Problematic substance use among forensic psychiatric community patients
Abstract
Purpose
An association between problematic substance use and severe mental illness has been demonstrated in various settings, but not among community forensic psychiatric patients. This paper aims to investigate the prevalence and correlates of problematic substance use among the community patients of one regional forensic psychiatric service.
Design/methodology/approach
Historical data on diagnosis, offending and problematic substance use were gathered by reviewing case notes. Current substance use and psychosocial functioning were ascertained from structured interviews with community psychiatric nurses. Outcome measures included HoNOS ratings, the Global Assessment of Functioning, and the Clinical Rating Scale for substance use.
Findings
Of 92 patients, 91.2 per cent had a history of problematic substance use and 31.5 per cent of them were currently using substances problematically, most commonly cannabis and alcohol. Current problematic substance use was associated with a range of negative outcomes, in terms of illness severity, compliance with treatment, and psychosocial functioning.
Research limitations/implications
The results may not be generalizable to services in different areas or those with different models of service provision. Causality should not be assumed from a cross sectional study.
Practical implications
Inpatient psychiatric treatment in secure services appears to be associated with a large reduction in the level of problematic substance use, but a large residual need remains among community patients. Services which provide community care for forensic patients must seek to integrate treatment for problematic substance use with treatment for mental illness.
Originality/value
This is the first description of the substance use related needs among community forensic psychiatric patients.
Keywords
Citation
Sender‐Galloway, S. and Clark, T. (2013), "Problematic substance use among forensic psychiatric community patients", The Journal of Forensic Practice, Vol. 15 No. 2, pp. 119-129. https://doi.org/10.1108/14636641311322304
Publisher
:Emerald Group Publishing Limited
Copyright © 2013, Emerald Group Publishing Limited