Integrated drug and alcohol intervention: development of an opportunistic intervention program to reduce alcohol and other substance use among psychiatric patients

Abstract

Objective: This paper describes the rationale, aims and processes involved in developing and implementing an opportunistic intervention program to reduce substance misuse detected among psychiatric patients.

Method: In this randomised, opportunistic intervention program, eligible patients recruited from a large psychiatric hospital and its associated community mental health centres are assigned to receive an integrated drug and alcohol intervention (IDAI) or alternatively allocated to a minimal intervention condition (MI). The IDAI is based on motivational enhancement and cognitive-behavioural principles, and incorporates harm-reduction approaches. This clinical program is based on the research findings and recommendations of the mental health and the drug and alcohol literature.

Results: A collaborative partnership between the Mental Health Services and the Drug and Alcohol Services was formed. Following a relatively short training period, mental health staff were trained to opportunistically detect drug and alcohol problems among psychiatric patients and offer appropriate integrated clinical care.

Conclusion: The process of implementing an integrated opportunistic intervention program is achievable and can be readily incorporated in psychiatric hospitals and community mental health clinics.