Better together 

In North Yorkshire and York we’ve been building a practitioner network of multi-agency and multi-professional partners to support the sharing of dual diagnosis skills and knowledge across the region. As part of this work, we shared with DDN readers our joint pledge for working better together to promote collaborative service execution (DDN, February 2022, page 20), and we’ve been developing shared training opportunities with the hope of building collective confidence and competency in this area.  

The Dual Diagnosis Network offers a shared space to support collaborative thinking.

It’s been wonderful to see the partnership between specialist substance misuse and mental health services grow and develop through regular forums, events, training, and open communication across the locality. We still have high aspirations about what we can achieve in North Yorkshire and York, and this work is our pledge going forward.

As part of this we identified that, while the process of collective learning in dual diagnosis is a priority, there is a continuing need for colleagues from different services to have shared spaces to talk, connect and learn together. The hope is that joint and collaborative working comes from not just service-level agreements and policy, but through relational connection and understanding of each other’s roles, culture, and values.  

The Dual Diagnosis Network offers a shared space to support collaborative thinking and reflection from multi-agency partners such as mental health, drug and alcohol services, police, probation, third sector providers, housing, social care, advocacy providers and education. However, there’s an identified need for shared, focused learning events to support skills development across the region.  

Training and supporting professionals to learn and develop their skills is essential and ensures individuals feel competent in what they do, which in turn supports improved clinical outcomes for service users. The implementation of any training strategy is, however, often fraught with complexity – as there are challenges around consistency, cost, application of learning and the return on investment. While tackling all these complexities and challenges is outside the work we’ve done, our approach to shared learning has supported people to learn and develop, fulfilling our overarching aim of helping clinicians from different services to come together and learn together to build better relationships. The aim is to model and support collaborative working on a clinician-to-clinician level.  

As an example of the learning together approach, for the last few years we’ve held an annual dual diagnosis conference. This has been hosted online and is open to all in the region, with a focus on developing understanding and knowledge for those both experienced and less experienced in working with service users with co-existing needs. One of the main aims of the Dual Diagnosis Network and conference is to engage people from mental health and drug and alcohol services in a way of working and learning that will benefit the people we work with. 

The dual diagnosis webinar focused on several clinical areas including developments in prescribing, lived experience perspectives on dual diagnosis and recovery and trauma-informed care, as well as break-out room discussions on partnership working for better outcomes and how we can develop a greater sense of collaborative connectedness for services and service users.  

Using live engagement software, we were able to collect data throughout the conference about who was in the room, their insights and their feedback. The data revealed that we had a varied mix of professionals, from more than 25 organisations and services. Results on the day showed us that, overall, attendees came away having learnt a lot about the shared topics, with individuals sharing service pathways with each other as well as concerns with commissioners and senior staff that they might otherwise have found hard to express.  

The Dual Diagnosis Network, and more specifically the annual conference, has allowed for spaces where passionate people working in the mental health sector, drug and alcohol support and wider services come together to interrogate and co-create shared ways of learning. What has also developed, however, is a process of better service connection. This way of connecting and its growth has supported us all to begin creating a shared professional movement to facilitate change in a steady and meaningful way. By being more systemically connected we support our service users together – and better.

Dolly Cook is area manager and co-chair of the Dual Diagnosis Network, Changing Lives.  

Dr Stephen Donaldson is clinical psychologist and co-chair of the Dual Diagnosis Network – Tees, Esk and Wear Valleys NHS Foundation Trust.  

Kate McLaven is digital inclusion coordinator at Changing Lives, York Drug & Alcohol Service


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