Dual Diagnosis: An Information Guide - Community Networks

Dual Diagnosis An information guide

Yona Lunsky, PhD, C.Psych Jonathan Weiss, PhD, C.Psych

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Dual diagnosis

An information guide

Yona Lunsky, PhD, CPsych Jonathan Weiss, PhD, CPsych

A Pan American Health Organization / World Health Organization Collaborating Centre

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Library and Archives Canada Cataloguing in Publication

Dual Diagnosis: an information guide / W.J. Wayne Skinner ... [et al.].

Issued also in electronic formats.

1. Dual diagnosis. 2. Mentally ill--Alcohol use. 3. Mentally ill--Drug use. 4. Substance abuse. 5. Mental illness. I. Skinner, W. J. Wayne, 1949- II. Centre for Addiction and Mental Health

RC564.68.C65 2011

616.86

C2011-901557-9

isbn: 978-1-77114-029-4 (print) isbn: 978-1-77114-030-0 (pdf) isbn: 978-1-77114-031-7 (html) isbn: 978-1-77114-032-4 (epub)

Printed in Canada Copyright ? 2012 Centre for Addiction and Mental Health

No part of this work may be reproduced or transmitted in any form or by any means electronic or mechanical, including photocopying and recording, or by any information storage and retrieval system without written permission from the publisher--except for a brief quotation (not to exceed 200 words) in a review or professional work.

This publication may be available in other formats. For information about alternative formats or other CAMH publications, or to place an order, please contact Sales and Distribution:

Toll-free: 1 800 661-1111 Toronto: 416 595-6059 E-mail: publications@ Online store:

Website: camh.ca

Disponible en fran?ais sous le titre : Le double diagnostic : Guide d'information

This book was produced by CAMH's Knowledge and Innovation Support Unit.

3973N/ 09-2012

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Contents

Acknowledgments iv

Introduction v

1 What is dual diagnosis? 1

Developmental disability How common is dual diagnosis?

2 Recognizing dual diagnosis 5

The relationship between developmental disability and mental health problems

3 Treatment 13

Treatment principles Where do people get treatment? Treatment planning Types of treatment Co-ordinating treatment Hospitalization

4 Crisis and emergency 32

Crisis and emergency plans Getting treatment in an emergency

5 How dual diagnosis affects families 44

Family relationships

6 Self-care for family members 48

Developing resilience Self-care strategies Building a self-care plan

References 55

Resources 58

Websites Books

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Acknowledgments

Our sincerest thanks to the many families we have worked with and learned from over the course of our work. We would not have been able to put together this guide without their willingness to share their stories of struggle, triumph and resilience. We were continually impressed and humbled by parents' ongoing desire to help other families and to improve the system of supports available to their sons and daughters, sisters and brothers with developmental disabilities.

We also wish to thank Wayne Skinner and Caroline O'Grady in the Concurrent Disorders Program at CAMH, who developed A Family Guide to Concurrent Disorders. Their insights and advice were invaluable in helping us to develop A Family Guide to Dual Diagnosis and this brief guide.

We could not have done this work without the support of the Dual Diagnosis Program at CAMH. The staff are tireless advocates for families, living and breathing family-centred care. We thank them for their valuable feedback. Thanks also to members of the Family Issues Committee of NADD Ontario--the Ontario Chapter of the National Association for the Dually Diagnosed--for their review and input. And we are grateful to Ami Tint for helping us to develop this guide over the past two years. A huge thanks to Caroline Hebblethwaite, who managed the development of this guide from the beginning. She is a real champion for our population and has remarkable patience and attention to detail. Finally, we want to thank our copy editors, Hema Zbogar and Jacquelyn Waller-Vintar.

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Introduction

This guide was developed for the families of people with developmental disabilities. It provides basic information about dual diagnosis and explains what we know about services and supports and how to best access them. It also suggests ways to take care of yourself while being a caregiver.

Concurrent substance use and mental health disorders: An information guide

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1 What is dual diagnosis?

The term dual diagnosis is used to describe a situation where someone has both a developmental disability and a mental health problem.

Developmental disabilities and mental health problems are sometimes very hard to tease apart. Family members and treatment professionals often find it difficult to determine whether the behaviour they are looking at is due to an underlying disability or a mental health problem--or both.

A NOTE ABOUT LANGUAGE

Dual diagnosis: In Ontario, and in most places in Canada, the term dual diagnosis refers to the combination of a developmental disability and mental health problem. In countries other than Canada, dual diagnosis might refer to a different problem: psychiatric disorder and alcohol or other substance use issue. In reading about dual diagnosis, it is important to know which diagnoses the authors are referring to.

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