The rise and rise of drug-related mental health problems

Cognitive behavioural therapy (CBT) has been used successfully within both mental health and drug treatment programming. Within substance use services, motivational interviewing and relapse prevention interventions are perhaps the best known of the CBT techniques and these approaches work within both a group and individual setting. Such methods are ideal for use with young people who have particularly complex problems and who may be unable to work within a more structured approach, and first need the development of greater trust and a rapport before more formal treatments.

The most effective application of CBT in the youth drug treatment and mental health sectors is not just limited to those times where a formal appointment to see a drug or mental health counsellor has been made. There is the prospect of using what the drug treatment sector calls opportunistic interventions and the mental health sector calls opportunity-led work: incidents or moments in the worker’s day-to-day engagement with the young person where there is an opportunity for the individual to gain a deeper insight or understanding into their life issues. While this approach is a key aspect of work in therapeutic communities, it is always applicable to any worker-young person interaction.

Such strategies reflect an orientation toward social health models and a more integrated approach to treatment. These approaches facilitate access to services by reducing the hurdles required of young people by not setting any preconditions for treatment. They also normalise and de-stigmatise particular behaviours and allow for earlier and more integrated interventions.

In conclusion

Developing effective cross-sector service responses to adolescents presenting with complex, comorbid conditions will take time and commitment. It will be important for both drug treatment and mental health services to identify points of commonality and agreement and points of difference, and for service systems to recognise the diversity of skills both required and available in supporting this marginalised group of young people.

While young people can perceive mental health services as stigmatising and at times unfriendly, this may be because of acute treatment responses related to crisis support and management. Young people value complementary and integrated service responses. Access, engagement and relationship development activities are highlighted as crucial, especially for adolescents who are particularly marginalised, under resourced, and may find comprehension of information more difficult due to the nature of their condition(s).