The prevalence and management of co-morbid substance misuse and mental illness: results of a screening survey in substance misuse and mental health treatment populations

Article

Weaver, T., Hickman, M., Rutter, D., Ward, J., Stimson, G. and Renton, A. 2001. The prevalence and management of co-morbid substance misuse and mental illness: results of a screening survey in substance misuse and mental health treatment populations. Drug and Alcohol Review. 20 (4), pp. 407-416. https://doi.org/10.1080/09595230120092724
TypeArticle
TitleThe prevalence and management of co-morbid substance misuse and mental illness: results of a screening survey in substance misuse and mental health treatment populations
AuthorsWeaver, T., Hickman, M., Rutter, D., Ward, J., Stimson, G. and Renton, A.
Abstract

A cross-sectional survey of clinical staff was carried out among statutory (public sector) substance misuse services and community mental health teams (CMHTs) in an inner London borough. We identified 368 current patients of drug and alcohol misuse services and 930 current patients of CMHTs. We measured the prevalence of co-morbid substance misuse and mental illness among thesepatients. We found strong evidence of co-morbid mental health problems in 128 substance misusepatients (34.8%) and evidence of possible co-morbidity in a further 18.5% of cases. Among mental health service patients, 227 (24%) were reported to have current substance misuse problems.Shared care of patients was uncommon and only a minority of co-morbid patients receivedtreatment for both problems or the specialist assessment which key workers felt they needed. The findings suggest that co-morbidity is highly prevalent among mental health and substance misusepatients. Further research is needed to corroborate these findings, but the development and provision of evidence-based treatment and service interventions is likely to become an increasing priority.

Keywordsco-morbid substance misuse and mental illness; prevalence; clinical management
Sustainable Development Goals3 Good health and well-being
Middlesex University ThemeHealth & Wellbeing
PublisherWiley
JournalDrug and Alcohol Review
ISSN0959-5236
Electronic1465-3362
Publication dates
Print31 Dec 2001
Online29 May 2009
Publication process dates
Submitted05 Oct 2000
Accepted12 Jul 2001
Deposited26 Aug 2022
Output statusPublished
Digital Object Identifier (DOI)https://doi.org/10.1080/09595230120092724
Web of Science identifierWOS:000172898500007
LanguageEnglish
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Borschmann, R., Patterson, S., Poovendran, D., Wilson, D. and Weaver, T. 2014. Influences on recruitment to randomised controlled trials in mental health settings in England: a national cross-sectional survey of researchers working for the Mental Health Research Network. BMC Medical Research Methodology. 14 (1), p. 23. https://doi.org/10.1186/1471-2288-14-23
Monitoring and management of metabolic abnormalities: mixed-method evaluation of a successful intervention
Wilson, E., Randall, C., Patterson, S., Emmerson, B., Moudgil, V. and Weaver, T. 2014. Monitoring and management of metabolic abnormalities: mixed-method evaluation of a successful intervention. Australasian Psychiatry. 22 (3), pp. 248-253. https://doi.org/10.1177/1039856214529000
The effect of organisational resources and eligibility issues on transition from child and adolescent to adult mental health services
Belling, R., McLaren, S., Paul, M., Ford, T., Kramer, T., Weaver, T., Hovish, K., Islam, Z., White, S. and Singh, S. 2014. The effect of organisational resources and eligibility issues on transition from child and adolescent to adult mental health services. Journal of Health Services Research & Policy. 19 (3), pp. 169-176. https://doi.org/10.1177/1355819614527439
Are problem-solving courts the way forward for justice?
Ward, J. 2014. Are problem-solving courts the way forward for justice? The Howard League for Penal Reform.
Multi-method Evaluation of the Management, Organisation and Staffing (MEMOS) in high security treatment services for people with Dangerous and Severe Personality Disorder (DSPD)
Trebilcock, J. and Weaver, T. 2010. Multi-method Evaluation of the Management, Organisation and Staffing (MEMOS) in high security treatment services for people with Dangerous and Severe Personality Disorder (DSPD). Personality Disorder Team.
