Addiction Psychiatry in NHS Lanarkshire: A 5 minute presentation

Addiction Psychiatry Staff Dr Adam Brodie: “North” North Lanarkshire – Airdrie, Coatbridge, and Cumbernauld areas (Monklands District General Hospital area); 18% of population in highest Scottish deprivation level Dr Yameen Qureshi: “South” North Lanarkshire –Bellshill, Motherwell, and Wishaw areas (Wishaw District General Hospital area); 25% of population in highest Scottish deprivation level Dr Ahmed Khan / Dr Donald McDonald: South Lanarkshire – Clydesdale, East Kilbride, Hamilton areas (Hairmyres District General Hospital area); 11% of population in highest Scottish deprivation level, but cover a much larger population Figures from Public Health 2009 /10 The Annual Report of the Director of Public Health, NHS Lanarkshire

Role of Addiction Psychiatrists Role of consultants with responsibility for substance misuse (addiction psychiatrists), RCPsych Faculty of Substance Misuse, June 2001 Mental health specialist within addiction services (assessment / risk assessment / management advice and medication-based treatment – particularly psychosis / suicidality with urgent and on-call work) Non-opiate based medication review (e.g. “protective” medication), such as baclofen, disulfiram and naltrexone In-patient treatment: detoxification and route to general mental health services in-patient services Other roles:

Role of Addiction Psychiatrists Role of consultants with responsibility for substance misuse (addiction psychiatrists), RCPsych Faculty of Substance Misuse, June 2001 Mental health specialist within addiction services (assessment / risk assessment / management advice and medication-based treatment – particularly psychosis / suicidality with urgent and on-call work) Non-opiate based medication review (e.g. “protective” medication), such as baclofen, disulfiram and naltrexone In-patient treatment: detoxification and route to general mental health services in-patient services Other roles: clinical (collaborative within hospital and community teams, staff clinical supervision, team clinical meetings)

Role of Addiction Psychiatrists Role of consultants with responsibility for substance misuse (addiction psychiatrists), RCPsych Faculty of Substance Misuse, June 2001 Mental health specialist within addiction services (assessment / risk assessment / management advice and medication-based treatment – particularly psychosis / suicidality with urgent and on-call work) Non-opiate based medication review (e.g. “protective” medication), such as baclofen, disulfiram and naltrexone In-patient treatment: detoxification and route to general mental health services in-patient services Other roles: clinical (collaborative within hospital and community teams, staff clinical supervision, team clinical meetings) / liaison (e.g. with mental health, GPs, medical specialists)

Role of Addiction Psychiatrists Role of consultants with responsibility for substance misuse (addiction psychiatrists), RCPsych Faculty of Substance Misuse, June 2001 Mental health specialist within addiction services (assessment / risk assessment / management advice and medication-based treatment – particularly psychosis / suicidality with urgent and on-call work) Non-opiate based medication review (e.g. “protective” medication), such as baclofen, disulfiram and naltrexone In-patient treatment: detoxification and route to general mental health services in-patient services Other roles: clinical (collaborative within hospital and community teams, staff clinical supervision, team clinical meetings) / liaison (e.g. with mental health, GPs, medical specialists) / training and education

Role of Addiction Psychiatrists Role of consultants with responsibility for substance misuse (addiction psychiatrists), RCPsych Faculty of Substance Misuse, June 2001 Mental health specialist within addiction services (assessment / risk assessment / management advice and medication-based treatment – particularly psychosis / suicidality with urgent and on-call work) Non-opiate based medication review (e.g. “protective” medication), such as baclofen, disulfiram and naltrexone In-patient treatment: detoxification and route to general mental health services in-patient services Other roles: clinical (collaborative within hospital and community teams, staff clinical supervision, team clinical meetings) / liaison (e.g. with mental health, GPs, medical specialists) / training and education / planning, service development, prevention and policy

Role of Addiction Psychiatrists Role of consultants with responsibility for substance misuse (addiction psychiatrists), RCPsych Faculty of Substance Misuse, June 2001 Mental health specialist within addiction services (assessment / risk assessment / management advice and medication-based treatment – particularly psychosis / suicidality with urgent and on-call work) Non-opiate based medication review (e.g. “protective” medication), such as baclofen, disulfiram and naltrexone In-patient treatment: detoxification and route to general mental health services in-patient services Other roles: clinical (collaborative within hospital and community teams, staff clinical supervision, team clinical meetings) / liaison (e.g. with mental health, GPs, medical specialists) / training and education / planning, service development, prevention and policy / research and audit

Role of Addiction Psychiatrists Role of consultants with responsibility for substance misuse (addiction psychiatrists), RCPsych Faculty of Substance Misuse, June 2001 Mental health specialist within addiction services (assessment / risk assessment / management advice and medication-based treatment – particularly psychosis / suicidality with urgent and on-call work) Non-opiate based medication review (e.g. “protective” medication), such as baclofen, disulfiram and naltrexone In-patient treatment: detoxification and route to general mental health services in-patient services Other roles: clinical (collaborative within hospital and community teams, staff clinical supervision, team clinical meetings) / liaison (e.g. with mental health, GPs, medical specialists) / training and education / planning, service development, prevention and policy / research and audit / “advocacy”

Statistics For example, for me 2010-11: 452 new patient appointments (40% mental health, i.e. “dual diagnosis” and 60% protective medication) 1263 return appointments (near enough 50 / 50) Also, we currently have 4 “detox beds” at each of the 3 General Hospital sites in NHSL (i.e. 12 beds total) – with 100% (+) bed occupancy.