Abstract

Researchers interviewed key workers of all NHS inpatient, day-patient and outpatient Adult Mental Health (AMH, n =708) and Addictions ( n =313) Services in eastern Dorset. 'Dual diagnosis' (cooccurring severe mental illness (SMI) and substance abuse or dependence) occurred in 12% of addictions, 12% of all AMH, and 20% of SMI, AMH patients (range 10% rehabilitation to 41% acute wards). Most 'dual diagnoses' in AMH were alcohol and/or cannabis abuse with psychoses, and in addictions heroin dependence and/or alcohol abuse or dependence with depression. Compared with other AMH, SMI patients, AMH 'dual diagnosed' patients were younger; were more often male, in less stable accommodation, unemployed, with more than one psychiatric diagnosis and personality disorder; and tended to have more crises and pose greater risk to themselves and others. Compared with 'dual diagnosed' addictions patients they were less involved with drugs, at less risk of abuse by others and less often acknowledged dual problems.