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file icon ICE-MH VDDI DIRECTORY Acute Behavioural Disturbance

1st August 2016: Clinicians working in Acute Mental Health Inpatient Services are frequently faced with challenges around the management of people with Acute Behavioural Disturbance - especially in regard to the increasing prevalence of people presenting with methamphetamine-related presentations. There are a number of current and in-development guidelines, presentations and papers which may assist. This resource – current at August 2016 – attempts to catalogue and provide links to the most useful, current resources.

Hits: 2074
file icon VDDI 2016 Forum
29th JULY 2016:

The 2016, 1-day, Victorian Dual Diagnosis Initiative Forum will be held on Tuesday October 25th at The Treacy Centre, Parkville. More details here

Hits: 2031
file icon BUDDHAS Older Adults Dual Diagnosis Resource Guide Training

29TH July 2016: The Building Up Dual Diagnosis Holistic Aged Services (BUDDHAS) group have scheduled 2 free training events around their recent BUDDHAS Older Adults Dual Diagnosis Resource Guide,

Download flyer here

The training aims to increase participant’s understanding and implementation of interventions with older adults experiencing dual diagnosis. There will be 2 iterations of the training:

  • 14th Sept. 10am - 1pm Kingston Education Centre, 400 Warringal Rd, Cheltenham, Education Room A Bookings here
  • 24th Nov.10am - 1pm Brennan Hall St Vincent’s Hospital Cnr Nicholson St and Victoria Pde Fitzroy Bookings here
Hits: 1635
file icon BUDDHAS Older Adults Dual Diagnosis Resource Guide_2015

BUDDHAS Older Adults Dual Diagnosis Resource Guide

26th November 2015 – Today, at the Building Up Dual Diagnosis Holistic Aged Services (BUDDHAS) forum (Shades of Grey- Diversity and Dual Diagnosis in Older Adults) Matthew Hercus, Assistant Director, Performance and Programs, Mental Health and Drugs Branch, DHHS will launch the BUDDHAS Older Adults Dual Diagnosis Resource Guide. This guide is intended to guide and support practice in working with those who are aged 55 and older with ‘dual diagnosis’.

You can now download the BUDDHAS Older Adults Dual Diagnosis Resource Guide here

Hits: 3568
file icon BUDDYS Resource Guide

26th October 2015 – Last Monday, at the BUDDYS Youth Service Provider`s Forum, Victoria’s Minister for Mental Health the Hon Martin Foley launched the BUDDYS (Building Up Dual Diagnosis in Youth Services) and HYDDI (Homeless Youth Dual Diagnosis Initiative) Youth Dual Diagnosis Resource Guide  2015.
This new resource considers practice issues for service providers working with young people with a dual diagnosis.  You can now download the BUDDYS Youth Dual Diagnosis Resource Guide 2015 here.
Minister Foley’s tweet about the resource can be read here


Hits: 3700
file icon VDDI Bulletin - March 2015
Victorian Dual Diagnosis Initiative Bulletin- March 2015
The Victorian Dual Diagnosis Initiative (VDDI) is a cross-sector (Alcohol and Drug, Mental Health Community Support and Clinical Mental Health) initiative funded by the Victorian Department of Health & Human Services. The VDDI’s role is to contribute to the further development of mental health and AOD workers, agencies and sector’s capacity to recognise and respond effectively to people experiencing co-occurring mental health and substance use concerns (‘dual diagnosis’).
A VDDI Bulletin (March 2015) can be downloaded here
Hits: 3808
file icon Guideline: Management Acute Behavioural Disturbance due to Amphetamine-Type Stimulant intoxication

Guideline for the management of Acute Behavioural Disturbance due to Amphetamine-Type Stimulant intoxication

- Oct 2014 version
New, 4-page guideline developed by VDDI-NEXUS Consultant Psychiatrist Dr Kah Seong-Loke . Dr Loke profiled the new guideline in a recent presentation to the 2014 Australian Drugs Conference Ice & Altered Realities: Amphetamine Intoxication Withdrawal - Management Guidelines for Acute Hospital Settings

