This blog first appeared on the St Mungo’s Broadway blog on November 4, 2014.
Dan Ware, Deputy Manager at our Lambeth Assessment Centre, took part in an innovative study trip this year, funded by the London Housing Foundation (LHF), to learn more about how homelessness services operate in the United States. In the fourth of a series about the trip, he writes about the importance of dual diagnosis – addressing mental health issues and substance issues together.
So here I am, sitting in a Portland Dual Diagnosis Anonymous meeting. The guy next to me says:
“Hi I’m Dave, and I am dually diagnosed.”
“Hi Dave!” replies the 10 strong group.
It’s my turn (oh no!):
“Hi I’m Dan and errr…I’m from London”
“Hi Dan!” replies everyone.
Everyone talks individually about how their week has been, some have had a bad one, some good, some indifferent, some quiet.
One guy nearly relapsed on whiskey, another guy says he’s been the happiest he’s ever been (despite a history of severe depression and suicide attempts).
Corbett Monica is the founder of Dual Diagnosis Anonymous (DDA).
Corbett is a cloth-capped, white bearded “cool cat” with that real West coast ‘peace and love’ vibe. He says “Right On” a lot (which I love).
But things were not so “Right On” for Corbett a few decades ago, when he had been admitted to a Mental Health Unit and become addicted to heroin. He talks about suffering from the mental scars of serving his country in the Vietnam war, getting clean and well, and then becoming a counsellor in the US’ large prison ‘rehabilitation’ system.
He told me he saw a lot of young men and women with not just addiction problems but addiction problems and mental health problems – diagnosed and undiagnosed personality disorders; learning disabilities; psychosis, depression, anger management issues, the list goes on.
He also saw that these people kept ending up back in prison, that they weren’t getting the help they needed…sadly, this sounded familiar to me too.
What Corbett did (and I do simplify the story here), was use his counselling skills and the already established AA Model to create Dual Diagnosis Anonymous (DDA).
The movement has increased in size and now has around 100 chapters (branches) in the state of Oregon.
Other chapters have also sprung up on the East coast of America, in Ireland and in Prague.
Doyal Smith, Chief Exec of DDA, explains to me that the DDA Fellowship continues to win local contracts, particularly in jails and hospitals, because it can consistently demonstrate that it reduces mental health hospital admissions and drug/ alcohol relapse.
It is essentially a peer support model – where people who have experienced dual diagnosis themselves work alongside with those currently experiencing mental health and substance use issues – which has minimal costs. In that meeting I went to I felt a strong sense of warmth, compassion and support for each other: it had a powerful effect.
Within the UK, St Mungo’s Broadway recently worked with Homeless Link on a report called Needs to Know.
This highlighted that highly vulnerable and chronically unwell homeless people are being overlooked by England’s local authorities’ in health plans and face barriers to accessing even basic healthcare. A recent survey revealed that:
- 73% of people who are homeless have a physical health problem
- 41% reported long-term health problems, compared with 28% of the general population
- 45% had been diagnosed with a mental health issue, compared with 25% of the general population
- 39% said they take drugs or are recovering from a drug problem
- 27% said they have or are recovering from an alcohol use problem
These statistics – and my personal experience – also reinforce my view that the status quo is in relation to dual diagnosis in the UK is ridiculous: it is inexcusable that the UK system doesn’t give it the acknowledgement and resources it requires.
What I also learnt from my time in America is that the substance use/ mental health service ‘divide’ does not exist with the same force as it does here in the UK…and that too was refreshing!
A Future. Now: Homeless Health Matters is our campaign focussing on health. One of our recommendations is that clinical commissioning groups should provide a wide range of therapies to meet the needs of their local communities – and this should include adequate provision of dual diagnosis services.
Dan was funded with a Personal Development Grant from the London Housing Foundation. To find out more ring us on 020 7934 0177 or email email@example.com