(2011) Evaluation of the Victorian Dual Diagnosis Initiative

1. Executive Summary
1 EXECUTIVE SUMMARY
1.1 Introduction
The Department of Health, Mental Health, Drugs and Regions Division has commissioned this
evaluation of the Victorian Dual Diagnosis Initiative (VDDI). The initiative was first formally funded in
2001, which saw four VDDI teams established each with a rural component. Since the inception of
VDDI, some additional strategies have been added, including youth specific positions, additional
psychiatric time, funding to support rotations between sectors and the establishment of an education
and training unit. A major policy document on Dual Diagnosis was released in 2007 by the Department
of Health.
The purpose of the initiative is to deliver an improved service response for people that experience dual
diagnosis issues.
1.2 Context
Dual diagnosis in this instance refers to people who have concurrent mental health and substance use
disorders. There are a number of compelling reasons for focusing on building improved responses to
people with dual diagnosis issues and these include:
• The high prevalence of dual diagnosis issues; between one third and one half of clients of
mental health and alcohol and other drug (AOD) services are affected
• People with dual diagnosis are more likely to experience poorer health outcomes across a
range of key indicators
• Treatment of dual diagnosis is challenging because of the chronic, relapsing, and impairing
nature of both issues
• Traditionally people with dual diagnosis have been very poorly serviced, often being rejected by
clinical mental health or AOD services because of the presence of the ‘other’ disorder
It was in recognition of these major concerns that VDDI was funded by the Victorian Government.
Three sectors are the target of the initiative, clinical mental health, Psychiatric Disability and
Rehabilitation Support Services and Alcohol and Other Drug Services. There is a total of approximately
6,000 workers across the three sectors, of which around 4,500 are employed in clinical mental health.
The three sectors provide quite diverse functions, use different frameworks for working with their client
groups and employ staff with differing qualifications and/or professional backgrounds.
The evidence on responding to dual diagnosis issues is still emerging and this makes the task more
challenging. Generally the acceptance is that responses that ensure that both disorders are identified
and taken account of, is the best approach. There is some consensus that integrated care offers the
most options for treatment particularly when the range of required services are located in the one
setting.
There is some complexity in the service environment around responding to mental health issues.
People with the most acute presentations of mental illness, and in particular those experiencing
psychosis are the target group for clinical mental health services. However the great majority of people
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