Pathways to care and community-based service contact patterns among clients with a dual diagnosis

Background: Little is known about typical service contact profiles and associated factors among clients with co-occurring mental health and substance use problems. Aim: Findings are reported from a 12-month audit of clients presenting to regional (NSW, Australia) adult community mental health and drug and alcohol services. Method: Raw data for this service evaluation project were extracted from an electronic clinical information database, comprising 61,062 community-based service contacts by 3344 clients (average age, 38.7 years; 49.8% male). Results: Several broad care pathways were identified. Substance use problems were experienced by 25.1%, with higher rates among males and younger clients. This group accounted for 35.4% of annual community-based service contacts, with substantially higher rates among clients with opiate dependence (133 contacts per client) and those with comorbid psychosis (44 per client), compared to the typical dual diagnosis client (18 per client). Clients actively engaged with a ...