Inpatient staff perceptions in providing care to individuals with co-occurring mental health problems and illicit substance use.

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SUMMARY: This paper reports on a piece of research which is summarized below. • This research explored how mental health inpatient staff, (including nurses, doctors and other professional disciplines) experience caring for patients who both have mental health problems and who use illicit drugs. (Illicit drugs are illegal drugs which incur a criminal prosecution for possession and/or use). The results of the study were gathered from questionnaires and interviews which asked staff about their viewpoints and experiences. • The questionnaire results included a section which measured staff attitude towards patients who use illicit drugs and who have mental health problems. Staff who had received training in how to work with people with these problems were found to have a less negative attitude towards these patients. The length of time staff members had worked in their posts or had worked in a particular setting did not have any effect on their attitude. For example, their attitude was not more or less negative towards patients with these problems. • Ten members of staff were interviewed to find out more in-depth information about their viewpoints and experiences. Overall, these staff members reported a lack of training, difficulty in accessing support and problematic issues within the teams they worked. • This paper highlights the importance of training to support staff in working with mental health patients who use illicit drugs; and how this affects staff attitude positively towards patients with these problems. ABSTRACT: The extent of illicit substance use within inpatient mental health settings is becoming a major cause of concern. This poses growing challenges not only for the management of inpatient units, but also for providing continuity of care. Service users with co-occurring substance use are more likely to disengage from services. The process of engagement can be hindered by negative attitudes of staff. This study aimed to identify and explore multidisciplinary staff attitudes and experiences in caring for inpatients with co-occurring ill-mental health problems and illicit substance use. A questionnaire incorporating the Drug and Drugs Problems Perceptions Questionnaire (DDPPQ) was used with a non-probability sample of 84 multidisciplinary staff working on nine mental health units. Semi-structured interviews were then carried out with 10 members of staff. Overall, respondents reported: lack of training; difficulty in accessing support structures; and problematic issues with multidisciplinary decision making and processes. The DDPPQ results showed that staff who had received training held less negative attitudes towards illicit substance users regardless of their length of clinical work experience or type of work setting. Recommendations are made about the importance of training and staff support for the development of less negative attitudes towards this client group.