A pilot study of dual diagnosis training in prisons

People with dual diagnosis have complex needsand vulnerabilities that may lead to incarceration inprisons. Mental health and substance use servicesin prisons should have the capabilities to addresstheir needs while incarcerated and facilitate thetransfer of care to community services on release.In order to develop these capabilities, a trainingprogramme is required.A pilot training programme for dual diagnosiswas developed and piloted in five London prisons.The training was based on a training needsassessment of prison staff and consultation withservice users. It was delivered in two forms: a fivedayclassroom based course, and a ‘blendedlearning’ method that comprised a manual andthree sessions of supervision. The course wasevaluated by a brief questionnaire that includeditems on attitudes, self-efficacy and knowledgeabout working with dual diagnosis.The evaluation of the training revealed that allworkers, no matter what method of training theyreceived increased their perception of their skills(self-efficacy) and increased their attitudes.Knowledge remained the same (although thescores pre-training were high). There was nodifference between the two types of training whenmean scores were compared at post-training. Therewas also no difference between the mental healthand substance workers regarding their mean scoresat follow-up, apart from knowledge.The conclusion is that the training pilot wasevaluated positively and did indicate that it has someeffect on attitudes and self-efficacy. More rigorousevaluation of the impact of the training is required,using a robust methodology and assessing theimpact on clinical skills and service user outcomes.