Download Many challenges face looked after children and

DUAL DIAGNOSIS
AND LOOKED
AFTER CHILDREN
Lois Dugmore Nurse Consultant – Dual
Diagnosis
1 www.leicspart.nhs.uk
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What do we know?
 Many challenges face looked after children and
within mental health services many present with:
 Complex substance misuse and mental health.
 Self medication through drugs and alcohol
 Unable to engage with education, and employmnet.
 Fail to engage with health teams
 Delayed emotional development. Reactive
attachment and emotional disorder including anxiety
and depression
 Sexual exploitation
 Financial, physical and emotional abuse
 Criminal justice system
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YPOD PROJECT
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
Housing project aimed at 16-22 year olds leaving care with complex need.

Specific dual diagnosis post funded by YPOD

Linked in for supervision/advice service contact to local dual diagnosis nurse
consultant from local nhs trust.

Developed service model that incorporated looked after children nurses from
child and adolescent mental health services being based at YPOD project TO
see client group.

Links in with youth offending service, children and young peoples service and
educational institutions

Therapeutic approach
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ISSUES FOR SERVICES
 COLLABORATIVE WORKING
REDUCES DUPLICATON OF
SERVICES.
 IMPROVES OUTCOMES FOR
CLIENTS.
 UNDERSTAND THE
BARRIERS TO MULTIAGENCY WORKING.
 ROLE OF INCLUSIVE
TRAINING ACROSS
AGENCIES.
 DEVELOPMENT OF DUAL
DIAGNOSIS SPECIFIC
POSTS.
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 INCREASES ENGAGEMENT
FOR CLIENTS WITH
COMPLEX CHALLENGING
BEHAVIOUR.
 CUT OFF AT 18 CAN LEAD
TO GREATER RISK OF
ABUSE, PREGNANCY AND
CRIMINAL JUSTICE
OUTCOMES FOR THIS
CLIENT GROUP
 AS BRAIN DEVELOPMENT IS
INCOMPLETE UNTIL THE
MID 20’S IT IS COUNTER
INTUITIVE THAT LAC LEAVE
SUPPORT AT 18.
Why are we stuck?
 Partnerships don’t work unless commissioned
 Mental health and public health commissioning
divide unable to consider complex need
 Too many referral pathways to negotiate
 Higher financial cost
 No integration with education system
 Lack of effective transfer from cmhs to adult mental
health
 Lack of strategic opportunities and communication
 Drug and alcohol seen as normal
 Resolution to create services that meet the need.
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