Everybody knows that the prisoner is going nowhere: Parole Board members’ views about dangerous and severe personality disorder in England and Wales
Trebilcock, J. and Weaver, T. 2012. Everybody knows that the prisoner is going nowhere: Parole Board members’ views about dangerous and severe personality disorder in England and Wales. International Journal of Criminology and Sociology. 1, pp. 141-150. https://doi.org/10.6000/1929-4409.2012.01.14
‘Talking a different language’: an exploration of the influence of organizational cultures and working practices on transition from child to adult mental health services
McLaren, S., Belling, R., Paul, M., Ford, T., Kramer, T., Weaver, T., Hovish, K., Islam, Z., White, S. and Singh, S. 2013. ‘Talking a different language’: an exploration of the influence of organizational cultures and working practices on transition from child to adult mental health services. BMC Health Services Research. 13. https://doi.org/10.1186/1472-6963-13-254
Punishing drug possession in the magistrates’ courts: time for a rethink
Ward, J. 2013. Punishing drug possession in the magistrates’ courts: time for a rethink. European Journal on Criminal Policy and Research. 19 (4), pp. 289-307. https://doi.org/10.1007/s10610-012-9191-1
The commissioning and provision of advocacy for problem drug users in English DATS; a cross sectional survey
Cargill, T., Weaver, T. and Patterson, S. 2012. The commissioning and provision of advocacy for problem drug users in English DATS; a cross sectional survey. Drugs: Education, Prevention, and Policy. 19 (2), pp. 163-170. https://doi.org/10.3109/09687637.2011.609204
Changing legal characteristics of dangerous and severe personality disorder (DSPD) patients and prisoners
Trebilcock, J. and Weaver, T. 2012. Changing legal characteristics of dangerous and severe personality disorder (DSPD) patients and prisoners. The Journal of Forensic Psychiatry & Psychology. 23 (2), pp. 237-243. https://doi.org/10.1080/14789949.2012.668212
‘It doesn't have to be treatable’: Mental Health Review Tribunal (MHRT) members’ views about Dangerous and Severe Personality Disorder (DSPD)
Trebilcock, J. and Weaver, T. 2012. ‘It doesn't have to be treatable’: Mental Health Review Tribunal (MHRT) members’ views about Dangerous and Severe Personality Disorder (DSPD). The Journal of Forensic Psychiatry & Psychology. 23 (2), pp. 244-260. https://doi.org/10.1080/14789949.2012.668208
Selecting outcome measures in mental health: the views of service users
Crawford, M.J., Robotham, D., Thana, L., Patterson, S., Weaver, T., Barber, R., Wykes, T. and Rose, D. 2011. Selecting outcome measures in mental health: the views of service users. Journal of Mental Health. 20 (4), pp. 336-346. https://doi.org/10.3109/09638237.2011.577114
Siblings of young people with Duchenne muscular dystrophy -- a qualitative study of impact and coping
Read, J., Kinali, M., Muntoni, F., Weaver, T. and Garralda, E. 2011. Siblings of young people with Duchenne muscular dystrophy -- a qualitative study of impact and coping. European Journal of Paediatric Neurology. 15 (1), pp. 21-28. https://doi.org/10.1016/j.ejpn.2010.07.006
Policing public drugs nuisance through the anti-social behaviour legislation: questions and contradictions
Ward, J. 2011. Policing public drugs nuisance through the anti-social behaviour legislation: questions and contradictions. European Journal on Criminal Policy and Research. 17 (4), pp. 323-341. https://doi.org/10.1007/s10610-011-9155-x
One problem among many: drug use among care leavers in transition to independent living
Ward, J., Henderson, Z. and Pearson, G. 2003. One problem among many: drug use among care leavers in transition to independent living. London, UK Home Office Research, Development and Statistics Directorate.
Tracking care leavers as they move to independence.
Ward, J. and Pearson, G. 2003. Tracking care leavers as they move to independence. Economic and Social Research Council.
Process, outcome and experience of transition from child to adult mental healthcare: multiperspective study
Singh, S.P., Paul, M., Ford, T., Kramer, T., Weaver, T., McLaren, S., Hovish, K., Islam, Z., Belling, R. and White, S. 2010. Process, outcome and experience of transition from child to adult mental healthcare: multiperspective study. The British Journal of Psychiatry. 197 (4), pp. 305-312. https://doi.org/10.1192/bjp.bp.109.075135
Drug service user groups: only a partial solution to the problem of developing user involvement
Patterson, S., Weaver, T. and Crawford, M. 2010. Drug service user groups: only a partial solution to the problem of developing user involvement. Drugs: Education, Prevention, and Policy. 17 (1), pp. 84-97. https://doi.org/10.3109/09687630802225495
The prevalence of personality disorder, its comorbidity with mental state disorders, and its clinical significance in community mental health teams
Newton-Howes, G., Tyrer, P., Anagnostakis, K., Cooper, S., Bowden-Jones, O. and Weaver, T. 2010. The prevalence of personality disorder, its comorbidity with mental state disorders, and its clinical significance in community mental health teams. Social Psychiatry and Psychiatric Epidemiology. 45 (4), pp. 453-460. https://doi.org/10.1007/s00127-009-0084-7
A qualitative study of illicit and non-prescribed drug use amongst people with psychotic disorders
Charles, V. and Weaver, T. 2010. A qualitative study of illicit and non-prescribed drug use amongst people with psychotic disorders. Journal of Mental Health. 19 (1), pp. 99-106. https://doi.org/10.3109/09638230802523039
Child involvement in the paediatric consultation: a qualitative study of children and carers' views
Taylor, S., Haase-Casanovas, S., Weaver, T., Kidd, J. and Garralda, E.M. 2010. Child involvement in the paediatric consultation: a qualitative study of children and carers' views. Child: Care, Health & Development. 36 (5), pp. 678-685. https://doi.org/10.1111/j.1365-2214.2010.01076.x
Delusions and qualitative confusions: a dialogic collaborative exploration
Patterson, S., Hart, J. and Weaver, T. 2010. Delusions and qualitative confusions: a dialogic collaborative exploration. Qualitative Health Research. 20 (7), pp. 1008-1018. https://doi.org/10.1177/1049732310363805
Assessment of adverse effects in clinical studies of antipsychotic medication: survey of methods used
Pope, A., Adams, C., Paton, C., Weaver, T. and Barnes, T.R.E. 2010. Assessment of adverse effects in clinical studies of antipsychotic medication: survey of methods used. The British Journal of Psychiatry. 197 (1), pp. 67-72. https://doi.org/10.1192/bjp.bp.109.070961
Flashback: drugs and dealing in the golden age of the London rave scene
Ward, J. 2010. Flashback: drugs and dealing in the golden age of the London rave scene. Cullompton, UK Willan Publishing.
