Challenging the Cultural Determinants of Dual Diagnosis in the Criminal Justice System

Pycroft, Aaron; Green, Anita

doi:10.1057/9781137453884_9

Cited by 2 publications

(2 citation statements)

References 11 publications

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“…Seeking treatment for problematic problematic and unhealthy alcohol use is only one component of services that need to be coordinated in the community to address not just alcohol but mental health problems. It is the case often that those working with the person with dual diagnosis do not always understand their problems that are often reported to be complicated and therefore better coordinated services are required (Pycroft and Green, 2016).…”

Section: Resultsmentioning

confidence: 99%

Understanding women’s help-seeking for problematic and unhealthy alcohol use through the lens of complexity theory

Cane

Newton

Foster

2022

ADD

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Purpose It is well established that women face multiple barriers accessing treatment for problematic and unhealthy alcohol use, but less is known about how their interconnected problems affect how they seek help from, and access, alcohol-treatment services. This study aims to explore the dynamic nature of women’s help-seeking for problematic and unhealthy alcohol use and how this can be compounded by unsuitable treatment services, especially when women present with complex needs. Design/methodology/approach Thirteen semi-structured interviews with women who had accessed alcohol-support services were conducted, audio-recorded, transcribed and analysed thematically using the complexity theory. Findings For women with complex needs, the process of seeking help may trigger unpredictable behaviours, health or social problems and intermittent serial access to treatment. Current services do not always address women’s holistic needs. Unless services focus on addressing interconnected problems – including historic trauma – they may compound the complexity of women’s problems. Complexity theory offers novel insights into this process, a concept not applied to problematic and unhealthy alcohol use treatment previously. Research limitations/implications Services should adopt the complexity-focused perspective featured in this study. While the authors acknowledge the increase in gender-responsive provision, the limitations of this study include a small sample size, the self-selecting nature of the sample and retrospective reporting. Participants were recruited and selected by service staff resulting in gatekeeping and possible sampling bias. Practical implications Services should adopt non-linear approaches to treatment. Implementing complexity approaches to treating women’s problematic and unhealthy alcohol use should capture the dynamics, complexity and non-linear nature of women’s help-seeking journeys as well as their internal and external responses that may result in relapse. The authors recommend complexity-focused, multiple-component and integrated collaborative strategies to address not only addiction but also all components of women’s needs, including past trauma. Originality/value Applying complexity-thinking to help-seeking experiences for alcohol treatment and recovery services is novel and proved useful in understanding the variety of women’s experiences and how these interact with their help-seeking behaviours, including treatment environments.

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Section: Resultsmentioning

confidence: 99%

Understanding women’s help-seeking for problematic and unhealthy alcohol use through the lens of complexity theory

Cane

Newton

Foster

2022

ADD

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“…It follows from the earlier description of the multiple and bidirectional explanatory processes that the oft-assumed categorical dichotomy between, on the one hand, a substance-induced mental/behavioural condition and, on the other hand, a so-called primary mental illness that coexists with (but is not caused by) substance use is in many cases likely to be a gross oversimplification. Questions have even been raised about whether the reductionist basis of the term dual diagnosis misleads the clinician into seeing a straightforward relationship between substance use and mental illness where it usually does not exist (Pycroft 2016). A pictorial representation of the problem (such as that presented in Fig.…”

Section: Assessment Approach For Coexisting Psychosis and Substance Mmentioning

confidence: 99%

Assessment of coexisting psychosis and substance misuse: complexities, challenges and causality

Nathan¹,

Lewis²

2020

BJPsych advances

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SUMMARY Substance misuse worsens the prognosis for people suffering psychosis and places them at risk of being denied appropriate mental health service interventions. To increase the chances of its success, the plan of management for patients with coexisting psychosis and substance misuse should be based on a valid formulation of their problems, which in turn is dependent on the clinician having (a) a thorough understanding of the bidirectional and changing ways that substance use and mental illness symptoms can interact, (b) an awareness of their own biased implicit assumptions about causality in explaining these interactions and (c) a framework for assessment and formulation. This article addresses these three areas with reference to the evidence base and to clinical experience in a way that guides mental health clinicians in the assessment of patients with coexisting psychosis and substance misuse.

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Challenging the Cultural Determinants of Dual Diagnosis in the Criminal Justice System

Cited by 2 publications

References 11 publications

Understanding women’s help-seeking for problematic and unhealthy alcohol use through the lens of complexity theory

Understanding women’s help-seeking for problematic and unhealthy alcohol use through the lens of complexity theory

Assessment of coexisting psychosis and substance misuse: complexities, challenges and causality

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