Co‐existing mental health and substance use and alcohol difficulties – why do we persist with the term “dual diagnosis” within mental health services?

Abstract

Purpose – The term “dual diagnosis” has been widely accepted as referring to co‐existing mental illness and substance misuse. However, it is clear from the literature that individuals with these co‐existing difficulties continue to be excluded from mainstream mental health services. The term “dual diagnosis” can be pejorative and therefore, complicate or obstruct engagement. It is argued within this paper that the association between mental illness and substance misuse (including alcohol misuse) is an intricate and often a complex relationship involving a multitude of psychosocial factors that cannot be simply explained by an individual having two co‐existing disorders. From this perspective, this paper seeks to argue that the term “dual diagnosis” should be actively de‐emphasised.Design/methodology/approach – This paper offers a critique of “dual diagnosis” and the potential impact on access and treatment through discussion of the literature and reflections on service provision.Findings – The paper ident...