Nursing Essay: Dual Diagnosis Challenges, Strategies, and Policies

This essay delves into the complexities of dual diagnosis within the nursing field. It defines dual diagnosis as the co-occurrence of mental health disorders and substance abuse, highlighting the significant challenges healthcare professionals face. These challenges include insufficient training, difficulties in identifying specific conditions, and the lack of a universally approved treatment method. The essay emphasizes workforce issues, such as the problem of identifying and treating each condition independently, and the impact of insufficient training on effective care. It proposes an integrated approach involving collaboration among healthcare professionals and the inclusion of dual diagnosis in educational curricula. The essay also underscores the need for government funding of community centers to support patients with dual diagnosis, promoting an environment of support and understanding. The conclusion reiterates the challenges and suggests that an integrated approach, coupled with policy and training, can help address the multifaceted challenges of dual diagnosis.

Running head: NURSING-DUAL DIAGNOSIS 1
Nursing-Dual Diagnosis
Institution’s Name
Date

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Introduction
In healthcare, various ailments exist that need the attention of health practitioners.
However, there are those that pose a great challenge on the workforce because, among other
reasons, they are complicated to treat. Dual diagnosis is one of them and creates challenges in
many ways. Therefore, below is an essay that intends to elaborate on the challenges in handling
dual diagnosis. It also intends to elaborate on the strategies, policies, and recommendations that
can be put in place to counter or remedy the problem on workforce. Lastly, but most importantly,
is to give an elaborate meaning of dual diagnosis.
Description of the Condition and Challenges
Dual diagnosis is a mental health condition resulting from a combination of mental
health and alcohol or substance addiction. Therefore, it is a case of treating two conditions at the
same time. In healthcare, medics tasked with the responsibility of treating and managing patients
under this condition face several challenges. To start with training, there are insufficient
personnel trained to handle such a cases (Antai-Otong, Theis, & Patrick, 2016). Nurses, for
instance, are not well equipped with skills necessary to tackle the condition. Moreover, there is
no elaborate and accurate way of treatment out there suitable for all clients. Below are some of
the problems, strategies and possible solutions.
Challenges of Workforce
Firstly, there is the problem of identification of specific ailments. Where two or more
conditions affecting the clients exist, it is hard for nurses to identify and treat each one of them
independently categorically. In the worst case scenario, one condition may overshadow the other
making it go unnoticed for so long while treating the one that is causing the overshadowing.

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Research indicates that most nurses or psychiatrist often get confused when dealing with clients
(McGovern et al., 2014). Thus, one condition blurs symptoms of the other, and in effect, the
client does not get proper treatment in regards to his or her condition. For instance, a person with
family difficulties may engage in drug and substance abuse and seek intervention from a
psychotherapist or family therapy. Although that is the right intervention, there is also the drug
or substance abuse case which may be overlooked, and as a result, the treatment will not be
effective for all that is troubling or affecting the client (Murthy, & Chand, 2012). Thus, within a
short period, he or she may drop out of the treatment program.
Another challenge is insufficient training to handle such cases. There is considerably
lacking in formal education. In particular, about evaluation of substance abuse and effective
treatment. There is minimal training in medical schools in this specialty. More often than not, the
program is an elective one, which suggests that only those interested in studying substance abuse
and not dual diagnosis take such classes (Mestre-Pintó et al., 2014). Without adequate training of
professionals supposed to act as a major problem solver, it becomes difficult to tackle it in
totality.
In addition to that, there is a problem of lack of experience, deliberate discrimination by
private hospitals and medics in handling dual diagnosis. For any professional to be competent in
any profession, working experience is important. With the rise of cases of dual diagnosis, it is
plausible to think that medics can run away from treating this group (Minassian, Vilke, &
Wilson, 2013). Thus, avoiding this group or neglecting to learn about dual diagnosis makes it
unlikely that this group will ever learn to handle these clients. Additionally, whenever patients
with dual diagnosis present themselves to medics, they are often referred to psychiatrists. Many
private practitioners demonstrate an unwillingness to treat clients with the same condition.