Young people’s perceptions of risk
Ward, J. and Bayley, M. 2007. Young people’s perceptions of risk. in: Thom, B., Sales, R. and Pearce, J. (ed.) Growing up with risk London Policy Press. pp. 37-56
User involvement in efforts to improve the quality of drug misuse services in England: a national survey
Patterson, S., Weaver, T., Agath, K., Rutter, D., Albert, E. and Crawford, M. 2009. User involvement in efforts to improve the quality of drug misuse services in England: a national survey. Drugs: Education, Prevention, and Policy. 16 (4), pp. 364-377. https://doi.org/10.1080/09687630802061544
Dedicated personality disorder services: a qualitative analysis of service structure and treatment process
Price, K., Gillespie, S., Rutter, D., Dhillon, K., Gibson, S., Faulkner, A., Weaver, T. and Crawford, M.J. 2009. Dedicated personality disorder services: a qualitative analysis of service structure and treatment process. Journal of Mental Health. 18 (6), pp. 467-475. https://doi.org/10.3109/09638230902968191
'They can't solve the problem without us': a qualitative study of stakeholder perspectives on user involvement in drug treatment services in England
Patterson, S., Weaver, T., Agath, K., Albert, E., Rhodes, T., Rutter, D. and Crawford, M. 2009. 'They can't solve the problem without us': a qualitative study of stakeholder perspectives on user involvement in drug treatment services in England. Health and Social Care in the Community. 17 (1), pp. 54-62. https://doi.org/10.1111/j.1365-2524.2008.00797.x
Drug consumption in London - A city of diverse and changing scenes
Ward, J. and Thom, B. 2009. Drug consumption in London - A city of diverse and changing scenes. in: Eisenbach-Stangl, I., Moskalewicz, J. and Thom, B. (ed.) Two worlds of drug consumption in late modern societies England Ashgate. pp. 39-56
Quantities, quality, costs and sources.
Moskalewicz, J., Ward, J. and Thom, B. 2009. Quantities, quality, costs and sources. in: Eisenbach-Stangl, I., Moskalewicz, J. and Thom, B. (ed.) Two worlds of drug consumption in late modern societies. Ashgate. pp. 247-280
Transitions of care from child and adolescent mental health services to adult mental health services (TRACK study): a study of protocols in Greater London
Singh, S., Paul, M., Ford, T., Kramer, T. and Weaver, T. 2008. Transitions of care from child and adolescent mental health services to adult mental health services (TRACK study): a study of protocols in Greater London. BMC Health Services Research. 8 (1), pp. 1-7. https://doi.org/10.1186/1472-6963-8-135
Attitudes of staff towards patients with personality disorder in community mental health teams
Newton-Howes, G., Weaver, T. and Tyrer, P. 2008. Attitudes of staff towards patients with personality disorder in community mental health teams. Australian & New Zealand Journal of Psychiatry. 42 (7), pp. 572-577. https://doi.org/10.1080/00048670802119739
Social functioning of patients with personality disorder in secondary care
Newton-Howes, G., Tyrer, P. and Weaver, T. 2008. Social functioning of patients with personality disorder in secondary care. Psychiatric Services. 59 (9), pp. 1033-1037. https://doi.org/10.1176/ps.2008.59.9.1033
Dedicated community-based services for adults with personality disorder: Delphi study
Crawford, M.J., Price, K., Rutter, D., Moran, P., Tyrer, P., Bateman, A., Fonagy, P. and Weaver, T. 2008. Dedicated community-based services for adults with personality disorder: Delphi study. The British Journal of Psychiatry. 193 (4), pp. 342-343. https://doi.org/10.1192/bjp.bp.107.043042
Researching drug sellers: an 'experiential' account from 'the field'
Ward, J. 2008. Researching drug sellers: an 'experiential' account from 'the field'. Sociological Research Online. 13 (1), pp. 31-42. https://doi.org/10.5153/sro.1673
Drug use and drug dealing in the rave club culture
Ward, J. 2007. Drug use and drug dealing in the rave club culture. PhD thesis Goldsmiths College (University of London) Goldsmiths College
Qualitative investigation of the mental health of migrants from former Yugoslavia: implications for epidemiological research
Djuretic, T., Crawford, M. and Weaver, T. 2007. Qualitative investigation of the mental health of migrants from former Yugoslavia: implications for epidemiological research. Journal of Mental Health. 16 (6), pp. 743-755. https://doi.org/10.1080/09638230701496394
Broadening the discussion on sexual exploitation: ethnicity, sexual exploitation and young people
Ward, J. and Patel, N. 2006. Broadening the discussion on sexual exploitation: ethnicity, sexual exploitation and young people. Child Abuse Review. 15 (5), pp. 341-350.
