Improving services for individuals with a dual diagnosis: A qualitative study reporting on the views of service users

Abstract

Individuals with high prevalence mental health (HPMH) and concurrent alcohol and/or drug disorders are vulnerable to falling ‘between the gaps’ of existing service systems. The aim of the current qualitative study was to explore service experiences (barriers to treatment and suggestions for improvements) from the perspective of those with this type of dual diagnosis. Of the individuals, 44 with a HPMH dual diagnosis participated in qualitative interviews. Thematic analysis was conducted on the data and major themes from the analysis presented. Barriers to treatment related primarily to knowledge (not knowing that services existed; breakdowns in referrals) and structure (delays in response; system inflexibility). Suggestions for improvements to services targeted barriers but took a holistic view including the need for worker and community education, addressing issues beyond the illness and the importance of relationships. The complex interaction between the disorders means that navigating either of the specialist systems has pitfalls not faced by people with a single disorder. Service user input is vital to minimise gaps and ensure service provision meets the needs of this group. These findings can now be used to inform service system redesign so that services are better able to meet the needs of this group.

• Comorbidity
• dual diagnosis substance-related disorders
• mental health
• health services
• qualitative research