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Article
Publication date: 12 November 2021

Hattie Catherine Ann Moyes, Lana MacNaboe and Kate Townsend

This paper aims to understand the current scale of substance misuse in psychiatric intensive care units (PICUs), identify how substance misuse affects members of staff…

Abstract

Purpose

This paper aims to understand the current scale of substance misuse in psychiatric intensive care units (PICUs), identify how substance misuse affects members of staff, patients and the running of wards and explore with staff what resources would be most useful to more effectively manage substance misuse and dual diagnosis on PICUs.

Design/methodology/approach

The paper used a mixed-methods approach, using a quantitative survey to determine the extent of substance use in PICUs and a co-design workshop to understand the impact of substance misuse on PICU wards, staff and patients.

Findings

The estimated rate of substance misuse in PICUs over a 12-month period is 67%, with cannabis the most frequently used substance. Despite the range of problems experienced on PICUs because of substance misuse, the availability of training and resources for staff was mixed.

Research limitations/implications

The findings may not be fully generalisable as research participants were members of a national quality improvement programme, and therefore, may not be representative of all PICUs. Data was collected from clinicians only; if patients were included, they might have provided another perspective on substance misuse on PICUs.

Practical implications

This paper emphasises the importance of substance misuse training for PICU staff to adequately respond to patients who misuse substances, improve the ward environment, staff well-being and patient outcomes.

Originality/value

This paper provides an updated estimation of rates of substance misuse in PICUs over a 12-month period and make suggestions for a training programme that can better support staff to address substance misuse on PICUs.

Details

Advances in Dual Diagnosis, vol. 14 no. 4
Type: Research Article
ISSN: 1757-0972

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Article
Publication date: 22 February 2021

Lois Dugmore and Saskia Bauweraerts

This paper aims to discuss an initiative developed between, Leicestershire Partnership National Health Service Trust and Turning Point, which is the locally commissioned…

Abstract

Purpose

This paper aims to discuss an initiative developed between, Leicestershire Partnership National Health Service Trust and Turning Point, which is the locally commissioned drug and alcohol service in Leicester, Leicestershire and Rutland. The aim was to improve outcomes for clients with dual diagnosis (co-occurring mental health and substance misuse) issues. The purpose of the change in working practice was to engage with local substance misuse agencies more effectively to improve clinical outcomes within this service user group. This was achieved through four interrelated approaches. This comprising providing an integrated service. It included building relationships with substance misuse services, providing specialist dual diagnosis clinics and the introduction of substance misuse workers onto mental health wards and group work specific to substance misuse. The outcomes included easier access to services for service users and greater uptake of service users who were moving onto substance misuse services. This led to a reduction in risk related to prescribing and fewer incidents related to prescribing changes and greater engagement in services. When service users were moving between services better communication led to prescriptions being transferred with no delay and to reduced dropout rates in service. There was improved access to substance misuse services, more referrals and take up of service taking place. There was a greater understanding by staff of co-occurring substance misuse and how to work with this client group. Closer working relationship with substance misuse services and shared skills led to greater confidence in managing this service user group. This demonstrates a cost effective service that can be replicated within similar settings.

Design/methodology/approach

In clinical practice, shared treatment has proved challenging in light of different service models (Laker, 2006). Substance misuse works on the premise of change comes from the individual, where recovery models in mental health offer a formalised approach. One of the challenges faced by services has been the inability for mental health services to recruit and services become overstretched (Rimmer, 2018); this gave an opportunity for a new method of working to be considered. This led to the development of a new service model.

These changes were:

• Improving the interface with substance misuse services to improve access to community substance misuse services for mental health clients.

• To provide specialist staff within the dual diagnosis field to provide a clinic jointly with local drug and alcohol services.

• Introduction of substance misuse workers as team members on acute mental health and rehab wards.

• Group Substance Misuse programmes.

