As part of a needs assessment conducted in 2016, CESPHN identified comorbidity between AOD and mental health conditions as a priority area, with low levels of service provision. By improving the capacity of healthcare providers to identify, intervene, and provide appropriate referral and coordinated care with this population, the standard of care, and the lives of people with co-occurring substance use and mental health conditions may be improved.

Key documents

• The final report from the project is  pdf available here. (1.27 MB)
• A two-page bulletin summarising the report and recommendations is available here.

Comorbidity Guidelines 

The Comorbidity Guidelines website provides evidence-based information, training and resources to assist with the management of co-occurring, or comorbid, AOD and mental health conditions.

This website and online training program was developed by Dr Christina Marel, Associate Professor Katherine Mills, Mr Jack Wilson and Professor Maree Teessonat The Matilda Centre for Research in Mental Health and Substance Use.

• Comorbidity Guidelines: Free online training is available here 
• Comorbidity Guidelines: Order a free hard copy here

 Mental Health & AOD Action Plan 

CESPHN Recognise that people who experience co-occurring mental health and drug and alcohol conditions can experience barriers to effective service provision. We worked in partnership with the Matilda Centre for Research in Mental Health and Substance Use, to understand the experiences of people who seek services as well as health care providers and this delivered important recommendations for increasing the capacity of the workforce to respond to people with co-occurring needs.

We convened a region-wide working party to progress this work in partnership with stakeholders across the region with a shared vision to achieve genuine change. Together with the Matilda Centre, lived experience workers, practitioners in public and NGO services, GPs, pharmacists, sector peaks, researchers and educators, developed an action plan to build system and workforce capacity to deliver holistic and integrated care that focuses on treating the person, not the illness.

pdf Mental Health & AOD Action Plan PDF (486 KB)

pdf Mental Health & AOD Poster (170 KB)

Co-existing mental health and AOD webinars

Comorbid mental health and substance use disorders 

• Co-Occurring Substance use and Mental Disorders: Implications for Managing and Delivering Best-Practice Health Care
• Identifying Mental Disorders and Related Conditions Among Patients with Alcohol and Other Drug Conditions
• Managing and Treating Co-Occurring Mental and Substance Use Disorders
• Managing the Physical Health of People with Co-Occurring Mental and Substance Use Disorders

Using opioid agonist treatment for pharmaceutical opioid dependence

• Using Opioid Agonist Treatment for Pharmaceutical Opioid Dependence

Routine Opioid Outcomes Monitoring (ROOM) Tool

• Overview of the Routine Opioid Outcome Monitoring (ROOM) Tool webinar

Tools for health professionals

Health professionals play an important role in smoking cessation. Supporting smokers to quit is an activity for the whole health care system and should be integrated into as many settings as possible, including hospitals, health services and community settings. Health professionals can be very effective in encouraging and supporting people to quit smoking regardless of their professional discipline.

Combining brief advice with other effective interventions, such as pharmacotherapy can greatly increase quit smoking success.

The following guidelines and resources will assist health professionals to confidently provide evidence-based management of nicotine dependence and smoking cessation for their clients/patients.

Clinical guidelines

• RACGP supporting smoking cessation: A guide for health professionals
• Clinical guidelines for the management of substance use during pregnancy, birth and the postnatal period Managing nicotine dependence: A guide for NSW Health staff - covers all aspects of management including the 5As brief intervention model, use of pharmacotherapies as well as helpful tools and strategies.

Resources related to management of nicotine dependence in the health care setting

• Tool 1: Flowchart of tools to help clinicians manage nicotine dependent clients
• Tool 2: Quick guide to smoking cessation brief intervention
• Tool 3: Assessing nicotine dependence
• Tool 4: Flowchart for NRT use in hospital
• Tool 5: Quick guide to nicotine replacement therapy (NRT)
• Tool 6: Tips for helping clients stay smoke-free
• Tool 7: Quick guide to drug interactions with smoking cessation
• Tool 8: Clozapine, olanzapine and smoking cessation
• Tool 9: Managing smoking in consumers who go on leave from a NSW Health facility
• Tool 10: Discharge checklist for smoking cessation
• Make a client referral to NSW Quitline

Resources related to nicotine replacement therapy (NRT)

• Nicotine replacement - frequently asked questions
• NSW Health factsheet on nicotine replacement therapy in pregnancy

Resources related to Aboriginal smoking

• ATRAC Framework aims to support the planning, integration and coordination of Aboriginal tobacco resistance and control efforts in NSW.
• A-TRAC Program had the broad goal to contribute to reduced smoking rates for Aboriginal people in NSW.
• Quit smoking booklets for Aboriginal clients. Three brochures to support Aboriginal people who are at different stage of quitting.
• Quit for new life brochures on smoking and pregnancy for Aboriginal women and their cohabitants.

Resources related to smoking and mental health and smoking and disadvantage

• Smoking and mental illness: A guide for health professionals
• Smoking and mental health factsheets for clients
• Cancer Council NSW Tackling Tobacco Program

Local mapping reports:

• CESPHN undertook a baseline needs assessment of the region, which informed the development of an evidenced based activity work plan. This plan details the priorities and activities of CESPHN for Drug and Alcohol Treatment Services Flexible funding 2016 – 2019. Under the priority area of services for high needs populations and service capacity, CESPHN seek to identify strategies to improve access to treatment services for families, and enhance withdrawal service referral pathways. To inform this work CESPHN commissioned Network of Alcohol and Other Drug Agencies (NADA) to undertake a mapping project in 2017 Report here
• Current Practices and support needs of healthcare providers in CESPHN in relation to addressing patient's co-occuring mental health and alcohol and other drug needs, National Drug and Alcohol Research Centre, Unviersity of New South Wales, 2018. Report here