The importance of socio-legal interventions in the case management of a severe dual pathology program: our 6 years’ experience

ABSTRACT

Interest in studying dual diagnosis comorbidity between mental disorders and addictions is increasing, but so far has focused only on epidemiological, clinical and prognostic aspects (Szerman et al, 2013). However, the socio-legal needs of these patients must also be assessed, especially if we are to address the problem using a holistic case management approach, as in the case of other serious mental disorders such as schizophrenia (Nordén, Eriksson, Kjellgren & Norlander, 2012). The Severe Dual Pathology Program (SDPP) at the Provincial Hospital of Castellón Consortium (Spain) began in 2008 and so far has treated 293 patients. The intervention model is integrated, both medically and socially and is based on case management; the inclusion criteria is a score of under 30 on the Global Assessment of Functioning (GAF) scale at admission which must have improved to over 50 for the patient to be discharged. 81.2 % of the patients we have treated so far were male, and most referrals were made from the Emergency Mental Health Unit (32.4 %), followed by the Unit of Addictive Behavior (23.5 %), and the Mental Health Units (15 %). The most prevalent diagnosis at the time of starting the program was schizophrenia (46.8 %), followed by personality disorder (11.3 %), schizoaffective disorder (8.5 %), and bipolar disorder (7.5 %). The majority of patients were polydrug addicts (49.5 %) or addicted to alcohol (27.9 %)