Treatment for Comorbid Mental Health Disorders Among Patients Treated for Opioid Disorder: The Role of a Hub and Spoke Intervention.

Individuals experiencing severe mental illness and neurodiversity are known to experience challenges such as social isolation, homelessness, stigma and discrimination (Han et al., ; Jenkins et al., ; Kerman & Stergiopoulos, ; Pellicano et al., ). International evidence suggests that mental health services are also fraught with difficulties. They are often not fit for purpose, are fragmented and operate in isolation (Melamed et al., ; Nicaise et al., ; Petrie et al., ; Royal Commission into Victoria’s Mental Health System, ; Triliva et al., ). As a result, their clients often disengage with the mental health system altogether (Isaacs et al., ). The term, severe mental health challenges [SMHC] has been used in this paper to refer to individuals who have been diagnosed with a mental health condition that has severely impacted their ability to carry out activities of daily life. The primary objective of contemporary mental health services is to facilitate personal recovery among their clients (Commonwealth of Australia, ). Personal recovery for individuals with SMHCs extends beyond mere symptom relief and is founded upon the principles of connectedness, hope and optimism, identity, meaning and purpose, and empowerment, often referred to as the CHIME framework (Leamy et al., ). When individuals are diagnosed with a severe Mental Illness [SMI], they often get disconnected from family and friends and lose hope, meaning and purpose. They also experience a loss of choice and control in their lives and begin to recognise a new version of themselves that is different from what it was prior to their illness (Isaacs et al., ). Such individuals are considered to be progressing towards personal recovery when they experience a sense of connection with family, friends, and society, maintain hope for the future, cultivate an identity distinct from their illness, and feel empowered through engagement in employment and volunteer activities (Leamy et al., ). Moreover, individuals with SMHCs can attain personal recovery even in the absence of complete symptom remission (Anthony, ). They achieve this by establishing meaningful roles, relationships, and activities that impart purpose to their lives, despite the persistent challenges associated with their illness. It is also well known that people who are exposed to unfavourable socioeconomic circumstances are more vulnerable to poor mental health (Kirkbride et al., ). Individuals with SMHCs have reported unmet socioeconomic needs such as those related to daytime activities, someone to spend time with, accommodation, food, and transport (Isaacs et al., ; Thornton, ; Whiteford et al., ). The ongoing state of unmet needs in this group of service users causes them substantial psychological distress (Riley. M & Moses, ).