For people with mental illness and comorbid alcohol and drug disorder, engagement in community rehabilitation is difficult with relapse commonly occurring.

Although an evidence base exists for treatment strategies that complement medication and family work for people with schizophrenia, it is difficult to engage them in additional community treatment programs.

This research project addresses the engagement issue with the development, implementation and testing of three programs designed to improve treatment engagement by providing the support required to link the patient in treatment to community treatment programs.

The project aims to improve long-term outcomes for people with mental illness and comorbid alcohol and drug disorders and schizophrenia, being treated at a Mental Health Unit, by supplementing family work and medication with voluntary linkage interventions based on evidence-based supported employment and community therapy.

The linkage interventions are designed to promote local service culture change and to overcome stigma and treatment engagement difficulties in mental illness and comorbid substance use disorder and schizophrenia.

The three interventions provide support in the areas of supported employment, substance use disorders and voice hallucinations.

Each intervention program is currently being tested in single-blind randomised controlled trials with treatment as usual or standard treatment.

The three interventions have been introduced as programs at the Mental Health Unit, Sir Charles Gairdner Hospital. These are:

• Supported Employment Trial: supports engagement to a local employment agency with good fidelity to the Individual Placement and Support approach to supported employment for people with schizophrenia.    
• Substance Use Trial: involves best evidence therapeutic principles for patients with mental illness and comorbid alcohol and drug disorder for engagement with the patient’s preferred long-term community alcohol and drug treatment program.
• Voice Hallucination Trial: clinical psychologist aiming to engage the patient with schizophrenia and distressing auditory hallucinations to a clinical psychologist in the community by choice.

This project is run in collaboration with Sir Charles Gairdner Hospital Mental Health Service, the West Australian RANZCP Postgraduate Training Program, and the Freshstart Recovery Program.