Addressing the needs of older people with co-morbid alcohol and mental health disorders: a case series from a London Community Mental Health Team (CMHT)

Tresa Andrews; Leena Reddy; Paul Whelan

doi:10.1108/17570971111155577

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Advances in Dual Diagnosis

ISSN: 1757-0972

Online from: 2008

Subject Area: Health and Social Care

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Addressing the needs of older people with co-morbid alcohol and mental health disorders: a case series from a London Community Mental Health Team (CMHT)

Document Information:
Title:	Addressing the needs of older people with co-morbid alcohol and mental health disorders: a case series from a London Community Mental Health Team (CMHT)
Author(s):	Tresa Andrews, (Consultant Lead Clinical Psychologist, Westminster Older Adult Psychology and Psychotherapy Services, Central and North West London NHS Foundation Trust, London, UK), Leena Reddy, (Specialty Doctor, North Westminster CMHT for Older Adults, Central and North West London NHS Foundation Trust, London, UK), Paul Whelan, (Consultant Psychiatrist Older Adults, North Westminster CMHT for Older Adults, Central and North West London NHS Foundation Trust, London, UK)
Citation:	Tresa Andrews, Leena Reddy, Paul Whelan, (2011) "Addressing the needs of older people with co-morbid alcohol and mental health disorders: a case series from a London Community Mental Health Team (CMHT)", Advances in Dual Diagnosis, Vol. 4 Iss: 1, pp.8 - 16
Keywords:	Alcohol use disorders in the elderly, Dual diagnosis, Ethics, Mental capacity, Mental illness, Multimodal treatment, Older people, Psychosocial interventions, Treatment effectiveness evaluation
Article type:	Case study
DOI:	10.1108/17570971111155577 (Permanent URL)
Publisher:	Emerald Group Publishing Limited
Acknowledgements:	The authors are grateful to the four service users and their carers for permission to share their case histories. They would also like to thank Eileen Bick (Team Administrator, North Westminster Community Mental Health Team for Older People) for her administration support and Amy Waugh (Psychology Assistant, Westminster Older Adults Psychology and Psychotherapy Department), Sarah Snow (Psychology Assistant, Westminster Older Adults Psychology and Psychotherapy Department) and John Nyman (Librarian, Imperial College Library, SMH) for searching and collating literature and resources.
Abstract:	Purpose – Despite older adult community mental health team (CMHT) workers inevitably encountering service users with alcohol use disorders (AUDs), they have a limited evidence base for working with this group. This paper aims to argue against a wholesale transfer of knowledge and practices from working age adults with dual diagnosis to the older age group. Design/methodology/approach – The paper aims to address the scant attention given to the needs of older service users with a dual diagnosis by detailing the progress of four older adult service users with AUDs in a CMHT. Findings – This case study series illuminates some of the clinical and professional dilemmas and challenges encountered when working with this group. Suggestions of how to respond to some of these challenges are provided by focussing on aspects of identification, assessment and treatment. Originality/value – This paper provides a catalyst to further discussion, debate and publications on the issue of older people misusing alcohol by presenting and reflecting on the issues raised by four practice vignettes.