title: An ethnographic study of the longitudinal course of substance abuse among people with severe mental illness.
abstract: A two-year ethnography conducted among 16 dually diagnosed clients yielded two longitudinal findings. First, four "positive quality of life" factors were strongly correlated with clients' efforts to cease using addictive substances: (1) regular engagement in an enjoyable activity; (2) decent, stable housing; (3) a loving relationship with someone sober who accepts the person's mental illness; and (4) a positive, valued relationship with a mental health professional. Second, the study revealed that five "negative background factors" in participants' childhood homes were predictive of long-term continuation of substance use: (1) substance abuse in childhood home, (2) childhood household in dire poverty, (3) "non-functional" household members, (4) reporting of abuse imputed to care-givers, and (5) serious mental illness in household. The implications of these findings for treatment are discussed.
authors.affiliation: Department of Anthropology, Dartmouth College, Hanover, NH 03755-3570, USA.
authors.forename: H
authors.initials: H
authors.lastname: Alverson
authors.forename: M
authors.initials: M
authors.lastname: Alverson
authors.forename: R E
authors.initials: RE
authors.lastname: Drake
mesh_terms: D000884:Anthropology, Cultural; D003266:Continuity of Patient Care; D003657:Decision Making; D017831:Diagnosis, Dual (Psychiatry); D006302:Health Services Research; D006801:Humans; D008137:Longitudinal Studies; D001523:Mental Disorders / Q000523:psychology*; D009513:New Hampshire; D010349:Patient Compliance; D011788:Quality of Life; D019966:Substance-Related Disorders / Q000523:psychology / Q000534:rehabilitation*