Findings

Working within an integrated model, yet maintaining separate organisations, by offering joint training and clinics has led to a greater understanding of each organisation’s work and increased engagement within the service user group.The introduction of substance misuse workers to acute and rehab mental health inpatient services encouraged service users to engage at the point of admission and to be referred into locally commissioned substance misuse services prior to the point of discharge. Engagement with staff has demonstrated better engagement with substance service by service users following discharge.For clients able to take leave assessment could take place prior to discharge. This led to an increased uptake in services. Due to no opiate substitution given on discharge decreased risk of prescribed medication overdose at point of discharge and led to increase in returning straight to substance misuse services. This meant that service users received medication quicker and the right dose and on discharge ensured reduced risk. The prescribing of Naloxone at discharge is yet to be assessed, but the risk of an overdose within seven days is well-documented and Naloxone is key in reversing this trend. This change in practice can be replicated in any mental health setting and has increased access to services for those using substances.

Originality/value

Is original no other services have substance workers or joint clinics across the UK. First inpatient unit to welcome patients back post-discharge to attend groups.

Details

Drugs and Alcohol Today, vol. 21 no. 2
Type: Research Article
ISSN: 1745-9265

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Article
Publication date: 11 December 2020

Linda Bell, Rachel Herring and Fizz Annand

The purpose of this paper is to review the following research questions from the available literature: What evidence is there to suggest that substance misuse specifically…

Abstract

Purpose

The purpose of this paper is to review the following research questions from the available literature: What evidence is there to suggest that substance misuse specifically by fathers (including alcohol and other drugs) causes wider harms, including child welfare concerns? substance misuse, recovery, parents, fathers, fathering, drugs/ alcohol services. How do professionals respond specifically to substance misuse by fathers? Do interventions aimed at parental substance misuse (particularly in the UK) include both mothers and fathers and if so how?

Design/methodology/approach

A scoping literature review was conducted which identified 34 papers (including scoping reviews published in 2006 and 2008, covering the period 1990-2005) and 26 additional studies published between 2002 and 2020.

Findings

The review in this paper is organised into six themes: Negative impact of men’s substance misuse problems on their parenting behaviours; quality of the relationship between parents affected by substance misuse of the fathers, in turn affecting the parenting behaviour and outcomes for children; importance to fathers of their fathering role (for example, as a financial provider); difficulties fathers may face in developing their fathering role; sidelining of the fathering role in substance misuse services; and professionals tending to focus on the mother’s role in parenting inventions and services.

Originality/value

This paper focusses on fathers and substance misuse, which is an under-researched field within the wider contexts of fathering research and research into parental substance misuse.

Details

Drugs and Alcohol Today, vol. 20 no. 4
Type: Research Article
ISSN: 1745-9265

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Article
Publication date: 1 September 2008

Rossi Owen, Paul Hughes, Catherine Baker and Laurence Chesterman

Individuals diagnosed with severe mental illness have higher rates of alcohol and substance misuse than the general population. This can present the client and the care…

Abstract

Individuals diagnosed with severe mental illness have higher rates of alcohol and substance misuse than the general population. This can present the client and the care team with a variety of issues around physical and psychological well‐being, as well as social and occupational functioning. In forensic psychiatry, the effect of comorbid substance misuse on offending behaviour is particularly pertinent. There have, however, been few studies examining the treatment of alcohol and substance misuse within this particular patient group.At a regional secure unit in North Wales, a group for inpatients was set up to provide education on alcohol and substance misuse over a course of six informal meetings, and to then evaluate participants' attitudes towards substance misuse. Of the six participants, five reported that their knowledge of substances had increased, and that they had no intention to use drugs again after discharge. Staff and client participants also suggested useful future topics for the group.

