Qualitative examination of rural service provision to persons with concurrent developmental and mental health challenges

Abstract

Although there has been an international trend away from institutionalization to community-based care, this has not always been successful, particularly for the unique and vulnerable population diagnosed with both mental health and developmental disabilities. The challenge of meeting the needs of this population is increased in rural and remote areas. As a part of a larger study, this paper reports on the voices of service providers for people dually diagnosed as they maneuver through the considerable challenges of meeting complex needs while located in remote northern communities. The complexities of rural service provision for those with a dual diagnosis of mental illness and developmental disability is also highlighted and includes challenges of northern living, difficulties in diagnosis, and system level issues. This paper confronts the inequities in provision of effective community-based services to this population and draws attention to the need to support and develop local, integrated services in order to build inclusive communities for all.

Keywords:

• dual diagnosis
• mental health
• developmental disability
• Canada
• rural

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes on contributors

Linda Kreitzer is an Associate Professor in the Faculty of Social Work, University of Calgary, Central and Northern Region. Her teaching includes professional use of self, international social work, community practice, social action, and international indigenous issues. Her research interests include social work in Africa, immigrant and refugee issues in Canada, compassion fatigue, and community development. She sits on the Board of Directors of the International Association of Schools of Social Work.

Anne Marie McLaughlin is an Associate Professor in the Faculty of Social Work, University of Calgary, Edmonton Division. Her research interests are in clinical social work practice and its relationship to social justice. Her extensive work history includes child welfare as well as community mental health practice in rural and northern communities.

Grace Elliott is a registered social worker and a Senior Instructor at the University of Calgary, Faculty of Social Work. She received a BA (Hons.) in Sociology from the University of Waterloo and her BSW (Edmonton) and MSW (Calgary) from the University of Calgary. Her teaching, research, and service interests include social work practice methods, field education, culturally relevant practice, social work ethics, community-university partnerships, and inter-professional collaboration.

David Nicholas is an Associate Professor in the Faculty of Social Work at the University of Calgary (Central and Northern Alberta Region). He brings a strong background in neuro-developmental disability research with an emphasis on social support and quality of life. His research addresses transitional processes from pediatric to adult care. Currently, Dr Nicholas leads a nationally funded program of research addressing labor market barriers and strategies for adults with developmental disability.

Notes

1. There are three Aboriginal groups in Canada: (1) First Nations, (2) Inuit, and (3) Metis. First Nations people are the various Aboriginal groups in Canada who are neither Inuit nor Metis. There are currently over 630 recognized First Nations governments or bands spread across Canada. Inuit are members of an aboriginal people who live in the coastal Canadian Arctic, in Alaska, and in Greenland.

2. Metis are descended from early French and English fur traders and First Nations women.