actcoss text final.indd - ACT Council of Social Service

wrong door’ policy. Indeed, despite the existence of
the links and contacts described above, consumer
consultation participants perceived that referral and
information pathways were ‘chaotic’, noting that it
was particularly difficult to get accurate information
about the crisis accommodation capacity of other
organisations. Consumers recounted experiences of
services being unable to assist them and failing to
provide them with links to other services.
An examination of specific
inter-sectoral relationships
The relationship between the ACT mental health
community sector and other areas of the community
sector varies considerably depending on:
• the particular sector area;
• the organisations concerned; and
• the existence of personal contacts between
the management and staff of particular
organisations.
Some of the primary issues arising around these
particular relationships are outlined below.
ALCOHOL AND DRUG SERVICES
People with a ‘dual-diagnosis’ or ‘co-morbid’
condition were consistently identified during
consultations as a primary area of unmet need. A
number of organisations suggested that the number
of dual-diagnosis service-users had increased in the
last few years partly due to increased use of crystal
methamphetamine (‘crystal meth’ or ‘ice’), and
that such cases were often linked to homelessness.
Services reported that the dual-diagnosis population
group were frequently ‘shunted’ from service to
service, and were unable to have all their service
needs met at any particular time. Although most
AOD service users with mental health problems can
be managed by such services, a person with a severe
mental health condition and a moderate or serious
drug and alcohol condition may be unable to access
residential AOD services until their mental health
condition has stabilised. Likewise, dual-diagnosis
clients pose challenges for mental health vocational
rehabilitation services which have strict prohibitions
on drug use within the workplace. Consumers
expressed the view that AOD services were easier to
access, with less of a diagnosis hurdle, than mental
health services.
Consultation participants indicated that relations
between the mental health and the alcohol and drug
sectors continued to be characterised by a mutual
lack of awareness, understanding and respect. This is
despite recent ACT Government initiatives to better
integrate the two sub-sectors. Such sentiments are
reflected in the following participant quotes:
‘Never the twain shall meet’.
‘Nobody knows who to talk to’.
Organisations consulted particularly highlighted the
lack of understanding of problem substance use
issues by those in the mental health sector. Alcohol
and drug services consulted suggested that they
had closer relations with government mental health
services than community mental health services.
For example, some joint case management occurs
between MHACT and AOD community services,
but little between the community AOD and mental
health sectors. One participant expressed the view
that existing case management systems needed to
be better streamlined. There seemed to be a fairly
low level of awareness, within both sectors, of the
particular services and facilities of the other.
Some community mental health day programs and
vocational rehabilitation services have a strict policy
of temporarily suspending service to clients who
are under the influence of alcohol or drugs. In this
event, though some indicated that they would liaise
with relevant AOD services, they did not have a
standing relationship with the AOD sector. Others
indicated that they were unaware what happened
to service users after eviction. AOD services also
have difficulty supporting dual-diagnosis clients.
One participant reported that she knew of dual
diagnosis service users, assessed as mentally stable
at the time of admission to a detoxification facility,
who then become extremely unwell over the
course of several weeks. This can have disastrous
NO WRONG DOORS Towards an integrated mental health service system in the ACT•June 2007
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