Details

Drugs and Alcohol Today, vol. 8 no. 3
Type: Research Article
ISSN: 1745-9265

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Article
Publication date: 6 June 2016

Philipp Schäfer and Nicole Braun

Short-term rentals are mainly of small flats, which are offered to tourists. Currently, the providers of short-term rentals, in particular Airbnb (ABB), are being…

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Abstract

Purpose

Short-term rentals are mainly of small flats, which are offered to tourists. Currently, the providers of short-term rentals, in particular Airbnb (ABB), are being criticized in several German cities, on the grounds that shares of residential flats are being removed from the housing market, due to illegitimate misuse as tourist accommodation. Thus, the conventional urban housing markets are contending with a decline in housing supply and increasing rents. This paper aims to support these findings empirically.

Design/methodology/approach

The paper opted first for a spatial analysis with ArcGIS for ABB in Berlin. Second, different online data requests of periods of up to two months were used to analyze the extent of misuse with regard to the Zweckentfremdungsverbot (misuse prohibition law). Third, analysis of variance was used to analyze rental growth on the ABB markets. The data were collected in different approaches from the website of airbnb.com.

Findings

The paper provides evidence that 5,555 residential flats are presently being misused by ABB (0.30 per cent of the total housing stock in Berlin) and that many providers of entire flats have more than one offer simultaneously. Moreover, the paper provides the first entire-market overview of ABB in Berlin. It is evident that the ABB market is mainly located centrally and that only a few neighborhoods have large ABB markets. Rental growth is higher in the ABB markets which have a significant share of misused flats, than in the ABB markets which have insignificant shares of misused flats.

Originality/value

To the authors’ best knowledge, the paper provides the first empirical approach regarding misuse through short-term rentals on a housing market with an innovative design and first-hand data.

Details

International Journal of Housing Markets and Analysis, vol. 9 no. 2
Type: Research Article
ISSN: 1753-8270

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Article
Publication date: 1 November 2003

Theodore Mutale

Although substance misuse by adolescents is widespread, few previous studies have investigated illicit drug use in adolescent psychiatric populations. The literature on…

Abstract

Although substance misuse by adolescents is widespread, few previous studies have investigated illicit drug use in adolescent psychiatric populations. The literature on adolescent substance misuse has focused on risk factors, and protective factors have received little or no attention. The study examined substance misuse and its correlates among young people referred to a regional adolescent psychiatric service. Co‐morbidity of substance misuse and psychiatric disorder was discussed, and the possible role of substance misuse as a gateway to adolescent offending examined. Recommendations for the development of adolescent substance misuse services are made.

Details

The British Journal of Forensic Practice, vol. 5 no. 4
Type: Research Article
ISSN: 1463-6646

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Article
Publication date: 3 July 2017

Yam B. Limbu

By applying the information-motivation-behavioral (IMB) skills model, the purpose of this paper is to examine the direct and indirect effects of credit card knowledge and…

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3592

Abstract

Purpose

By applying the information-motivation-behavioral (IMB) skills model, the purpose of this paper is to examine the direct and indirect effects of credit card knowledge and social motivation on credit card misuse behavior mediated through credit card self-efficacy among college students in the USA.

Design/methodology/approach

A sample of 427 participants was surveyed. Structural equation modeling was used to assess the hypothesized model.

Findings

Credit card knowledge and social motivation were inversely associated with credit card misuse mediated through credit card self-efficacy. Credit card knowledge had a direct negative relationship with credit card misuse. The results confirm the theoretical relationships in the IMB model.

Practical implications

The results offer several implications for bank marketers and policy makers. The IMB model could be used to predict credit card abuse among college students; credit card literacy programs should incorporate strategies that can enhance students’ knowledge, social motivation, and behavioral skills with regard to responsible use of credit cards.

Originality/value

This study is unique in that it applies the IMB model to examine predictors of credit card misuse among college students.

Details

International Journal of Bank Marketing, vol. 35 no. 5
Type: Research Article
ISSN: 0265-2323

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Article
Publication date: 14 March 2016

Christine Day, Alexandra Lampraki, Dean Ridings and Karen Currell

The purpose of this paper is to provide a narrative review of the literature on substance use/misuse within an intellectual disability (ID) population. The paper is…

Abstract

Purpose

The purpose of this paper is to provide a narrative review of the literature on substance use/misuse within an intellectual disability (ID) population. The paper is focused on the prevalence, motivation and implications of substance use as well as the interventions for misuse.

