The Comorbidity Roundabout
The top causes of disease burden among Australians are dominated by mental health and alcohol or other drug use (AOD) disorders. Of significant concern is the common co-occurrence (i.e. comorbidity) of mental health and AOD disorders. It is estimated that almost one in five Australians with a mental health disorder also have a co-occurring AOD disorder.
Conversely, between 47-100 per cent of people in AOD treatment in Australia have co-occurring mental health disorders. This common comorbidity remains a major cause of disability, poor quality of life, early mortality and poses a significant challenge for the Australian health system. Despite growing evidence about integrated treatment, people with mental health and alcohol or another drug use comorbidity can find themselves on a ‘comorbidity roundabout’.
This study collated the perspectives of people with lived experience of these issues to better understand how mental health and AOD services can better address their experiences and treatment needs.
“I find that I use alcohol to escape feeling the fear and loss of control over my own mind. When I’m drunk it’s almost like I have a rest and my brain recovers and I can be again safe at my grandma’s place without a worry in the world. I would be loved again and I would be worth something not just the scraps of who I used to be.”
“Often people use drugs to relieve their mental health problems or memories of trauma. They are isolated and scared. Everyone wants to be included in life.”
“People thinking that I’m weak for taking medications, family thinking that all I need is a job, or to do something better, or that I have caused it myself, or that I just need to get over what happened to me and to stop playing the victim.”
“Providing education through visual means to the community regarding the causes and triggers for these issues and the struggles faced by individuals living with mental health and or AOD issues is crucial. Using all available channels such as social media, radio and television so that people are more understanding and equipped to better handle situations where a friend or loved one may need help and support.”
“Empowering those suffering from it and helping them to set boundaries to protect themselves from social media and others who abuse them. Educating the victims of mental health problems and having a more integrated or holistic approach when treating them, which will allow for educating their families and support systems.”
“Both MH and AOD issues went hand in hand for me. I think I would have started healing and growing much faster [if they had been treated in an integrated way].”
“It’s hard enough to open up to people and get a good connection. Only explaining yourself once would be fantastic.”
“In my experience it is difficult to see which one came first, but sitting in my shoes, it does not matter, it needs to be treated together, not sending me from mental health services to AOD services, back and forth. It needs to be treated holistically, and people need not give up on me because I have not ceased my drug use, or I relapse.”
“As soon as mental health services see AOD issues, they either refuse support or refer out. Mental health services do not do dual diagnosis well.”
“I had to go to so many different services and practitioners to find help. It took many years to and a lot of hard work and time by me to finally get on the right track.”
Reference: Barrett, E., et al. (2019). Lived experiences of Australians with mental health and AOD comorbidity and their perspectives on integrated treatment: Newparadigm Summer 2018 – 2019. NHMRC Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre (NDARC), University of New South Wales, School of Medicine and Public Health, University of Newcastle, Australia. Pages 38 – 42.