Defining dual diagnosis: a qualitative study of the views of health care workers

Abstract

Background: ‘Dual diagnosis’ is the term of choice in many countries to describe clients with co-occurring mental health and alcohol and other drug (AOD) issues. However, it is not known if its meaning is consistently represented within and across health care services. This uncertainty has significant implications for referral, consultation and research.

Aim: To obtain information about the way that different health care professionals understand the term ‘dual diagnosis’.

Method: Twenty-nine health care workers across five service types (medical, mental health, AOD, dual diagnosis and community health) in Victoria, Australia were interviewed about their understanding of the term ‘dual diagnosis’.

Results: The findings indicated that service providers working in AOD and Mental Health had a shared general understanding of what was meant by ‘dual diagnosis’, despite uncertainties about more specific inclusion criteria. In contrast, medical and community health staff lacked a similar shared understanding, and were more likely to recommend change, but offered no consensus on alternatives.

Conclusion: The results indicate that while the term ‘dual diagnosis’ has value in efficiently directing attention to the complexity of treatment issues, health practitioners cannot assume it will convey the intended meaning outside mental health or AOD services. Clear articulation of the intended definition may be a necessary requirement in wider health care communication.

Keywords:

• co-morbidity
• co-ocurring disorders
• dual diagnosis
• health services
• service providers
• terminology

Acknowledgements

We would like to thank the service providers for their participation and Sophia Liddy for her assistance with data collection and analysis. The research was funded by beyondblue Victorian Centre of Excellence in Depression and Related Disorders Program.