The term ‘dual diagnosis’ refers to people who suffer from grave mental illness and have problems with drugs or alcohol to the extent that their mental and physical health is affected. The condition of substance misuse disorder does not entail that there is dependence or an addition rather it defines a spot where the person’s use of drugs or alcohol has become problematic and it impairs the person’s tone of spirit and their ability to work as part of a community. Some reasons that people who are mentally ill drink and get hold of drugs include they are self-medicating, to normalize entry into social groups, to run away or to disengage because their spirit is difficult ...view middle of the document...
S. Department of Justice on murder in families found that more than half of defendants accused of murdering their spouses had been drinking alcohol at the time of the incident (National Coalition Against Domestic Violence).
Challenges that are associated with dual diagnosis include that there is a combination of severe mental illness and problems with drugs or alcohol, one-third have substance misuse problems, there are adverse effects of mental and physical health, there is a complexity of mental health and social needs, high rate of non-compliance with treatment, and there is confusion of responsibility between substance misuse services and mental health services (Kinsella, Kinsella, & Patel, 2006).
Challenges that are seen through the eyes on the client include having a negative perception of services and treatment, those who are pessimistic about the outcome of treatment are likely to be resistance to change and unlikely to fully engage in the change process (Rassool, 2008). Challenges that are seen by the clinicians include the diversity of the problems that the client encounters, the severity of the mental illness and addiction can range from mild to severe, a spectrum of services is needed to cover all aspects of the person’s life for those with severe mental illness, and are able to participate fully in traditional programs with only minor modification (Henderson, 2001).
According to Rassool (2008) “components of counseling include information, including substance related education, recognition of problems and self-monitoring, identification of high risk behaviors, family conflict resolution, social supports and alternatives to substance use, a range of coping strategies and advice on relationships” (p. 102). Secondly, that there is a therapeutic alliance that will engage and offer support to the client (Rassool, 2008). An intervention that can be used with co-occurring client’s is motivational interviewing which aims to facilitate and enhance the client’s intrinsic motivation to change problem behaviors by engaging the client in an emphatically supportive but strategically directed conversation (Rassool, 2008).
Dual diagnosis programs in which both conditions are given equal emphasis have been developed over the past decade or so to address this problem. Both conditions must be treated vigorously, and specialized follow-up is sometimes included. Dual Recovery Anonymous consists of 12step groups involved in recovery from both addiction and severe mental illness. And many facilities also offer long-term therapy groups that work with patients at any level of recovery, with the aim of keeping people engaged in the treatment process so that gradual progress can be made (Henderson, 2001).
Principles of treatment of substance misuse with severe mental illness include: assertive outreach to facilitate engagement, flexibility and specialization through modified approaches, instilling hope in patients, close...