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Transcript
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 Youth Coalition of the ACT November 2010 1 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 Youth Coalition of the ACT November 2010 2