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Therefore, it creates a huge burden to community centers where this group of patients often seeks
intervention. More often than not, the community centers are underfunded and overburdened.
Lastly, there is no approved method of treating people with dual diagnosis (Padwa et al., 2013).
What medical researchers have tried to put across are models that one can apply in handling
people with dual diagnosis. However, all these models have shortcomings in one way or another.
Strategy, Policy, and Training
The best strategy for medics to use in dual diagnosis is an integrated approach. Even
though the method used to treat each ailment is not different, the integrated approach makes it
possible for coordinating the process for the best effect. This entails health care professional
working in the same setting but with different responsibility (Basu, Sarkar, & Mattoo, 2013).
Also, it involves both substance abuse and mental health in a cooperating manner without any
form of division. Treatment may include motivational talks to clients, either through education or
counseling, especially, to clients that are deeply demoralized by their condition. This in effect
will enable them to see their self-worth and appreciate self-ill management.
On the other hand, proper training, both formal and informal must be put in place for the
sake of churning out competent medics with sufficient knowledge in handling dual diagnosis
cases. One way of doing this is including the program in the curriculum, thus, enabling every
professional to be conversant with the skills (Keltner, 2013). Moreover, those with working
experience must train the junior staff and encourage them not to shy away from handling cases of
dual diagnosis. Lastly, the government needs to put measures that will see sufficient funding to
community centers accommodating this group of patients. Furthermore, it is the responsibility of

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the government to encourage different communities to support this group of people and not
discriminating them.
Conclusion
Therefore, dual diagnosis denotes a condition where a person is suffering from mental
health and substance or alcohol abuse. There are many challenges to a health professional in
treating the condition, among others, is that there is no recommended method for treatment but
rather, models that have flaws in one way or another. Additionally, lack of proper training is a
problem to the workforce making others to shy away from treating this group. However, using an
integrated approach, which entails including the program in learning curriculum and sufficient
government funding of community centers housing this group can help in solving the problem.

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References
Antai-Otong, D., Theis, K., & Patrick, D. D. (2016). Dual Diagnosis: Coexisting Substance Use
Disorders and Psychiatric Disorders. Nursing Clinics of North America, 51(2), 237-
247.
Basu, D., Sarkar, S., & Mattoo, S. K. (2013). Psychiatric comorbidity in patients with substance
use disorders attending an addiction treatment center in India over 11 years: Case for
a specialized “Dual Diagnosis Clinic”. Journal of Dual diagnosis, 9(1), 23-29.
Keltner, N. L. (2013). Psychiatric nursing. Elsevier Health Sciences.
McGovern, M. P., Lambert-Harris, C., Gotham, H. J., Claus, R. E., & Xie, H. (2014). Dual
diagnosis capability in mental health and addiction treatment services: an assessment
of programs across multiple state systems. Administration and Policy in Mental Health
and Mental Health Services Research, 41(2), 205-214.
Mestre-Pintó, J. I., Domingo-Salvany, A., Martín-Santos, R., & Torrens, M. (2014). Dual
diagnosis screening interview to identify psychiatric comorbidity in substance users:
development and validation of a brief instrument. European addiction research,
20(1), 41-48.
Minassian, A., Vilke, G. M., & Wilson, M. P. (2013). Frequent emergency department visits are
more prevalent in psychiatric, alcohol abuse, and dual diagnosis conditions than in
chronic viral illnesses such as hepatitis and human immunodeficiency virus. The
Journal of emergency medicine, 45(4), 520-525.

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Murthy, P., & Chand, P. (2012). Treatment of dual diagnosis disorders. Current Opinion in
Psychiatry, 25(3), 194-200.
Padwa, H., Larkins, S., Crevecoeur-MacPhail, D. A., & Grella, C. E. (2013). Dual diagnosis
capability in mental health and substance use disorder treatment programs. Journal of
dual diagnosis, 9(2), 179-186.