Dual diagnosis means someone has both a mental illness and a substance use problem. Many people with alcohol and drug problems have a range of mental health problems at higher rates than the general community. In many cases, it is hard to tell which problem came first; perhaps the mental illness prompted the person to abuse drugs, or else their drug problem pre-dated their mental illness. The substance use could also worsen the symptoms of the person’s mental illness – for example, smoking marijuana can trigger a psychotic episode in some people.
This includes increased instances of anxiety and depression. The abused substance could be prescribed medication, illegal drugs or alcohol.
A recognised problem is that many services for substance abuse and mental illness don’t overlap, which means that the person with dual diagnosis is managed through separate systems. This can make diagnosis and treatment more difficult.
Common Characteristics of Dual Diagnosis Sufferers
A typical person with dual diagnosis is likely to have the following characteristics and experiences:
- May be alienated and lack support from family and friends.
- Won’t cooperate with their health care providers.
- Is very emotional.
- Is likely to have severe psychiatric symptoms.
- May be homeless or moving frequently from one place of residence to another.
- Is likely to relapse.
- May be hospitalised or taken to accident and emergency departments reasonably often.
Issues for People with Dual Diagnosis and Their Families
The lack of professional knowledge about dual diagnosis can be frustrating for those affected and their families. Common experiences may include:
- Health care providers may blame the client for being difficult and unresponsive to treatment, rather than questioning whether the health care system is failing to provide effective treatments and support for people with dual diagnoses.
- If a dual diagnosis client first seeks treatment for drug abuse, the drug and alcohol workers may consider their mental illness as a secondary issue or side effect. Similarly, if they first seek treatment for their mental illness, then the mental health professionals may also consider their drug abuse as a secondary issue or side effect. The two problems are often not seen as interdependent and equally important.