title: Mental health among clients of the Sydney Medically Supervised Injecting Centre (MSIC).
abstract: The Sydney Medically Supervised Injecting Centre (MSIC) is a supervised injecting facility (SIF) where people who inject drugs (PWID) can do so legally, under health professional supervision. The majority of clients have low levels of education and employment, high rates of incarceration and unstable housing and poor social networks, and 70 % do not access local health services. These factors increase the risk of poor mental health, and it has been documented that PWID have elevated rates of mood, anxiety, personality and psychotic disorders; post-traumatic stress disorder (PTSD); and higher rates of trauma exposure, suicidality and self-harm. The current study is the first to investigate the mental health among clients of a SIF. Validated instruments to examine clients' mental health, social networks and trauma histories were administered to 50 frequently attending clients by a mental health nurse. The majority of respondents were unemployed, homeless and had a history of incarceration, and 82 % report they had been diagnosed with a mental health problem, but only 24 % report they were receiving treatment. Respondents had poor social networks, had poorer mental health symptoms compared to US inpatients and had experienced multiple traumatic events, and a high number of respondents had scores indicative of PTSD. These results highlight the need for mental health clinicians to be employed in SIFs and other drug consumption rooms (DCRs) to assist clients to address their mental health and psychosocial needs, particularly in light of the fact that these services are often the only places these PWID engage with in an ongoing way.
authors.affiliation: Sydney Medically Supervised Injecting Centre, PO Box 293, Kings Cross, Sydney, NSW, 1340, Australia. mgoodhew@uniting.org.
authors.forename: Mark
authors.identifier: 0000-0002-1108-8293
authors.initials: M
authors.lastname: Goodhew
authors.affiliation: Sydney Medically Supervised Injecting Centre, PO Box 293, Kings Cross, Sydney, NSW, 1340, Australia.
authors.forename: Allison M
authors.initials: AM
authors.lastname: Salmon
authors.affiliation: Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Sydney, Australia.
authors.forename: Christina
authors.initials: C
authors.lastname: Marel
authors.affiliation: Centre of Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Sydney, Australia.
authors.forename: Katherine L
authors.initials: KL
authors.lastname: Mills
authors.affiliation: Sydney Medically Supervised Injecting Centre, PO Box 293, Kings Cross, Sydney, NSW, 1340, Australia.
authors.forename: Marianne
authors.initials: M
authors.lastname: Jauncey
mesh_terms: D000328:Adult; D005260:Female; D006703:Ill-Housed Persons / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008603:Mental Health / Q000706:statistics & numerical data; D018671:Needle-Exchange Programs / Q000706:statistics & numerical data*; D020380:Needs Assessment; D009517:New South Wales / Q000453:epidemiology; D012944:Social Support; D016320:Substance Abuse Treatment Centers / Q000706:statistics & numerical data; D015819:Substance Abuse, Intravenous / Q000523:psychology*; D014478:Unemployment / Q000706:statistics & numerical data
keywords: Mental disorders; Mental health; Supervised injecting centres, supervised injecting facilities, illicit drugs