Table 3 Consideration of concurrent problems
Guideline | Is the link between mental health and misuse of substances mentioned as part of the background? | Does the guideline mention that either SMI or SUD can worsen the outcome of another? | Does the guideline provide recommendations about Screening/Assessment for coexisting disorders? | Does the guideline mention the competence of healthcare professionals in recognition the existence of the other comorbidity (i.e. either substance misuse or mental health problems)? | Does the guideline requests healthcare professionals to seek advice or training from the other service i.e. training from substance misuse service staff to staff in mental health services? | Does the guideline specifically mention not to exclude patients who misuse substance from age-appropriate treatment settings of mental illness due to use of substances? | Does the guideline specifically mention not to exclude patients who have mental illness from age-appropriate treatment setting of substance misuse due to mental health problems? | Who refers patients to a mental health setting or to the substance misuse/alcohol misuse services? | If a guideline is for mental health, does it mention not to discharge patients from inpatient services because of their substance misuse? |
|---|---|---|---|---|---|---|---|---|---|
NICE 2011 (coexisting disorders) [37] | Yes | Yes | Mentioned. Suspected patients should be asked about any drugs and alcohol drinking including: its type, quantity, frequency, route of administration, and duration of use. | Yes | Yes | Yes | Yes | Mentioned. All staff who have direct contact with patients, including professionals in primary care and educational settings. | Yes |
NICE 2016 (coexisting disorders) [38] | Yes | Yes | Mentioned. A Full evaluation for suspected patients. | No | Yes | Yes | No | Mentioned. All staff who have direct contact with patients, including professionals in primary care and educational settings. | No |
Australian government 2016 [39] | Yes | Yes | Mentioned. After abstinence, a full assessment of the patient should ideally occur. | Yes | Yes | No | No | Not mentioned | Not applicable |
SIGN 2013 [47] | Yes | Yes | Not mentioned | Yes | Yes | Yes | No | Not mentioned | No |
NICE 2014 [48] | Yes | Yes | Not mentioned | No | Yes | No | No | Mentioned. Primary healthcare professionals | No |
WFSBP 2015 [49] | Yes | Yes | Mentioned. Detailed assessment of substance use disorder should be obtained. | No | No | No | No | Not mentioned | No |
RANZCP 2016 [50] | Yes | Yes | Mentioned. Any suspicions regarding the use of stimulant drugs should be raised if there are recurrent episodes of psychosis. | Yes | Yes | No | No | Mentioned. Health care professionals and any other professionals involved in providing care for patients, such as GPs and social counsellors. | No |
BAP 2019 [51] | Yes | Yes | Mentioned. A detailed assessment of substance use disorder should be obtained. | No | No | No | No | Not mentioned | No |
APA 2020 [52] | Yes | Yes | Mentioned. Any initial assessment of a patients with a possible psychotic disorder should include an assessment of their tobacco use and other substance misuse. | Yes | Yes | No | No | Not mentioned | No |
VA/DoD 2010 [53] | Yes | Yes | Mentioned. A complete clinical assessment should be obtained. | No | No | No | No | Not mentioned | Yes |
Singapore MOH 2011 [54] | Yes | Yes | Not mentioned | No | No | No | No | Not mentioned | No |
NICE 2014 [55] | Yes | Yes | Not mentioned | No | Yes | No | No | Mentioned. Primary healthcare professionals | No |
BAP 2016 [56] | No | Yes | Mentioned. The clinician should assess to what extent does substance misuse contribute to bipolar symptoms. | No | Yes | No | No | Not mentioned | No |
CANMAT and ISBD 2018 [57] | Yes | Yes | Not mentioned | Yes | No | No | No | Not mentioned | No |
BAP 2012 [40] | Yes | Yes | Mentioned. Substance history, family history, urinalysis and blood tests, as well as an assessment of psychiatric disorder onset, and the misuse of substances should be carried out. | No | No | No | No | Not mentioned | Not applicable |
WFSBP 2017 [41] | Yes | Yes | Not mentioned | No | No | No | No | Not mentioned | Not applicable |
gov.uk 2017 [42] | Yes | Yes | Mentioned. Identifying any current or previous psychological problems | Yes | Yes | Yes | No | Mentioned. GPs | Not applicable |
DGPPN and DG-Sucht 2017 [43] | Yes | Yes | Mentioned. The assessment process derived from alcohol use disorder identification test guidelines | No | No | No | No | Not mentioned | Yes |
NICE 2011 [44] | Yes | Yes | Mentioned. Patients should be referred to a psychiatrist for effective assessment and treatment. | Yes | Yes | No | No | Mentioned. Whole range of healthcare such as a GP. | Not applicable |
APA 2018 [45] | Yes | Yes | Mentioned. Patients should be assessed for alcohol use disorder and comorbid mental health disorder. | No | No | No | No | Not mentioned | No |
ASAM 2015 [46] | Yes | Yes | Mentioned. A comprehensive assessment of the patient and any ideas related to suicide should be evaluated. The patient’s full medical history and a physical examination should also be obtained. | Yes | Yes | No | No | Not mentioned | Not applicable |