Psychiatrists’ views on the treatment of persons with dual diagnosis: A study in mental health and drug rehabilitation services of the Psychiatric Hospital of Thessaloniki Katerina Bletsa, Olga Bampani & Eugenie Georgaca Psychology Department Aristotle University of Thessaloniki Qualitative Research on Mental Health Conference The University of Nottingham, August 2010

Introduction Definition of dual diagnosis Definition of dual diagnosis Division between mental health and drug rehabilitation services Division between mental health and drug rehabilitation services Both services are insufficient for dealing with the problems of people with dual diagnosis Both services are insufficient for dealing with the problems of people with dual diagnosis

This study Focuses on the views of psychiatrists regarding people with dual diagnosis Focuses on the views of psychiatrists regarding people with dual diagnosis Covers both mental health and drug rehabilitation services Covers both mental health and drug rehabilitation services Takes place at the Thessaloniki Psychiatric Hospital Takes place at the Thessaloniki Psychiatric Hospital

Methodology Sample: psychiatrists working in mental health services (5) and drug rehabilitation services (5), who are in daily contact with people with dual diagnosis Sample: psychiatrists working in mental health services (5) and drug rehabilitation services (5), who are in daily contact with people with dual diagnosis Focus on experience rather than theoretical knowledge Focus on experience rather than theoretical knowledge Brief ethnographic study Brief ethnographic study Semi-structured interviews Semi-structured interviews Abbreviated version of grounded theory Abbreviated version of grounded theory

1. Definition and identification of dual diagnosis Definition of dual diagnosis Definition of dual diagnosis Definition and causes of addiction Definition and causes of addiction Prevalence of dual diagnosis Prevalence of dual diagnosis Clinical picture Clinical picture Relation to personality disorders Relation to personality disorders Difficulties posed by dual diagnosis Difficulties posed by dual diagnosis Role of psychiatrists Role of psychiatrists

2. People with dual diagnosis at the Thessaloniki Psychiatric Hospital Difficulties in getting admitted to mental health units Difficulties in getting admitted to mental health units No service takes overall responsibility for their treatment No service takes overall responsibility for their treatment They end up wandering between services They end up wandering between services Lack of fit in any of the two kinds of services Lack of fit in any of the two kinds of services

3. The treatment of people with dual diagnosis Prognosis Prognosis Use of medication Use of medication Between service collaboration Between service collaboration Proposals for treatment Proposals for treatment

Discussion Vagueness regarding the concept and treatment of dual diagnosis Vagueness regarding the concept and treatment of dual diagnosis Neglect of people with dual diagnosis by psychiatric services Neglect of people with dual diagnosis by psychiatric services Similarities between professionals – medical orientation Similarities between professionals – medical orientation Problems created by the psychiatric system Problems created by the psychiatric system