Addiction Beliefs: Do Staff Working in Substance Misuse and Mental Health Services View Clients with Co-existing Mental Health and Substance Use Problems in the Same Way?

Previous research has indicated addiction beliefs differ in staff working in Mental Health and Substance Misuse Services, but limited attention has been paid to this in the UK. Given the reported prevalence of clients who present to both types of service with co-existing mental health and substance misuse problems, and recent government guidance on the management of these clients within existing NHS services, the current study was developed. The aim was to explore whether any differences in beliefs about addiction existed between staff working in NHS Mental Health and Substance Misuse services in the UK, and identify any barriers/levers to joint-working between services to support these clients. Staff working in Mental Health, Substance Misuse and Dual Diagnosis services across five NHS Trusts were recruited to participate in a survey study. Participants completed questionnaires designed to identify their beliefs about addiction to three substances (alcohol, cannabis and heroin) and were also asked to report their opinions about current/potential barriers/levers to these services working jointly to support clients with co-existing mental health and substance use problems. A significant difference between Mental Health and Substance Misuse staff ratings on the ‘Addiction Belief Inventory’ was observed; staff in each type of service held different views about addiction on the following subscales: ‘chronic disease’, ‘responsibility for actions’, ‘responsibility for recovery’ and ‘genetic basis’. Interaction effects between service type and demographic information were also explored. The hypothesis that staff would report significantly different beliefs about different substances was also supported. Staff comments about barriers and levers to joint-work were analysed thematically. Given that the current study suggested that addiction beliefs differ on a number of elements across services, and substances; the implications for intervention and joint-working are discussed in light of previous research and suggestions by clinicians. A full critical appraisal of the study was included.