Barriers and facilitators to social participation in people with mental health and substance use disorders: a formative qualitative study

Abstract

PurposeThis study aims to explore how people with concurrent mental health and substance use disorders and lived experience of deep social marginalization perceived barriers and facilitators to mainstream social participation. The purpose of this study is to identify meaningful and relevant learning content for a virtual reality-based intervention to promote social participation in this group.Design/methodology/approachThis formative qualitative study was conducted in Norway during Autumn 2022. Nine in-depth individual interviews with adults recovering from dual diagnosis were conducted, audiotaped, transcribed and analysed using reflexive thematic analysis in a collaborative analysis process.FindingsResults indicated that social alienation, poor social skills, stigma, low self-esteem and social anxiety were key barriers to social participation in this group. This study suggests a need to learn appropriate social behaviour in mainstream society, in addition to better employability skills, civic literacy and health literacy to improve utilization of social opportunities.Practical implicationsThis study implies that virtual reality-based interventions for promoting social participation in people with dual diagnosis should primarily focus on learning and practising appropriate social behaviour in shared public spaces before practising advanced social skills such as employability skills in simulated work environments. Learning and practising social skills appears decisive for using more complex social opportunities, such as in education, health, social services and work.Originality/valueThis research provides suggestions for the content of a novel virtual reality-based intervention to promote social participation among people in recovery from dual diagnosis.