The management of young men (aged 18 to 35) with co-occurring difficulties is a source of significant stress and distress within families and clinical practice settings (public and private). Frequently patients and their families are ‘hand-balled’ between multitudes of specialist services seeking assistance to manage a complex set of presentations. One of the most common problems faced by patients seeking help is that most specialist services are reluctant to take on complex cases that involve co-occurring mental health problems and illnesses, substance misuse and impulse control (violence) disorders. When you also take into consideration the developmental factors typical of adolescents and young men (for example, anti-authority attitudes and the need for individuation) and legal involvement (court and/or community corrections requirements), service provision needs to ensure ease of access and responsiveness. This however, is often not the case for complex presentations leading to low engagement, poor clinical outcomes and non-attendance. In 2009 an innovative relationship between a drug and alcohol service (at a private hospital), local general practitioners (specialised in drug and alcohol treatment), and a clinical psychologist (in private practice) was formed to establish a care pathway and clinical program for adolescents and young people that included co-location, access to appropriate clinical expertise at no cost, with links to specialized nursing and general practice. Five years into operation, clinical outcomes indicate that the collaborative management of these co-occurring issues within this unique pathway and service model has the ability to reduce the incidence of mental health problems, substance misuse and violence/legal complications. This paper will explore the development of this pathway, the model, and present a clinical case that demonstrates the effectiveness of providing a coordinated, youth friendly and affordable service to manage co-occurring clinical presentations.

Co-occurring anxiety, depression and substance use disorders are among the leading causes of burden among people aged 15-24. These problems disorders typically have their onset in adolescence and young adulthood and once established, each set of problems serves to exacerbate the other, resulting in substantial impact on individuals and those who love them. The NHMRC Centre of Research Excellence in Mental Health and Substance Use at the National Drug and Alcohol Research Centre, UNSW (CREMS) was established in 2012, as a collaboration across 7 universities from around the world to conduct and disseminate research on comorbidity, focusing on epidemiology, prevention, treatment and translation. This talk will present an update on the epidemiology of co-occurring mental and substance use disorders among young people in Australia. It will ask: how many young people experience co-occurring mental and substance use disorders? What is the impact? And what are the implications for research, prevention and treatment? It will include discussion of some recent trends in drug and alcohol use among young Australians, changing gender patterns across the world, and will raise some questions for future directions in research and prevention of mental and substance use disorders in young people.

This paper describes the continuing journey of the NSW Community Managed Mental Health and Drug and Alcohol Research Network (CMHDARN). CMHDARN was established in 2010 by the Network of Drug and Alcohol Services (NADA) and Mental Health Coordinating Council (MHCC). Its aim is to: broaden involvement of the community mental health and drug and alcohol sector in practice-based research; promote the value of research and the use of research evidence in practice; and, to improve service delivery to people affected by drug and alcohol and mental health issues. Last year, CMHDARN was privileged to be awarded an inaugural Tom Trauer Research and Evaluation Award at the TheMHS Conference.

CMHDARN’s activities and impacts were externally evaluated in 2014. Some of the history and achievements of CMHDARN are described. This includes reflections on our NSW Health funding arrangements of the first three years and our more recent and evolving research and development partnership with the NSW Mental Health Commission. A key focus of CMHDARN has been to promote the translation of best practice research into reality and consumer lead research. We will present two best practice guides completed in 2015 to facilitate: 1) consumer participation in research, and 2) ethical considerations in community sector mental health and drug and alcohol work research and development.