How do users with comorbidity perceive participation in social services? A qualitative interview study.

Area of Science:

• Social Work
• Psychiatry
• Public Health

Background:

• Individuals with comorbid substance use and mental illness face unique challenges in accessing and engaging with social services.
• Understanding user perspectives is crucial for improving service delivery and support systems.

Purpose of the Study:

• To develop a theoretical framework explaining how users with comorbid substance use and mental illness perceive their participation in social work.
• To identify factors influencing user engagement and decision-making within social work encounters.

Main Methods:

• A constructivist grounded theory approach was employed.
• Semi-structured qualitative interviews were conducted with 12 users experiencing comorbid substance use and mental illness.

Main Results:

• A central finding is the pervasive low trust users have in social services, perceived as mutual.
• Establishing mutual trust is identified as a core social process influencing participation.
• Prerequisites for participation include user motivation, willingness to engage with support, utilization of user/staff knowledge, and access to help.

Conclusions:

• The developed model uniquely frames participation as a social process, diverging from power-level analyses.
• Social work staff must acknowledge and address low trust perceptions to foster mutual trust.
• Individualized approaches and user involvement in decision-making are essential for effective social work practice.