Unrecognised dual diagnosis – a risk factor for dropout of addiction treatment

Background: While many studies have examined the prevalence of concurrent substance misuse and mental health problems across different treatment populations, we know little as to what extent such co-morbidity is identified in routine clinical practice. However, literature in the field has emphasised the importance of recognising co-morbidity early to avoid adverse treatment outcomes. Aims: To determine: (1) the degree to which co-morbidity is recognised and addressed in outpatient addiction services; and (2) whether unaddressed co-morbidity increases the risk of dropout. Method: Clients (n = 176) starting treatment at six UK-based drug and/or alcohol services and their 46 practitioners were followed for 3 months. Multiple assessments were carried out in order to obtain information about clients' mental health, 90-day retention rates, treatment perceptions and practitioners' expertise and training levels in the co-morbidity field. Services' assessment protocols and in-treatment case notes for each client w...