Prevalence of personality disorder in alcohol and drug services and associated comorbidity
Bowden-Jones, O., Iqbal, M., Tyrer, P., Seivewright, N., Cooper, S., Judd, A., Weaver, T. and the COSMIC study team 2004. Prevalence of personality disorder in alcohol and drug services and associated comorbidity. Addiction. 99 (10), pp. 1306-1314. https://doi.org/10.1111/j.1360-0443.2004.00813.x
User involvement in the planning and delivery of mental health services: a cross-sectional survey of service users and providers
Crawford, M.J., Aldridge, T., Bhui, K., Rutter, D., Manley, C., Weaver, T., Tyrer, P. and Fulop, N. 2003. User involvement in the planning and delivery of mental health services: a cross-sectional survey of service users and providers. Acta Psychiatrica Scandinavica. 107 (6), pp. 410-414. https://doi.org/10.1034/j.1600-0447.2003.00049.x
Assessing the value of assertive outreach: Qualitative study of process and outcome generation in the UK700 trial
Weaver, T., Tyrer, P., Ritchie, J. and Renton, A. 2003. Assessing the value of assertive outreach: Qualitative study of process and outcome generation in the UK700 trial. The British Journal of Psychiatry. 183 (5), pp. 437-435. https://doi.org/10.1192/bjp.183.5.437
Some practical and ethical issues encountered while conducting tracking research with young people leaving the 'care' system
Ward, J. and Henderson, Z. 2003. Some practical and ethical issues encountered while conducting tracking research with young people leaving the 'care' system. International Journal of Social Research Methodology. 6 (3), pp. 255-259. https://doi.org/10.1080/1364557032000091851
Review essay
Ward, J. 2001. Review essay. Policy Studies. 22 (2), pp. 135-142. https://doi.org/10.1080/01442870120096376
Results of a screening survey for co-morbid substance misuse amongst patients in treatment for psychotic disorders: prevalence and service needs in an inner London borough
Weaver, T., Rutter, D., Madden, P., Ward, J., Stimson, G. and Renton, A. 2001. Results of a screening survey for co-morbid substance misuse amongst patients in treatment for psychotic disorders: prevalence and service needs in an inner London borough. Social Psychiatry and Psychiatric Epidemiology. 36 (8), pp. 399-406. https://doi.org/10.1007/s001270170030
Residents' perceptions of water quality improvements following remediation work in the Pymme's Brook catchment, north London, UK
Faulkner, H., Green, A., Pellaumail, K. and Weaver, T. 2001. Residents' perceptions of water quality improvements following remediation work in the Pymme's Brook catchment, north London, UK. Journal of Environmental Management. 62 (3), pp. 239-254. https://doi.org/10.1006/jema.2001.0435
Opportunities for research: Changing Youth Transitions—new risks and vulnerabilities
Ward, J. 1998. Opportunities for research: Changing Youth Transitions—new risks and vulnerabilities. Drugs: Education, Prevention, and Policy. 5 (1), pp. 105-107. https://doi.org/10.3109/09687639809035776
Substance use among young people 'looked after' by social services
Ward, J. 1998. Substance use among young people 'looked after' by social services. Drugs: Education, Prevention, and Policy. 5 (3), pp. 257-267. https://doi.org/10.3109/09687639809034087
The Bentham unit: a pilot remand and assessment service for male mentally disordered remand prisoners. II: Report of an independent evaluation
Weaver, T., Taylor, F., Cunningham, B. and Maden, A. 1997. The Bentham unit: a pilot remand and assessment service for male mentally disordered remand prisoners. II: Report of an independent evaluation. The British Journal of Psychiatry. 170 (5), pp. 462-466. https://doi.org/10.1192/bjp.170.5.462