actcoss text final.indd - ACT Council of Social Service

people with a dual diagnosis are not a separate
population group, rather they are represented
in the current client base of existing services, are
receiving poor services and are generally seen as
too hard by many professionals. 79
The Project went on to outline a number of issues
and problems arising around dual-diagnosis clients in
the ACT:
between services and sectors’ would enable the ACT
to more effectively implement a coordinate dual
diagnosis strategy.
In proposing the establishment of a ‘change
management’ approach to implement a new
integrated service delivery model, the report rejected
the proposal to develop a designated dual-diagnosis
facility, concluding that:
• access barriers to services from both ACT
Mental Health Services (ACTMHS) and Alcohol
and Drug Program (ADP) for both consumers
and their families;
• the absence of a co-ordinated and shared case
management approach with people being
shunted between services;
• significant professional differences between
the two fields, underpinned by different
professional orientations to treatment and
support and a limited understanding of the
respective diagnoses by the other service area;
• the absence of mechanisms to involve
consumers and families in service planning and
evaluation;
• a lack of respect for consumers;
• a failure to understand the need for a
commitment to engagement and long-term
interventions;
• limited understanding of and active involvement
with other sectors including NGOs and the
private sector services; and
• a poor understanding of dual diagnosis and
a lack of adequate and ongoing training. 80
(emphasis added)
The Project reported that a number of joint initiatives
were being undertaken between MHACT and the
Alcohol and Drug Program (ADP). It argued that the
size of the ACT population, its compact geographic
location and the nature of ‘overall good relationships
There is considerable evidence that specialist,
stand-alone services are neither the best service
response nor the most effective or efficient.
The international evidence suggests that a
comprehensive, integrated service system which
brings together mental health and alcohol
and drug services, working collaboratively
with consumers, families and non-government
services, delivers the best outcomes for
consumers and their families.
As noted above, the Project, though government
service centred, acknowledged the importance of
collaborative engagement with non-government
services (including Indigenous health services),
in addition to consumers, carers and general
practitioners. Nonetheless, consultation participants
perceived that relations had not significantly
improved since the Project. One development has
been the introduction of ‘Getting to know the
service system bus tours’, which have an emphasis
on dual-diagnosis, incorporating a number of mental
health and AOD facilities, organised monthly by the
Youth Coalition. Though not ‘cooperative’ as such,
these tours provide an opportunity for community
sector workers to gain an insight into the variety of
AOD, mental health and other community services
available, as well as facilitating interaction between
workers from different parts of the sector.
The ACT Mental Health Strategy and Action Plan
2003-2008 noted that some progress had been
made with the establishment of the dual diagnosis
service, but indicated that consultation informants
emphasised the need for ‘increased training across
services, closer working relationships and the
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79 Ibid.
80 Ibid.
NO WRONG DOORS Towards an integrated mental health service system in the ACT•June 2007
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