Jacqui Cameron, Penny Buykx, Tracey Talko, Nicole Lee, Alison Ritter and Lynda Berends¹
Turning Point Alcohol & Drug Centre - Clinical Research Program
beyondblue Victorian Centre of Excellence
Project completion year
This study aimed to identify common patterns of depression treatment among people who were receiving treatment for their alcohol and/or drug use. It also aimed to identify barriers to depression treatment and to look at how people managed their depression without professional help.
In-depth, semi-structured interviews were conducted with 30 people receiving alcohol and drug treatment regarding their experiences of depression and depression treatment. Through the identification of barriers and supportive mechanisms, it has been possible to make recommendations for the improvement of depression treatment access and service delivery. The information collected focused on treatment-related issues from the viewpoint of those who have accessed services.
Experiences of depression treatment were mostly negative and compliance with medication was extremely poor.
Of the two treatment responses, counselling and pharmacotherapies, counselling was viewed more favorably. There were positive experiences of counselling, but this was dependent on the type of counsellor.
Despite health promotion and other messages about access to services, AOD users are still not aware of where and how to access treatment for depression.
While a small proportion of participants utilised other strategies to cope with depression, their use was sporadic and haphazard and not always effective.
Participants’ first depressive episode often preceded problematic drug use, therefore once attending AOD treatment, depression had already manifested itself.
Implications for Policy and Practice
Education messages about effective treatment and effective treatment engagement are needed to target this population specifically. Working with GPs and other community health centres could facilitate this process.
Further investigation into the role of therapeutic alliance in a co-morbidity setting with this population is needed, as well as the type of intervention that is useful and effective e.g. CBT.
Information needs to be user-friendly and accessible to this population. Where do people currently access information? This is something that could be investigated further, with a view to facilitating access to accurate consumer information (for example websites such as beyondblue, Blue Pages etc).
AOD workers and other health professionals can support AOD users to manage their depression by identifying it as a treatment issue and by exploring strategies that are meaningful to the client. This could be done through individual treatment plans.
The results of this study have been presented at two conferences including Winter School in the Sun, July 2006 and the Turning Point Alcohol & Drug Centre Symposium, August 2006.
Two grant applications have been submitted since the completion of this study, to further investigate the role of therapeutic alliance & other factors in the treatment of depression among drug & alcohol users within AOD services and to investigate the needs of benzodiazepine users in treatment, including potential mental health needs.
Thank you to the participants who made valuable contributions to our understanding of the experiences of people with alcohol and drug problems coping with depression.
A special thanks to the staff at each of the following sites who facilitated recruitment - including Barkly St Medical Centre, The Windana Society, Banyule CHC/NEODAS and De Paul House.
We are sincerely grateful for the support and guidance provided by the reference group members Assoc Prof Nick Allen, Ms Gwenda Cannard, Ms Jenelle Chaplin, Mr Keith Edwards, Ms Rhonda Nelson, Antigone Quince, Professor Susan Sawyer, Ms Jackie Shaw and Dr John Sherman.
Thanks also to Turning Point staff, Tracey Brooke, Paul McElwee, Kate Gleeson and Anna Guthrie for all their assistance.