from YAPRap March 2004
by Al Bingham, YAPRap Feature Writer
Dual diagnosis in young people is a hot issue in NSW. It has emerged as a priority area across the three major youth peaks - YAPA, YAA and NAAH. The term commonly refers to young people who have a mental illness, along with a dependency on alcohol or other drugs. Some sectors prefer to speak in terms of multi-diagnosis, as many young people are not only grappling with these issues but also with physical or emotional ill health, low finances or a whole range of other issues.
The reason why dual diagnosis is becoming such a large area of concern is that more and more young people are presenting with a dual diagnosis. At the same time it is becoming apparent that many services are struggling to deal appropriately with these young people.
Many rehabilitation services can't work with young people who have a mental illness, as this can prove an obstacle to the rehabilitation process. On the other hand, many mental health services can't work with young people who are using alcohol or other drugs, as these substances make it difficult to develop effective mental health outcomes.
When accommodation is sought for young people with a dual diagnosis the situation becomes even more problematic. Many housing services can't take young people with either mental illness or who are dependent on alcohol or other drugs, let alone accommodating young people who are dealing with both of these issues.
Enter the Richmond Fellowship. Set up to deal specifically with young people living with a mental illness, this innovative program also works with those same young people if they are undertaking a moderate level of alcohol and other drug use.
The program has three levels. The entry point is a house that accommodates six young people, providing them with intensive support. This support is offered in the form of information on dealing with mental illness and other associated issues, medication to bring mental illness under control, and regular meetings with a mental illness management team. Youth housing workers are on site for twelve hours each day.
Each young person in this high support housing works co-operatively with a mental illness management team. The team is comprised of the young person, a key worker that supports them in their accommodation, a case worker and a doctor. This team is client driven and meets regularly to discuss how the mental illness of the young person is progressing.
After a young person has achieved a certain amount of knowledge about their mental illness, their medication is under control, and they have learnt basic living skills, they will move on to the next part of the program. This is accommodation for four young people that offers a medium level of support for each person. Staff are only available at this housing for a couple of hours every day. Management of mental illness is not as intense at this stage, but the young person continues to meet with their mental illness team. Peer support from other young people sharing accommodation is strongly encouraged at this point, as is networking with other services which can assist with a variety of youth issues.
The final step of the program is an outreach or independent living situation which houses three young people. By this time tenants are expected to pay their own rent and bills, be responsible for their own shopping, clean the premises, and perform other tasks required for independent living. The idea is that this type of housing acts as a trial run to see whether the young people are ready for living independently. It provides a link between the Richmond Fellowship program and the wider community.
At this stage of the program young people address issues to do with their mental illness through a case manager alone, and not through their entire mental illness management team. Staff only visit this housing service up to three times a week.
The end goal of the program is to see young people being able to successfully manage their mental illness and live independently outside the program. Quite a few of the young people who have been through the program end up living on their own in Department Of Housing accommodation.
It takes approximately one year for a young person to move through each stage of the program. Much time is spent fully explaining how the program works to a young person before they join it, and at each step of the way through it. A weekly combined house meeting for all tenants allows young people to work through any accommodation problems they are having, as well as increasing their peer support network. It can be very useful for people in the early stages of the program to see how others have progressed.
Referrals for the program often come through the Early Psychosis Intervention Team of Wentworth Area Health. Some young people are sent to the program as part of Community Treatment Orders, when it has been deemed that they are endangering themselves or others, due to mental illness. The trend has been for more young men than young women to be referred to the program. The Richmond Fellowship is always on the lookout for more referrals from young people in the Penrith LGA, particularly females.
It would be terrific to see such a successful and innovative service, addressing an issue that is becoming a wider concern for young people, replicated in other geographical areas. Then more young people dealing with mental illness and related issues could share in the benefits of what Scott Turner, Residential Support Worker, describes as "a positive and inspiring program".
snapshot
who
Young People aged 17 to 25 living in the Penrith Local Government Area (LGA), with a mental illness.
replication
With funding the program could easily be set up in other areas.
More information
Scott Turner, Service Manager
Wentworth Young People's Program
www.rfnsw.org.au
referrals
(02) 4735 8585
Young women are particularly encouraged to apply.
