Addressing AOD use and mental health, together
Alcohol and other drug (AOD) dependencies often go hand in hand with mental ill health. As David Balakrishnan at St John of God’s Drug and Alcohol Withdrawal Network (DAWN) explains, it’s a chicken-and-egg relationship – or comorbidity – that’s at the heart of DAWN’s approach to helping individuals and families address substance use.
21 Jun 2024
“While anyone can refer themselves to DAWN, we generally get referrals from health professionals,” says David. “An individual will go to their GP, hospital or another healthcare provider with a physical health issue, like poor liver function, diabetes or hepatitis C, and if the doctor or practitioner identifies an underlying substance-use issue they’ll make a referral to DAWN.“But mental ill health is just as common among the people who come to DAWN and other AOD support and treatment services.”
In fact, according to the government’s Mental Health Productivity Commission, between 50–76% of people accessing alcohol and other drug (AOD) treatment services in Australia meet the diagnostic criteria for at least one mental health disorder.
“Sometimes, there’s a pre-existing mental health issue and the person tries to self-medicate with alcohol or other drugs. Other times, the person might engage in some form of substance use for other reasons – say, family or relationship issues – which leads to a mental health issue,” says David.
“Either way, it’s a vicious circle where both the substance-use issue and the mental health issue are likely to worsen unless both are diagnosed and addressed simultaneously.”
This concept is fundamental to DAWN’s approach to AOD support and treatment, which focuses on the individual and working closely with them, their family and their other healthcare and support providers, from government agencies to other non-government organisations.
David says, “From our first phone contact with each client – where we try to get to know them, their substance use, the severity, the risks, complications and their circumstances – we always ask them what it is they want. It’s no good assuming or imposing, it’s about where they are and what they want to achieve, whether it’s the person with the substance-use issue or a family member.
“We look at all this complexity, which is different from person to person, then invite them for a face-to-face assessment and encourage them to bring their partner or loved ones with them.”
This is when David and the DAWN team get a comprehensive understanding of the person and any mental health issues that may underpin their substance use, or vice versa.
“This holistic view of their substance use and physical and mental health enables us to recommend support and treatment that suits them,” says David. “There are so many options available to us, from individual and family counselling to psychotherapy (using things like cognitive and dialectal behavioural therapy) and pharmacotherapy (using pharmaceutical drugs to improve ongoing symptoms, assist with withdrawal and help treat the underlying condition).
“Whatever program we decide on with the individual and their family, we work closely with their GP and local agencies providing support in different areas of their life so we understand how the individual is getting on and what’s working or not working for them.
“There’s a lot of ongoing liaison on how they are progressing. And the key word there is ‘ongoing’. We’re not going anywhere. Even after someone is discharged from our service, even if they’ve made a lot of progress, we’re always here and they are welcome to re-engage with us at any time wherever they are on their substance use and mental health journey.”
If you or someone you know is struggling with substance use and dependency, or if you’d just like to find out more about St John of God Drug and Alcohol Withdrawal Network (DAWN), visit www.sjog.org.au/dawn
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