Comorbidity and Complexity

Comorbidity and Complexity

Level ~ Masters
Teaching period ~ Semester 1

Using the CanMEDS domains of Health Advocate and Scholar students will develop advanced knowledge and skills in applying the principles of recovery-oriented care when working with people with three types of comorbidities that may be associated with mental illness: substance disorders, forensic issues and intellectual disability.

The co-occurrence of one or more disorders presents challenges for people with mental illness, their supporters and communities as well as for health practitioners in mental health care management. This is further complicated through issues addressed earlier, where the consumer’s context added compounding social, cultural or other factors that need to be taken into account in the determination and implementation of care.

A recovery-orientation presents the challenge of ensuring that its key principles are aspired to and met, even within highly restrictive environments. Students will familiarise themselves with consumer perspectives of experiencing ‘comorbidity’ and develop skills in health advocacy to support people with complex mental health needs. Social justice, inclusion and citizenship campaigns for the rights of people with disabilities interface with the recovery movement and students will consider these issues in the light of barriers to the application of collaborative recovery-oriented mental health care.


Learning Outcomes

Upon completion of the unit, students will be able to:

  • Critically appraise the application of clinical and ‘lived experience’ leadership in identifying and enacting opportunities to improve collaboration.
  • Critically appraise the role and ethics of the doctor working with people with mental illness with comorbidity in regards to medicolegal reports.
  • Debate and critique the effects of the presence of comorbidities upon violence risk assessment and management within recovery-oriented mental health care.
  • Deconstruct management approaches in working with people with comorbidity including appropriateness of use of supervision and reflection upon the effects of the student’s own cultural values and stigma.
  • Describe the pharmacology of the common drugs of abuse and dependence, the epidemiology and aetiology, physical and psychological sequelae and treatment interventions for substance abuse and dependence.
  • Critically analyse implications of Aboriginal people’s social and emotional wellbeing for mental health leadership and improvement.
  • Justify and present a plan to improve access to prevention, promotion and/or early intervention activities for individuals with comorbidity, their families and carers, with evidence and epidemiological justification of the approach.

Teaching Schedule
Topic 1 Leadership in recovery-oriented care
Topic 2 Improving Aboriginal social and emotional wellbeing
Topic 3 Limiting the harm from alcohol abuse
Topic 4 Neuropharmacology and stimulants
Topic 5 People with mental illness and drug misuse
Topic 6 Assessing risk and management of harm to others
Topic 7 Reducing over-the-counter and prescribed medication abuse
Topic 8 Working with people with opiate dependence
Topic 9 Professionalism in forensic related mental health – assessment and reporting
Topic 10 Working to improve the mental health of people with intellectual disability
Topic 11 Understanding people with intellectual disability
Topic 12 Working with people with intellectual disability
Topic 13 Forensic mental health systems and legislation
Topic 14 Working with difficult people
Topic 15 Disorders and problems more common in forensic populations
Topic 16 Sleep Disorders – Social, Psychiatric or Medical?
Topic 17 Working with people with problems with gambling
Topic 18 Preventing nicotine misuse in people with mental illness