A Consultation-Liaison Service on Integrated Treatment: A Program Description

Objective: This article reports the results of an evaluation of a consultation-liaison service for people with combined mental health and substance use problems. The service is one component of an overall integrated service framework for this group of clients developed and delivered across one of the largest Mental Health Foundation Trusts in the UK. A full description of the client group referred to consultation-liaison over a 3-year period is provided, as well as a description of different referral pathways and a preliminary evaluation of a brief intervention offered as part of the service. Methods: Service evaluation data were collected through routine practice and provided demographic and diagnostic information on the clients who were referred to the consultation-liaison service (N = 173). A sample of these clients (n = 39) received a full brief motivational intervention consisting of six sessions delivered over a 12-week period. Quantitative questionnaire data collected for clients who received this component subsequently allowed a baseline and follow-up cohort assessment of changes on various substance-related outcomes in those receiving the brief intervention. Results: The results indicated that clients referred to the service (N = 173) were typically male (69.9%), in their mid-30s (M = 36.6years, SD = 9.98) and considered to be white British (61.8%). They often presented with psychotic (52.6%) or depressive (16.8%) disorders and were commonly using alcohol (67.1%) or cannabis (47.4%). Of the clients who completed the full brief intervention (n = 39), baseline and follow-up outcome measures were available on a subsample (n ranged from 11 to 25 depending on each specific measure) and results showed significant changes in a number of areas, including increased engagement with treatment (p < .001), reduced alcohol (p = .001) and cannabis use (p = .015), fewer signs of hazardous alcohol use (p = .026), and improved confidence to change substance use (p = .006). These findings have to be considered as preliminary given the limitations of the service evaluation methodology. Conclusions: The consultation-liaison service appears to be a helpful component within an overall service framework for dual diagnosis in a number of ways, for example through the enhancement of existing services such as assessment, advice, and consultation, as well as the delivery of a brief intervention. (Journal of Dual Diagnosis, 9: 149-157, 2013)