Design/methodology/approach

Research focused on substance use and ID (IQ of 70 or less with onset in the developmental period) were considered.

Findings

The findings indicate a disparity between research findings regarding the prevalence of substance use/misuse within ID populations. Previous research indicates that individuals with ID may use/misuse substances as a form of relief or respite from negative experiences. Although there is a clear need for intervention, many of the ID population do not engage with generic interventions for substance misuse. Additionally, professionals responsible for the provision of interventions identify a lack of training and support to meet the needs of ID populations.

Research limitations/implications

Minimal research in this areas, barriers to language and demographics being underreported.

Practical implications

Highlights problems with the current evidence base and barriers this poses indicates a need for further research and intervention.

Social implications

Implications for the equality for individuals with an ID and their access to appropriate intervention. Focus on prevention of offending behaviour and intervention as appose to management.

Originality/value

In order to build a greater understanding of this issue, a shared universal language and definition of ID must be implemented. Further research to improve the understanding of why those with ID misuse substances is imperative before designing and implementing useful interventions.

Details

Journal of Intellectual Disabilities and Offending Behaviour, vol. 7 no. 1
Type: Research Article
ISSN: 2050-8824

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Article
Publication date: 5 March 2014

Anne-Marie Laslett, Robin Room and Paul Dietze

The purpose of this paper is to determine whether the diagnosis of both carers’ mental health problems and substance misuse increase the likelihood of recurrent child…

Abstract

Purpose

The purpose of this paper is to determine whether the diagnosis of both carers’ mental health problems and substance misuse increase the likelihood of recurrent child maltreatment over and above the individual effects of these factors.

Design/methodology/approach

Retrospective secondary data analysis of 29,455 children where child maltreatment was confirmed in the Victorian child protection system between 2001 and 2005. Recorded mental health, alcohol misuse and other drug misuse variables were entered into multivariate logistic regression models predicting repeated child maltreatment. Interactions and a range of other child, carer and socio-economic factors were included in these models.

Findings

Carer alcohol misuse, other drug misuse and mental ill health all independently predicted recurrent child maltreatment. The presence of both other drug misuse and mental ill health increased the likelihood that recurrent child abuse was recorded over the likelihood that mental health alone predicted recurrent child maltreatment, and while alcohol misuse had an effect when there was no mental health condition recorded it did not have an additional effect when there was evidence of mental health problems.

Research limitations/implications

Children in families where there is both mental health problems and other drug use problems are at greater risk of repeated maltreatment than where there is evidence of mental health problems or other drug use alone. Where there was evidence of carer mental health problems, alcohol misuse did not add to this likelihood. However, the effect of mental health and other drug use was similar in size to the effect of alcohol misuse alone.

Originality/value

These findings add to understandings of the effects of co-occurring mental health problems and substance misuse on recurrent child maltreatment and differentiate between cases that involve alcohol and other drug misuse.

Details

Advances in Dual Diagnosis, vol. 7 no. 1
Type: Research Article
ISSN: 1757-0972

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Article
Publication date: 26 June 2009

Rob Hill, Megan Underhill, Katherine Atnas and Jenny Harris

In this paper, we explore the role that psychology can play in enhancing dual diagnosis provision in substance misuse wards. In order to understand what can be achieved…

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569

Abstract

In this paper, we explore the role that psychology can play in enhancing dual diagnosis provision in substance misuse wards. In order to understand what can be achieved, we will review: the nature of the client group presenting to substance misuse wards; the role and function of such wards; the role of clinical psychology within these wards; and specific issues relating to inpatient substance misuse treatment. We conclude by identifying some key elements that we believe can enhance effective dual diagnosis working within inpatient substance misuse services.

Details

Advances in Dual Diagnosis, vol. 2 no. 2
Type: Research Article
ISSN: 1757-0972

Keywords

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