Download Policy Platform: Comorbidity Youth Coalition of the ACT

Policy Platform: Comorbidity
Youth Coalition of the ACT
For more information on comorbidity, refer also to the Mental Health Policy Platform,
and the Alcohol, Tobacco and Other Drug Policy Platform.
Comorbidity refers to the concurrent occurrence of more than one disease or
disorder in one person. The National Comorbidity Initiative’s definition of comorbidity,
and the broad definition used for this document, is the ‘coexistence of substance use
and mental health disorders’, where the disorders are assumed to occur
concurrently1. For the purposes of this policy, substance use may also be referred to
as alcohol, tobacco and other drug (ATOD) use.
Young people with mental health disorders are 5 times more likely misuse drugs than
those without a mental health disorder (36% compared to 7%)2. Some population
estimates indicate that over one third of people with an ATOD use disorder also have
at least one comorbid mental health disorder3.
A critical period for developing comorbidity is throughout adolescence. Although
comorbidity affects a range of age groups, young people have been identified as at
significant risk of poor treatment outcomes as a result of comorbidity4.
Supporting young people to address their mental health and ATOD use issues
requires a high degree of flexibility, a commitment to collaborative approaches and a
respect for the complexities of comorbid presentations. The duel stigma of mental
health diagnosis and ATOD use can present unique barriers to young people seeking
support. Further to this, the casual link between ATOD use and mental health issues
can be confusing and difficult for young people to identify, or those working to
support them.
The Youth Coalition strongly supports headspace ACT, an early intervention service
for young people experiencing low to moderate mental health issues, and/or alcohol
and other drug issues. headspace ACT is a key agency in the ACT youth mental
health service system, and currently receives no funding from the ACT Government,
despite experiencing increasing demand. The Youth Coalition urgently advocates for
the ACT Government to contribute funding to this vital service before it reaches
capacity.
It is also vitally important to recognise the broader disadvantages and issues facing
young people experiencing comorbidity, and that youth services need greater
resources and ongoing professional development to effectively engage with this
cohort.
Existing evidence suggests that homeless people are more likely to experience
mental health conditions than those who are not homeless. Moreover, it suggests
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that prevalence rates of substance use disorders among homeless persons exceed
general population estimates and that co-morbidity of substance use and other
mental disorders is common5. This research indicates that a wrap-around model of
service provision is necessary to address comorbidity in young people.
Commitments
1. Sourcing and delivering up-to-date and evidence based training for the youth
sector on the issue of comorbidity.
2. Advocating for further funding and resources for agencies that support young
people with comorbid presentations.
3. Promoting greater collaboration within the youth sector to address issues for
young people with comorbid presentations in areas such as housing,
education and criminal justice settings.
4. Advocating for the active involvement of young people in designing, planning
and evaluating youth policy and service delivery frameworks.
5. Advocating for the active and supported participation of young people in their
individual care planning and case management.
6. Advocating for the establishment of a Youth Health Network to:
- Facilitate linkages between mental health services and the youth sector to
improve co-ordination, collaboration and advocacy on youth issues and
ensure integrated health service provision;
- Provide networking and information sharing opportunities for workers and
services in the youth mental health sector; and,
- Facilitate linkages and partnerships between NGO and Government mental
health agencies.
7. Progressing cross-sectoral approaches, such as the partnership between the
Alcohol Tobacco and Other Drugs Association of the ACT, the Mental Health
Community Coalition ACT, and the Youth Coalition of the ACT in operating
the ‘Comorbidity Bus Tours’.
1
Australian Institute of Health and Welfare (2005) National Comorbidity Initiative, Australian
Government, Canberra
2
Australian Bureau of Statistics (2007) Mental Health of Young People, Australian Government,
Canberra
3
National Drug and Alcohol Research Centre (2009) Guidelines on the Management of Co-Occurring
Alcohol and Other Drug and Mental Health Conditions, New South Wales
4
National Youth Affairs Research Scheme (2005) Barriers to Service Provision for Young People with
Presenting Substance Misuse and Mental Health Problems, Department of Families, Housing,
Community Services and Indigenous Affairs, Canberra.
5
Flatau, P; Conroy, E; Clear, A; Burns, L (2010) Position Paper No. 132: The Integration of
Homelessness, Mental Health and Drug and Alcohol Services in Australia, Australian Housing and
Urban Research Institute
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