Public Health addressing illicit drug use and mental health disorders: Interinstitutional Community Intervention Group

Background: Illicit drug use disorders are associated with high costs to society due to lost productivity, premature mortality, and costs related to health care, criminal justice, and social welfare. Individuals can manifest isolated addictive behaviors, but mental health disorders and/or severe behavioral dysfunction can be associated as well. Thus, different institutions play a role when it comes to address needs of that population. First, in terms of health system, the Mental Health Law is implemented when acute mental disorders put in danger individuals; thus, compulsory admission can occur after an assessment in psychiatry emergency room. However, a subsequent outpatient treatment is needed, taking place in Centers for Integrated Responses or Therapeutic Communities specialized in addictions. Second, social security system aims to support individuals who face difficulty in accessing to basic needs, such as hygiene and food. Third, drug consumptions rooms represent a safer way of consuming drugs and in Porto district that facility is provided. At last, the legal system is called when legal sanctioned behaviors occur; depending on severeness of behaviors and individual insight when committing them, legal sanctions as security measure, prison incarceration, or attribution of a legal tutor can be implemented. 
Methods: Given the complexity of problems that can arise in persons with illicit drug addictions, we proposed to develop more articulated intervention strategies. Thus, the Public Health Unit has assumed the leadership in assessing the various health, social, and legal responses, and promoting their alignment and integrated articulation. 
Results: We implemented some interventions, including an Interinstitutional Community Intervention Group where a multidisciplinary team has focused on the most complex cases of illicit drug use and mental health disorders. 
Conclusions: Connecting health, social, and legal responses is essential for effectively addressing the needs of individuals with illicit drug use and mental health disorders at the local level.