Psychiatrists’ views on the treatment of persons with dual Psychiatrists’ views on the treatment of persons with dual diagnosis: A study in mental health and drug rehabilitation diagnosis: A study in mental health and drug rehabilitation

services of the Psychiatric Hospital of Thessalonikiservices of the Psychiatric Hospital of Thessaloniki

Katerina Bletsa, Olga Bampani & Katerina Bletsa, Olga Bampani & Eugenie GeorgacaEugenie Georgaca

Psychology DepartmentPsychology DepartmentAristotle University of ThessalonikiAristotle University of Thessaloniki

Qualitative Research on Mental Health ConferenceQualitative Research on Mental Health ConferenceThe University of Nottingham, 25-27 August The University of Nottingham, 25-27 August

20102010

Introduction Introduction

Definition of dual diagnosisDefinition of dual diagnosis Division between mental health and Division between mental health and

drug rehabilitation servicesdrug rehabilitation services Both services are insufficient for Both services are insufficient for

dealing with the problems of people dealing with the problems of people with dual diagnosiswith dual diagnosis

This studyThis study

Focuses on the views of psychiatrists Focuses on the views of psychiatrists regarding people with dual diagnosisregarding people with dual diagnosis

Covers both mental health and drug Covers both mental health and drug rehabilitation servicesrehabilitation services

Takes place at the Thessaloniki Takes place at the Thessaloniki Psychiatric HospitalPsychiatric Hospital

Methodology Methodology

Sample: psychiatrists working in mental Sample: psychiatrists working in mental health services (5) and drug rehabilitation health services (5) and drug rehabilitation services (5), who are in daily contact with services (5), who are in daily contact with people with dual diagnosispeople with dual diagnosis

Focus on experience rather than Focus on experience rather than theoretical knowledgetheoretical knowledge

Brief ethnographic studyBrief ethnographic study Semi-structured interviewsSemi-structured interviews Abbreviated version of grounded theoryAbbreviated version of grounded theory

1. Definition and identification of 1. Definition and identification of dual diagnosisdual diagnosis

Definition of dual diagnosisDefinition of dual diagnosis Definition and causes of addictionDefinition and causes of addiction Prevalence of dual diagnosisPrevalence of dual diagnosis Clinical pictureClinical picture Relation to personality disordersRelation to personality disorders Difficulties posed by dual diagnosisDifficulties posed by dual diagnosis Role of psychiatristsRole of psychiatrists

2. People with dual diagnosis at the 2. People with dual diagnosis at the Thessaloniki Psychiatric HospitalThessaloniki Psychiatric Hospital

Difficulties in getting admitted to Difficulties in getting admitted to mental health unitsmental health units

No service takes overall No service takes overall responsibility for their treatmentresponsibility for their treatment

They end up wandering between They end up wandering between servicesservices

Lack of fit in any of the two kinds of Lack of fit in any of the two kinds of services services

3. The treatment of people with 3. The treatment of people with dual diagnosisdual diagnosis

PrognosisPrognosis Use of medicationUse of medication Between service collaborationBetween service collaboration Proposals for treatmentProposals for treatment

Discussion Discussion

Vagueness regarding the concept Vagueness regarding the concept and treatment of dual diagnosisand treatment of dual diagnosis

Neglect of people with dual diagnosis Neglect of people with dual diagnosis by psychiatric servicesby psychiatric services

Similarities between professionals – Similarities between professionals – medical orientationmedical orientation

Problems created by the psychiatric Problems created by the psychiatric systemsystem