Nutt, Rachel, Gilchrist, Gail, Marsa sambola, Ferran and Baldacchino, Alexander (2017) Staff regard towards working with patients with co-morbid depression and substance misuse: an exploratory study. Heroin Addiction and Related Clinical Problems, 19 (2). pp. 5-16. ISSN 1592-1638

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Abstract

Background. Patients having co-morbid mental health and substance misuse experience poorer treatment outcomes than
those treated for either condition alone. Studies suggest health professionals regard towards these patients is a factor.
Aims. To compare regard towards patients with co-morbid depression and substance misuse across different health professions
and services, relative to independent conditions (depression, diabetes, alcohol and/or drug misuse). Methods.
A cross-sectional comparative exploratory study of regard towards five patient groups conducted on multi-disciplinary
staff (general practitioners, psychiatrists, psychologists, nurses and social workers. Total n=113) in three Scottish NHS
board regions – NHS Fife, Tayside and Forth Valley. Services from three main treatment entry points were recruited in
each region - 10 primary care services (43.5%), 7 mental health (70%) and 4 specialist addiction (100%). Descriptive
statistics were calculated for regard towards each patient group. Multifactorial between subjects ANOVA examined influences
on Medical Condition Regard Scale (MCRS) scores. Results. Regard towards patients with co-morbid depression
and substance misuse was frequently lower than towards patients with independent conditions. Male professionals held
lower regard towards these patients than female (p=0.03). Addiction services held the highest regard and general practice
lowest (p <0.001). Over-45’s held the lowest regard towards these patients (p=0.02). Health professional’s satisfaction
with working with these patients was also low (mean 1.98, sd 1.22) compared to other conditions. Conclusions. Regard
towards patients with co-morbid depression and substance misuse is lower than either condition independently, particularly
among older, male professionals and those in general practice.

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