Dual diagnosis and homelessness

We are used these days to signing petitions, made easier because we can often do so from the comfort of our own computer wired up to the Internet. Being the skeptic I am, I have no illusion the amount of good done is anywhere near what I might hope for, yet find myself signing as it is the right thing to do and might achieve something.

The latest petition I signed had the title “Call on Southend to employ a dual diagnosis worker to reduce gaps in mental health service” and was initiated by a friend who has strong views on the matter and those views I happen to agree with (or else I would not have signed). I thought to devote the rest of the blog to explaining why I agree with the petition and why it matters, and why I am inviting others to sign too in order to reach that magic number to at least initiate a debate that might go toward getting what is being asked for.

Given these are significant reoccurring themes, I have already written and blogged about mental health and substance misuse (mainly alcohol but also non prescribed drugs, including Legal Highs) and the important and uncomfortable relationship these have with people becoming and remaining homeless (one group of people who are particularly affected). The bottom line is one sixth of homeless people have a significant mental health issue (even if not a psychotic one) and one sixth misuse substances. One sixth have both and regarding that half of the homeless population with a mental health and/or substance misuse issue all too often professional help is missing. The dilemma often faced by those professionals dealing with these issues is which to address first and since this remains a perplexing conundrum then the answer is neither, with the result those affected suffer and so does society and the economy. This is compounded given mental health services often do not serve well the  homeless and the success rates in helping homeless folk in overcoming their addictions is a lot lower than one might hope for.

Having been around as long as I have and politely and not so politely pointed out those involved in these areas what appear to be uncomfortable truths, I know making changes happen is not easy especially when who and how to make representations to changes too.  Right now after yet another set of changes in the way health is commissioned and a decreasing pot of money to spend on services, we have an entity that involves Council and NHS commissioner types and notwithstanding the need for other important services may have some power to do what the petition asks for, which is to appoint a dual diagnosis worker to operate in Southend-on-Sea and I, along with people like my friend, could point him/her if appointed to such a post to more than enough clients to keep him/her busy.

The reasons for having a professional onboard is so important is manifold. Firstly, in order to access appropriate professional help a professional is needed on board to do the referring. A significant number of people could benefit given the nature of their issues and their accommodation status (and there are others who are accommodated that would benefit too) and the cost saving would likely negate the social and economic costs resulting from such issues not getting addressed. Secondly, and has been witnessed by those working with “dual diagnosis folk” is it may be possible to prevent some of the tragic waste of lives when a life time of suffering that might have been dealt with isn’t. Thirdly, there is a cohort of folk who are doing our bit trying to help such folk but in order to crack doing what needs to be done, a partnership involving those working at the coal face and dual diagnosis professionals is needed.

In the meantime, many like me will continue to pick up the pieces as best we can concerning folk with often not officially recognised or ignored dual diagnosis issues. Better if we can do so along with a dual diagnosis professional who understands the issues that has the right qualities and will work with us to address the needs.

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