Patients with a dual diagnosis and their encounter with the psychiatric treatment system

Abstract

In this article, we present 17 interviews with patients with a dual diagnosis (the coexistence of a substance use disorder and a psychiatric disorder). These patients uniformly describe
experiences of being rejected or treated as second rank patients by the psychiatric treatment system. Based on a content-analysis of the 17 interviews we identify three different answers to the question of why patients are being meet this way. Firstly, drug use is generally stigmatized by society at large – and hence also by psychiatric staff. Secondly, patients with a dual diagnosis is living up to the traditional role of patient, among other things because they continue to use. And thirdly, the concept of disease that psychiatry apply – that of sharply distinguished disease entities – complicates treatment of complex diseases, such as dual diagnosis. We end the article by presenting the wished of the patients with regard to the psychiatric treatment system: to be met as a person and to receive competent treatment for their problems, including the substance use.