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Heroin Addiction and Related Clinical Problems: 2017, 19, N2 (pages: 5 - 16)

Staff regard towards working with patients with co-morbid depression and substance misuse: an exploratory study

Nutt R., Gilchrist G., Marsa-Sambola F., and Baldacchino A.

Summary: Background. Patients having co-morbid mental health and substance misuse experience poorer treatment outcomes than those treated for either condition alone. Studies suggest health professionals regard towards these patients is a factor. Aims. To compare regard towards patients with co-morbid depression and substance misuse across different health professions and services, relative to independent conditions (depression, diabetes, alcohol and/or drug misuse). Methods. A cross-sectional comparative exploratory study of regard towards five patient groups conducted on multi-disciplinary staff (general practitioners, psychiatrists, psychologists, nurses and social workers. Total n=113) in three Scottish NHS board regions – NHS Fife, Tayside and Forth Valley. Services from three main treatment entry points were recruited in each region - 10 primary care services (43.5%), 7 mental health (70%) and 4 specialist addiction (100%). Descriptive statistics were calculated for regard towards each patient group. Multifactorial between subjects ANOVA examined influences on Medical Condition Regard Scale (MCRS) scores. Results. Regard towards patients with co-morbid depression and substance misuse was frequently lower than towards patients with independent conditions. Male professionals held lower regard towards these patients than female (p=0.03). Addiction services held the highest regard and general practice lowest (p <0.001). Over-45's held the lowest regard towards these patients (p=0.02). Health professional's satisfaction with working with these patients was also low (mean 1.98, sd 1.22) compared to other conditions. Conclusions. Regard towards patients with co-morbid depression and substance misuse is lower than either condition independently, particularly among older, male professionals and those in general practice.