 Domains

• Values

Practice development

• Role legitimacy
• Therapeutic optimism
• Acceptance of uniqueness of each individual
• Non-judgemental
• Demonstrate empathy

• Learning needs
• Seek out supervision
• Life long learning

• Knowledge and skills

• Engagement
• Interpersonal skills
• Education and health promo
• Recognise need (assessment)
• Risk assessment and management
• Ethical legal and confidentiality
• Evidence based interventions
• Help people access care from other services
• Multi-agency/multi professional learning

7
How its been used

• Inform training strategies and content
• Appraisal- evidence of capability- testimonies
  etc
• Job descriptions, recruitment

8
Closing the Gap-National spread

• Northampton
• Derbyshire
• Leicestershire
• South Staffs
• Leeds
• Bradford
• Manchester
• TEWV

• Central and NW London
• East London
• Camden and Islington
• Oxleas
• SLAM
• Sussex
• Cornwall
• Swindon
• Bristol
• Informs MSc DD course at Middlesex

9
DD networks and information

• Twitter me _at_lizhughesDD PROGRESS
  _at_dualdiagnosisuk
• Linkedin Progress dual diagnosis network (728
  members)
• News page of PROGRESS website
• www.dualdiagnosis.co.uk

10
references

• Menezes, P, Johnson, S, Thornicroft, G et al
  (1996) Drug and alcohol problems amongst
  individuals with severe mental illness in South
  London British Journal of Psychiatry 168 612-619
• Weaver T Madden P Charles V Stimson G
  Renton A Tyrer P Barnes T Bench C
  Middleton H Wright N Paterson S Shanahan W
  Seivewright N Ford C (2003) Comorbidity of
  substance misuse and mental illness in community
  mental health and substance misuse services.
  British Journal of Psychiatry 304-13
• Hughes, E (2006a) Closing the Gap A Capability
  Framework for working effectively with people
  with combined mental health and substance use
  problems (Dual Diagnosis) CCAWI, University of
  Lincoln and Care Services Improvement Programme
• Hughes, E (2006b) A Pilot Study of Dual Diagnosis
  Training In Prisons. Journal of Mental Health
  Workforce Development. Volume1, Issue 4,
  December 2006
• Hughes, E Robertson, N Kipping, C and Lynch, C
  (2007) The Challenges of Developing Dual
  Diagnosis Capabilities for Acute Inpatient Staff.
  Journal of Mental Health Workforce Development
  Volume 2 (2), p.36-43
• S. Johnson, G. Thornicroft, S. Afuwape, M. Leese,
  I. R. White, E. Hughes, S. Wanigaratne, H. Miles
  and T. Craig (2007) Effects of training community
  staff in interventions for substance misuse
  British Journal of Psychiatry 191 (5)
• Hughes, E. Wanigaratne, S, Gournay,K. Johnson,
  J, Thornicroft,G Finch, E. Marshall, J., and
  Smith, N. (2008) Training in Dual Diagnosis
  Interventions (The COMO Study) A Randomised
  Controlled Trial Biomedical Central Psychiatry.
  February 2008. 812
• Craig, T. K. J, Johnson, S., McCrone, P.
  Afuwape, S. Hughes, E. Gournay,K. White,I.
  Wanigaratne, S. Leese, M. and Thornicroft, G.
  (2008) Integrated Care for Co-occurring
  Disorders Psychiatric Symptoms, Social
  Functioning, and Service Costs at 18 Months
  Psychiatric Services, 59 276 - 282.
• Hughes, E. and Kipping, C (2008) Policy context
  for dual diagnosis service delivery. Advances in
  Dual Diagnosis 1(1) p4-8
• Barrowclough, C., Haddock, G., Wykes, T.,
  Beardmore, R., Conrod, P., Craig, T., Davies, L.,
  Dunn, G., Eisner, E., Lewis, S., Moring, J.,
  Steel, C., and Tarrier, N (2010) Integrated
  motivational interviewing and cognitive
  behavioural therapy for people with psychosis and
  comorbid substance misuse randomised controlled
  trial. British Medical Journal 341c6325
• National Institute for Health and Clinical
  Excellence (2011) CG115 Alcohol Use Disorders.
  Diagnosis, assessment and management of harmful
  drinking and alcohol dependence.
  http//guidance.nice.org.uk/CG115/NICEGuidance/pdf
  /English accessed 1/4/11

11
Focus Group

• In small groups
• Read through the capability framework
• Think about
• The levels 1, 2, 3
• Anything important missing?
• Leeds specific information to be added?
• How could it be used to help develop a better
  city wide response to people with
  complex/multiple needs?