Treating Dual Diagnosis Patients: Challenges and Opportunities

Howland, Robert H

doi:10.29046/jjp.008.1.002

Cited by 2 publications

(4 citation statements)

References 17 publications

(13 reference statements)

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“…It is thus difficult to provide extra treatment for patients with multiple problems. Patients with dual diagnosis are often depicted as the square pegs of psychiatry, not fitting into the round hole of mental health (Howland, 1990), and the findings of this study are thus consistent with this picture.…”

Section: Discussionsupporting

confidence: 84%

“…This finding was represented by six categories of challenges, of which four were presented in the paper. The identified categories of challenges resemble some of the challenges identified in the existing literature (Adams, 2008; Baldacchino et al , 2011; Drake et al , 2001; Howland, 1990; Roberts, 2013; Sorsa et al , 2017).…”

Section: Discussionmentioning

confidence: 83%

“…It is argued here that a treatment system which is dependent on compliant patients fits badly to patients with dual diagnosis because this patient group is often less compliant than other patient groups (O’Brien et al , 2009). Non-compliance and poor treatment response are often “blamed” on the patient (Howland, 1990). This neglects the disability that can result from the patient’s condition and it assumes that the offered treatment is infallible (Howland, 1990).…”

Section: Discussionmentioning

confidence: 99%

“…Non-compliance and poor treatment response are often “blamed” on the patient (Howland, 1990). This neglects the disability that can result from the patient’s condition and it assumes that the offered treatment is infallible (Howland, 1990). Instead of perceiving patients as passive recipients of treatment, where the treatment success depends on whether they are compliant or not, it is argued here that it is more relevant to discuss what characterises a good or bad treatment system.…”

Section: Discussionmentioning

confidence: 99%

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Challenges in working with patients with dual diagnosis

Pinderup

2018

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Purpose Studies have shown that mental health professionals find working with patients with dual diagnosis challenging, and the purpose of this paper is to examine some of these challenges. Design/methodology/approach In total, 85 mental health professionals from 8 different mental health centres in Denmark were interviewed. The data analysis was inspired by a grounded theory approach. Findings Different challenges in the dual diagnosis treatment were identified and they suggested that the focus of treatment was mainly on the mental illness rather than the substance use disorder. The single focus of the treatment made it challenging to treat patients with dual diagnosis sufficiently. While several studies explain the single focus by inadequate competencies among professionals, the present study suggests that the single focus is also explained by the way that the treatment is organised. For instance, standardized treatment packages and insufficient guidelines on substance abuse treatment make it challenging to treat patients with dual diagnosis. Originality/value This paper suggests that a more flexible, and a longer period of, treatment, together with more sufficient guidelines on dual diagnosis treatment and a more formalized collaboration with the substance abuse treatment centres, will make it a less challenging issue to treat patients with dual diagnosis.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Challenges in working with patients with dual diagnosis

Pinderup

2018

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The treatment of persons with dual diagnoses in a rural community

Howland

1995

Psych Quart

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Persons with dual diagnoses of psychiatric illness and substance abuse represent a large subpopulation within the mental health system, but mental health service delivery systems typically do not adequately address their special needs. The literature on dual diagnoses is marked by the paucity of information on such persons in rural settings. This paper describes the characteristics of a rural community mental health system, which illustrate the difficulties in treating persons with dual diagnoses in rural communities. These problems include a fragmented system of services, centralized services in a large geographic area, overly restrictive regulations, conceptual differences in treatment approaches, confidentiality and stigma in a rural culture, and the academic and professional isolation of mental health workers, leading to high turnover and a shortage of staff having sufficient training and experience to work with persons with dual diagnoses. Some recommendations to address these problems and to improve the delivery of services to persons with dual diagnoses are suggested.

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Treating Dual Diagnosis Patients: Challenges and Opportunities

Cited by 2 publications

References 17 publications

Challenges in working with patients with dual diagnosis

Challenges in working with patients with dual diagnosis

The treatment of persons with dual diagnoses in a rural community

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