How can researchers support alcohol and other drug services to manage co-occurring mental health needs?

Student: Erin Madden

PhD title: Improving evidence-based-practice for co-occurring alcohol and other drug and mental health conditions: the role of implementation toolkits

For many, the co-occurrence of mental health conditions and alcohol and other drug (AOD) use is more common than we think.

Whether it be using AOD to cope with mental distress, mental distress arising because of AOD use, or anything in between, research has long suggested that there are links between how mental health and AOD use interact.  

It is important to note that AOD use is not only illicit drug use, like many may think. Needing a few wines in the afternoon to unwind from anxious thoughts, needing a vape or cigarette to cope with the stress of the day, or being on edge if alcohol isn’t available at a social event may indicate an interaction between AOD use and mental health.  

With studies showing that approximately half of people accessing AOD treatment have at least one co-occurring mental disorder, it is critical that the Australian AOD sector are supported to implement evidence-based practices for co-occurring AOD and mental health conditions.

As part of this support, Matilda Centre PhD candidate Erin Madden is developing an implementation toolkit to facilitate the translation of guidelines on co-occurring AOD and mental health conditions into practice. To ensure the toolkit is effective, she is consulting with AOD workers, and people with lived experience and their loved ones about how we can bridge evidence-to-practice gaps in the Australian AOD sector.   

I struggled with anxiety from a young age and eventually decided on a career change, which led me to completing a Masters of Brain and Mind Sciences. I was hoping to understand why my brain was the way it was, and that knowledge helped me immensely. I’ve been lucky enough to have mostly positive experiences with mental health treatment providers, but I still noticed a big discrepancy between what I was being taught was evidence-based and the treatment I received.

These experiences motivated me to work on research projects that could help translate evidence to practice, which led me to working on the dissemination of the Guidelines on co-occurring conditions (the Guidelines) at the Matilda Centre. Working as part of the Guidelines team has been a fantastic opportunity to ensure research evidence is accessible to anyone working with people experiencing co-occurring AOD and mental health needs. 

The Guidelines (now in their third edition) are an Australian Government Department of Health and Aged Care-funded resource that provides evidence-based information and training for AOD workers on how to identify and manage co-occurring mental health and AOD conditions. The Guidelines are widely used by workers across the AOD sector, but they are focused on the workforce.

It is currently outside the scope of the Guidelines to address organisational or systemic barriers that may prevent workers from using what they’ve learnt in practice. This is the gap the implementation toolkit aims to address.

For service managers or quality improvement staff seeking to implement the Guidelines in their organisation, the toolkit will outline why some Guidelines recommendations may be more difficult to implement in practice, and strategies organisations can take to address barriers to implementation. 

Perspectives about what evidence-to-practice gaps currently exist and why these may differ between people delivering care (e.g. AOD workers) and people receiving care (e.g. people receiving AOD treatment and their loved ones). The toolkit will need to capture perspectives of stakeholder groups across all aspects of AOD service delivery to properly identify and address current evidence to practice gaps, which is why I’m consulting with AOD workers, AOD service managers or quality improvement staff, people with lived experience of receiving AOD treatment and their loved ones.

I hope the implementation toolkit will not only acknowledge the barriers AOD services and staff face when trying to implement evidence-based care, but also help address these barriers. People who experience co-occurring mental health and AOD use, their loved ones and AOD workers face a lot of adversity and stigma, but in my experience often still do everything they can to help themselves or others.

In an ideal world it would be easy to implement evidence-based practice, but in reality a lack of resources makes it difficult. Research projects like the Guidelines implementation toolkit will hopefully help AOD services overcome these barriers, improve evidence-based practice, and ultimately improve treatment outcomes for people experiencing co-occurring mental health and AOD use. 

Interested in learning more about Erin’s work? Find out more about getting involved in the Guidelines implementation toolkit study below.

Study information for AOD staff 

Study information for AOD service managers or quality improvement staff

Study information for people with lived experience 

Study information for loved ones or carers