Needs assessment of dual diagnosis: A cross-sectional survey using routine clinical data

Aims: Department of Health guidance on dual diagnosis (DD) recommends that services measure local need, and use this to inform service planning. This study aimed to use routine clinical data to estimate the prevalence of DD and unmet treatment need in a community drug and alcohol service, and to appraise the feasibility of using routine data for such purposes. Methods: First, a screening checklist was developed to determine whether a particular service-user met DD caseness criteria. Second, the electronic care records of 227 service-users were screened for DD caseness, as well as for documentation of current and/or previous receipt of mental health treatment. Findings: Seventy-two percent screened positive for having DD. Of these, around half were not receiving current treatment for their mental health, while 37% had never received mental health treatment. Higher rates of DD were found amongst women and those in treatment for alcohol dependence. Conclusions: The findings corroborate previous research showing high prevalences of DD and unmet treatment need within drug and alcohol services in general, and amongst certain high-risk subgroups in particular. The study demonstrates that using routine data to estimate unmet treatment need is feasible within the limited resources available to frontline services.