Page 1 of the Guideline provides guidelines for acute assessment and management of ATS intoxication and toxicity (see explanation in slides 18-22 of the conference presentation)

Page 2 of the Guideline provides guidelines for the management of acute behavioural disturbance due to ATS intoxication  (see explanation in slides 23-37 of the conference presentation). Here Dr Loke profiles detailed suggested regimes from:
- Management of Patients with Psychostimulant Toxicity: Guidelines for Emergency Departments DoHA 2006 

- Management of Acute Amphetamine Related Problems (DAO WA, 2006) (not available online but medication regime summarised p19 in Turning Point’s Methamphetamine dependence and treatment 2007 guideline

- Guidelines for the medical management of patients with methamphetamine-induced psychosis DASSA 2006 (Abbreviated 2-page guideline here )

- Management of acute agitation in psychosis: an evidence-based approach in the USA. Schleifer, J. 2011 Advances in psychiatric treatment. 

- The psychopharmacology of agitation: Consensus statement of the American Association for Emergency Psychiatry Project BETA 2012)

N.B.: Note, in step 3 of page 2, that use of Midazolam is mentioned and alert below that cautioning that 'IM Midazolam should only ever be prescribed by a consultant and special precautions MUST be followed’. Local policies will provide further guidance re use of Midazolam

 Page 3 of the Guideline suggests interventions matched to the client’s stage of change

• Page 4 of the Guideline provides guidelines for the long-term management of amphetamine misuse and dependence (BI’s., supported withdrawal etc - see explanation in slides 39-46 of the conference presentation)


Hits: 3650
file icon Infographic Victorian DUAL DIAGNOSIS POLICY @ Nov 2014_A3

Infographic: What are the principle current Victorian policy documents guiding and supporting mental health and alcohol and drug workers and services in their recognition of and responses to people with dual diagnosis?

Infographic suitable for A3 printing and laminating

Hits: 3265
file icon Thesis: Extent and Patterns of Substance Use in Older Adults with a Mental Illness

2nd October 2014: Dr Kathleen Ryan’s PhD thesis An Exploratory Study into the Extent and Patterns of Substance Use in Older Adults with a Mental Illness  focused on older people disadvantaged through coexisting mental illness and substance use issues (dual diagnosis). Her study investigated the extent and types of substances used in 60 older people with a mental illness. This study explored the frequency and types of substances used; the reasons for use; and, views on change. The study also examined the applicability of the ASSIST substance-screening instrument for an older population. The results indicated that a range of licit and illicit substances were used with varying frequency. The study found that the extent of alcohol/drugs used previously and currently is high. Alcohol, sedatives and tobacco are the most commonly used.

Those aged 55-64 have used and currently use to a larger extent a greater range of substances, most noticeably cannabis, as well as alcohol, benzodiazepines and caffeine than those aged 65+. Only those aged 55-64 have used a (non-medical) drug by injection. Complex and multi-faceted reasons for substances use and views on change were found along with an overlap between reasons for use and reasons for change. It is anticipated that the findings from this study will provide the basis for further policy development within the dual diagnosis field and will help contribute towards more effective clinical practice with an older population with dual diagnosis.


Hits: 3876
file icon Report: Carers’ experience of providing care and support to family members with dual diagnosis

23 January 2013: This report, by Laura David of the Victorian Mental Health Carers Networkdocuments a 2011 exploratory research project around carers’ experience of providing care and support to family members with co-occurring severe mental health and substance use issues (‘dual diagnosis’) and their engagement in mental health service delivery.

This topical report, funded by the Victorian Department of Health, builds on qualitative interviews with carers from three Melbourne mental health services and follow-up discussion groups with mental health service staff.

The report offers valuable:

  • Carer interview findings
  • Staff discussion group findings
  • Implications and recommendations: 10 recommendations are made on strategies for strengthened carer engagement with MH and AOD services and improved collaboration and integration between the MH and AOD sectors.
  • Key implications for decision makers


Hits: 5704
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