Histories of Social Functioning and Mental Healthcare in Severely Dysfunctional Dual-Diagnosis Psychiatric Patients.

Abstract Disengagement from mental health services is a major obstacle to the treatment of homeless dual-diagnosis patients (i.e., those with severe mental illness and substance-use disorder). A subgroup of these patients is considered to be treatment resistant and we aim to explore whether patients...

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Published in:International Journal of Mental Health & Addiction Vol. 18; no. 4; pp. 904 - 917
Main Authors: van Kranenburg, Grieke D., Diekman, Wout J., Mulder, Wijnand G., Pijnenborg, Gerdina H. M., van den Brink, Rob H. S., Mulder, Cornelis L.
Format: Article
Published: Springer Nature Aug2020
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        10.1007/s11469-018-9992-7
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        atl: Histories of Social Functioning and Mental Healthcare in Severely Dysfunctional Dual-Diagnosis Psychiatric Patients.
      aug:
        au:
          van Kranenburg, Grieke D.
          Diekman, Wout J.
          Mulder, Wijnand G.
          Pijnenborg, Gerdina H. M.
          van den Brink, Rob H. S.
          Mulder, Cornelis L.
        affil:
          Drenthe Mental Healthcare Organization, Sustainable Residence, PO Box 30007, Beilen, 9400 AA, Assen, the Netherlands
          Bouman GGZ, Rotterdam, the Netherlands
          Drenthe Mental Healthcare Organization, Department of Psychotic Disorders, Assen, University of Groningen, Groningen, the Netherlands
          Department of Clinical Psychology and Experimental Psychopathology, Faculty of Behavioural and Social Science, University of Groningen, Groningen, the Netherlands
          University of Groningen, University Medical Center Groningen, Department of Psychiatry, Rob Giel Research Center, Groningen, the Netherlands
          Department of Psychiatry, Epidemiological and Social Psychiatric Research Institute, Erasmus MC, Rotterdam, the Netherlands
      su:
        Social skills
        Mental health services
        Social history
        Involuntary treatment
        Unemployment
        Medical care
        Involuntary hospitalization
      sug:
        subj:
          Social skills
          Mental health services
          Social history
          Involuntary treatment
          Unemployment
          Medical care
          Involuntary hospitalization
          Offices of Mental Health Practitioners (except Physicians)
          Psychiatric and Substance Abuse Hospitals
          Residential Mental Health and Substance Abuse Facilities
      keyword:
        Compulsory treatment
        Difficult-to-engage
        Dual diagnosis
        Homeless
        Severely mentally ill
        Treatment resistance
        Compulsory treatment
        Difficult-to-engage
        Dual diagnosis
        Homeless
        Severely mentally ill
        Treatment resistance
      ab: Abstract Disengagement from mental health services is a major obstacle to the treatment of homeless dual-diagnosis patients (i.e., those with severe mental illness and substance-use disorder). A subgroup of these patients is considered to be treatment resistant and we aim to explore whether patients' reasons for disengagement may stem from negative experiences in their lives and treatment histories. This retrospective, explorative study examined the medical files of 183 severely dysfunctional dual-diagnosis patients who had been admitted involuntarily to a new specialized clinic for long-term treatment. Most patients shared common negative experiences with respect to childhood adversities, low school achievement, high levels of unemployment, discontinuity of care, and problems with the judicial system. The lifetime histories of treatment-resistant, severely dysfunctional dual-diagnosis patients showed a common pattern of difficulties that may have contributed to treatment resistance and disengagement from services. If these adversities are targeted, disengagement may be prevented and outcome improved.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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