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(2003) stated that tobacco use is the most common and overlooked comorbidity in mental health patients. The remote generalist nurse delivering mental healthcare is confronted with and must care for a cohort of patients who require complex care often related to multiple comorbidities, which requires a breadth of knowledge not limited to mental healthcare. 2.4 Treatment Facilities for Drugs and Alcohol In 2010–2011, most drug and alcohol treatment agencies were located in metropolitan areas (52%, 344 agencies) and inner regional areas (27%, 182 agencies), with 7% located in remote and very remote areas. With fewer drug and alcohol service providers in remote areas, there are also fewer facilities and less infrastructure for providing in-patient or even out-patient treatment. This creates a greater reliance on counselling and education (see Table 2.8).

0 10 20 30 40 50 60

Major Cities Inner Regional Outer Regional Remote Very Remote

Withdrawal management (detoxification)

Counseling Support and case management only

Information and education only

Assessment only

Figure 2.1. Mental health episodes by main treatment type and remoteness (as percentage of total population according to Remoteness Classification Index), 2010–2011. Source: AIHW, 2012.