What helps and what hinders recovery: narratives of service users and practitioners about dual diagnosis (co-existing mental health and substance misuse problems)

Manley, David Steven (2015) What helps and what hinders recovery: narratives of service users and practitioners about dual diagnosis (co-existing mental health and substance misuse problems). PhD thesis, University of Nottingham.

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Prevalence rates for mental health problems amongst drug and alcohol service users in the UK were 74.5% and 85.5% respectively (Weaver et al 2003). 44% of people with psychiatric problems also had a substance misuse problem (Weaver 2003).

Aims and objectives: This study aims to identify what service users with dual diagnosis and practitioners who work in this area perceive to be the factors that foster and inhibit their recovery (a meaningful quality of life). This is a narrative study using unstructured interviews to develop a framework for understanding the experiences of people who have a dual diagnosis and to guide those that help them.

Methodology: Ten service users and ten practitioners were interviewed using a narrative approach. These were then transcribed and analysed using Langdridge’s (2012) Critical Narrative Analysis framework (CNA). Goffman’s, Link and Phelan’s and Sayce’s theories on stigma and Frank’s discussion of the role of narrative storytelling in illness were used as hermeneutics of suspicion to study meaning within the narratives.

Findings: The study explores how four key themes Stigma, Motivation, Recovery and Tension narratives provide an explanatory framework of recovery and identity for both service users and practitioners. It uncovers the interrelationships between the spoiled identities (double jeopardy) of service users and the influence this stigma has on practitioners. The study develops a perspective of how narrative storytelling can help articulate and reframe identities to aid recovery amongst people with a Dual Diagnosis.

Relevance: There have been very few studies that explore the lived experience of people with a Dual Diagnosis or the practitioners who work with them. Meta analyses of randomised controlled trials in Dual Diagnosis have found little conclusive evidence of interventions that are effective. The study suggests that in pursuing empiricist research standards, previous studies have missed the holism provided by seeing individual experience as an important factor in affecting the course and effect on people who experience Dual Diagnosis and those around them who try to help.

Item Type: Thesis (University of Nottingham only) (PhD)
Supervisors: Stickley, Theo
Repper, Julie
Keywords: Dual diagnosis, Quality of life, Stigma, Motivation, Recovery, Tension, Narratives, Practitioner and service user relations
Subjects: W Medicine and related subjects (NLM Classification) > WM Psychiatry
Faculties/Schools: UK Campuses > Faculty of Medicine and Health Sciences > School of Health Sciences
Item ID: 30662
Depositing User: Manley, David
Date Deposited: 18 Jan 2016 09:21
Last Modified: 30 Sep 2016 12:21
URI: http://eprints.nottingham.ac.uk/id/eprint/30662

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