Staff training should address knowledge, skills and attitudes in mental health, substance misuse and co-occurring problems.
Within an overall philosophy of a client centred approach focusing on the service user experience, the development of systematic practice, including the use of screening tools, is a useful method of increasing knowledge of important symptoms and behaviours. This requires support by a Staff Development programme.
Training should focus on screening, assessment and appropriate interventions by mental health and substance misuse agencies for co-occurring problems. It should also focus on identification and appropriate support for carers of those with co-occurring problems. Staff training on carer awareness should be included in NHS Boards' Carer Information Strategies. NHS Boards should incorporate training to tackle negative staff attitudes and to promote understanding of the difficulties faced by carers of those with mental health and substance misuse problems to reduce stigma and improve support.
Substance misuse services should develop and maintain the skills and capacity of staff to deal with a range of mental health issues: including low self esteem; relationship problems; suicide prevention; risk assessment; basic life skills; education; housing. There is a significant need for training and confidence-building of staff in the area of inquiring about sexual abuse, receiving disclosures and consulting clients who have substance misuse and trauma issues about their needs. Staff should have skills in the detection of mental illness and knowledge of appropriate additional services in their own and other agencies.
The Scottish Government funds the Scottish Association for Mental Health ( SAMH) Safe to Say project - a National Training for Trainers Programme working with both statutory and voluntary agencies to establish a national network of training practitioners equipped to deliver best practice training for staff in all sectors consistently across Scotland. This is a key initiative from the National Strategy for Adult Survivors of Childhood Sexual Abuse and will help build capacity and quality of responses to adult survivors of childhood sexual abuse within existing agencies.
Mental health services should develop staff skills to identify substance misuse. Knowledge and skills in Harm Reduction, motivational approaches and relapse prevention should be a priority. More specialist elements of substance misuse treatment, such as substitute prescribing should be provided by Substance Misuse services through a joint working arrangement, and mental health staff should have a familiarity with these interventions.
For Substance Misuse services, Scottish Training on Drugs and Alcohol ( STRADA) offers specific modules on substance misuse and mental health. These modules are well developed and accessible and could provide a model for Mental Health agency training. STRADA is currently taking forward work with the University of Dundee to deliver 'Children at the Centre' training to professionally qualified social workers on the identification of child abuse or protection issues and its relationship to substance misuse, mental health and domestic abuse.
Service user input to training programmes is valuable in many ways, including the tackling of negative staff attitudes. Links need to be made to existing training and education strategies in order to ensure that these messages are imbedded into practice.
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