The University of Newcastle, Australia

Tackling substance misuse and mental health with implementation science

Dr Kylie Bailey is investigating the complicated relationship between mental health and addiction. Within a typically under-researched field, she’s determined to break prevailing social stigmas and implement evidence-informed solutions.

It’s no secret that mental health and substance misuse can have an adverse, symbiotic relationship.

People with mental health disorders, such as depression, can be more likely to use and misuse alcohol and other drugs. Likewise, alcohol and drug use can ignite underlying mental health challenges and fuel further health problems.

But even though comorbidity is common, responding health interventions tend to focus on either alcohol and other drug use or mental health disorders—rarely both.

Through education and research, Dr Kylie Bailey is helping to change this siloed approach to care.

“I’m working to improve mental health and addiction treatments by upskilling healthcare workers, improving policies and interventions, and researching how evidence can be better applied in practice.”

The science of implementation

Kylie has spent many years researching and developing clinical interventions and policies that target substance abuse. More recently, she has shifted her attention to the emerging research area of implementation science.

Kylie uses implementation science to pose a critical question: how can we use evidence to successfully embed new policies and interventions into routine healthcare?

After all, even the best strategies can’t have an impact without practitioner support, patient engagement and the ability to be scaled up from pilot stage to community-wide initiative.

“Implementation science, sometimes called translational research, is the future for health research.

“It will help us to better evaluate treatment effectiveness for patients, and ultimately improve their quality of life.”

Whether she’s developing interventions and policies, or informing better implementation strategies for their success, Kylie’s core mantra remains the same: reduce alcohol and other drug use, improve access to mental health and addiction treatments, and see the whole community benefit.

“Addiction significantly affects the burden of disease and mortality of the individual, their family and their community.

“Along with the emotional impact on families, addiction costs society through unemployment, legal settings, hospital and healthcare costs, as well as the worst-case scenario—death.

“Reducing risks for addiction and shortening the time-frame for addiction duration is important for everyone: the individual, their family and communities.”

From evidence to outcomes

To help turn evidence into action, Kylie is focused on providing the right information to patients and the necessary support for health professionals.

This includes developing plain English e-cards to help share drug and alcohol information with patients, and conducting evidence check rapid reviews for the NSW Ministry of Health (brokered by Sax Institute) into the recruitment and retention of the AOD workforce.

“The opportunity to influence health policies for AOD intervention workers at the state level is exciting!”

Kylie’s work supports improved mental health and addiction outcomes for people across multiple community groups—including PTSD patients and pregnant women.

Among her most recent work includes the development of training modules for general practitioners on the topics of maternal drinking, tobacco use and related gestational weight gain during pregnancy.

“The training involved incredible interdisciplinary collaboration. It brought together the expertise of the University’s Dr Melanie Kingsland, the research staff at Population Health, Hunter Primary Care, Hunter Medical Postgraduate Institute and the Primary Health Networks.”

While these types of impressive collaborations indicate a promising future for the field of mental health and addiction research, Kylie warns there’s still a long way to go.

“We know that significantly more attention and research is needed.

“That’s why I’m passionate about inspiring other health professionals to work in the area of addiction and provide evidence-based treatments for patients.”

Breaking social stigmas

Alongside her research, Kylie is committed to educating current and future health professions on how to respond effectively to mental illness and addiction.

Through education, Kylie hopes to reduce prevailing stigma attached to the issues and support a more empathetic and competent workforce.

“I want to upskill healthcare workers so that they are not judgemental, and they don’t unconsciously stigmatise these two patient groups. Upskilling will also improve the quality of care that they can provide to patients.”

As a senior clinical psychologist, Kylie knows how difficult addiction and mental health can be for everyone involved: individuals, families and communities.

Though she’s recevied awards, peer recognition and funding grants, it’s the personal success stories that give Kylie the most motivation to continue finding new solutions for patients and their families.

“I will never forget the day that a young boy—just seven years old—gave me hand-picked flowers wrapped in foil and a hand-made card thanking me for ‘fixing his mummy’ who had a methamphetamine use disorder. You can’t get any award or recognition that’s better than that.”