'Dual diagnosis' is when people have a mental-health problem and a substance-abuse problem and is common in forensic units which deal with mentally-ill offenders. Surveys of patients in such units have shown that a third are alcohol abusers and half drug abusers. Substance abuse is of particular concern in forensic mental health services as it increases the risk of crime, particularly theft and violence. As patients are often in forensic units for a considerable period of time they represent a good chance of getting patients off drink and drugs. A study of dual-diagnosis offenders at the Denis Hill unit at the Bethlem Hospital looked at a programme of two stages of 12-week treatment groups supporting people in becoming and remaining drug and alcohol free through motivational interviewing, psycho-education and relapse prevention. After their release the offenders took part in the 'Just Say No' participant-led social group to support their continued abstinence for the six months after their discharge. The study found that the 'Just Say No' group had a significant effect on whether people remained drug-free. By the end of the treatment people reported more insight into their problems, felt more confident that they could stay off drugs and felt less cravings for cannabis.
Miles, Helen ... [et al] - 'Just say no' : a preliminary evaluation of a three-stage model of integrated treatment for substance use problems in conditions of medium security The Journal of Forensic Psychiatry and Psychology June 2007, 18(2), 141-159