A Narrative Exploration of Service Providers’ Understanding of the Relationship Between Co-Occurring Mental Health and Substance Use Issues Among Women in Nova Scotia.

Abstract

This qualitative study explored narrative accounts of how service providers in Nova Scotia understand and work with the relationship between co-occurring mental health and substance use issues. More specifically this research focused on understanding and working with this relationship among women. This concept was explored through in- depth narrative accounts of service provide experiences who work in the field of mental health and/or substance use and who have experienced working with women that identify as experiencing both co-occurring issues. In-depth one-on-one interviews were conducted with master’s level social workers (MSW). Data was analyzed using through methods consistent with a narrative inquiry approach (i.e., thematic analysis and discourse analysis). The findings of this study were consistent with current literature suggesting that the relationship between mental health and substance use, especially among women, is complex and still not entirely understood. Service provider narratives contain contradictory stories about etiology and interaction. Participant narratives spoke to their understanding of a strong relationship existing between co-occurring issues as well as using substance use as a secondary coping response to mental health and trauma. Service providers identified a number of treatment barriers affecting their practice in working with women (i.e., institutional ideology, organizational, and women’s socioeconomic, political, cultural and historical experiences). Service providers also identified primarily eclectic approaches to intervention and treatment in working with women who experience co-occurring issues. This research contributes to the growing discussion on how front-line mental health and addiction service providers are working with and implementing the new Mental Health and Addiction Strategy in Nova Scotia.