title: Lived experiences in help-seeking from the perspective of a mother with a dual diagnosis.
abstract: Mothers with a co-occurring mental illness and substance abuse (dual diagnosis) use numerous different services. Help-seeking and engagement are complex processes which have not yet been sufficiently conceptualized. A descriptive phenomenological approach was used to explore these experiences from different service contexts and to describe the decisions in and structure of help-seeking over a 13-year period. Four in-depth interviews were conducted and data were analysed with a descriptive phenomenological method developed by Giorgi. The essential meaning structure is an inner conflict within the client, including a realization that change starts from within. The essential meaning structure combines the other meaning structures: disbelief of receiving help and admitting the need for help, keeping up the perfect façade and the risk of total collapse, being given and making own choices regarding care and being forced to use services and inner emptiness and search for contentment in life. It is possible that clients in the help-seeking process do not always recognize they have a need for care. If the client experiences inner powerlessness as emptiness and resistance to being helped, it is probably not possible to create relationships with care providers. Clients may have several ambiguous inner processes which prevent them from accepting the need for care. Theoretically and empirically a long-term approach is crucial, since the inner transformative processes take time. The services can contribute new experiences to the personal level of understanding and decision-making, if they consider the experiential level of their clients.
authors: School of Health Sciences, Nursing Science, University of Tampere and Finnish Doctoral Programme in Nursing Science, Tampere, Finland. minna.sorsa@uta.fi
authors: Minna A
authors: MA
authors: Sorsa
authors: Päivi
authors: P
authors: Åstedt-Kurki
mesh_terms: D000223:Adaptation, Psychological; D017831:Diagnosis, Dual (Psychiatry) / Q000523:psychology*; D036262:Empirical Research; D005260:Female; D006801:Humans; D008603:Mental Health; D008605:Mental Health Services; D009035:Mothers / Q000523:psychology*; D033262:Narration; D010342:Patient Acceptance of Health Care / Q000523:psychology; D036301:Qualitative Research; D019966:Substance-Related Disorders / Q000523:psychology*
keywords: Giorgi; Help-seeking; dual diagnosis; mental health; mental health services; mothers; phenomenology; substance abuse
references: Am J Drug Alcohol Abuse. 1979;6(4):431-46
references: 549471
references: Soc Psychiatry Psychiatr Epidemiol. 2009 Jul;44(7):558-68
references: 19037573
references: Am J Orthopsychiatry. 1996 Jan;66(1):42-51
references: 8720640
references: Psychiatr Serv. 2010 Mar;61(3):250-7
references: 20194401
references: Arch Psychiatr Nurs. 2010 Apr;24(2):76-88
references: 20303448
references: Health Serv Res. 2004 Apr;39(2):393-415
references: 15032961
references: J Behav Health Serv Res. 2001 Feb;28(1):81-8
references: 11330001
references: J Subst Abuse Treat. 1999 Apr;16(3):195-219
references: 10194738
references: Drug Alcohol Depend. 2007 Jan 5;86(1):1-21
references: 16759822
references: Nurse Res. 2004;11(4):7-19
references: 15227895
references: Qual Health Res. 2005 Mar;15(3):365-81
references: 15761105
references: Am J Psychiatry. 1993 Apr;150(4):554-61
references: 8465869
references: J Subst Abuse Treat. 2005;28 Suppl 1:S51-62
references: 15797639
references: Psychiatr Rehabil J. 2003 Spring;26(4):368-76
references: 12739907
references: Subst Use Misuse. 2011;46(6):808-18
references: 21174496
references: Psychiatr Serv. 2001 Apr;52(4):469-76
references: 11274491
references: Community Ment Health J. 2002 Jun;38(3):253-70
references: 12046678
references: J Obstet Gynecol Neonatal Nurs. 1997 Sep-Oct;26(5):567-75
references: 9313187
references: Psychiatr Serv. 2000 Sep;51(9):1119-25
references: 10970913
references: J Adv Nurs. 1994 May;19(5):976-86
references: 8056928
references: Lippincotts Prim Care Pract. 2000 May-Jun;4(3):290-301
references: 11271126
references: J Subst Abuse Treat. 1999 Jul-Sep;17(1-2):37-44
references: 10435251
references: Br J Psychiatry. 2007 Apr;190:299-306
references: 17401035
references: J Consult Clin Psychol. 1993 Jun;61(3):373-80
references: 8326037
references: BMC Psychiatry. 2012 Jun 20;12:36
references: 22546012
references: Am J Orthopsychiatry. 1996 Jan;66(1):61-70
references: 8720642