Katrine Schepelern Johansen

Purpose: This study aims to explore young service users’ and carers’ experiences of dual diagnosis treatment, and their perceptions of the changes brought about by the implementation of integrated treatment in mental health services throughout Denmark. It also aims to explore which factors may come to work as barriers or facilitators to realizing the potential of integrated treatment for young people in practice. Design/methodology/approach: The study is based on qualitative interviews with four young service users and four carers with experiences of dual diagnosis treatment in mental health and substance use services. Data was analyzed using reflexive thematic analysis. Findings: The study identified five needs to be addressed to facilitate the potential of integrated treatment in practice for young people: the need for the “whole person” to be seen; the need for trauma-informed care; the need for coherent, intersectoral services; the need for a paradigmatic shift in mental health services’ approach to substance use; and the need for developmentally informed care and early interventions. Originality/value: Perspectives of young service users and carers are crucial in shaping novel mental health interventions such as integrated dual diagnosis treatment. The findings of this exploratory study highlight potential barriers and facilitators to realizing the potential of integrated treatment for young people, offering valuable insights to inform practice.

This study aims to describe time trends in dual diagnosis occurrence among adolescents and young adults (ages 12-25) treated in mental health services throughout Denmark between 2010 and 2022. It also aims to describe how incident cases are distributed by age, sex, diagnoses, educational attainment, and enrollment in substance use treatment services. The study used diagnostic data on every admission to public mental health services in Denmark linked with data from other national social service- and educational registers. Our analyses show a substantial increase in dual diagnosis occurrence in 2010-17, followed by a declining trend. When distributed by sex, age and diagnoses, dual diagnosis was most frequently occurring among males; young adults (ages 22-25); adolescents and young adults with schizophrenia, schizotypal and delusional disorders; neurotic, stress-related and somatoform disorders; as well as cannabis related disorders across the study period. Our analyses also show an increase in the proportion who were enrolled in substance use treatment at the time of their first dual diagnosis contact with mental health services, but a decreasing trend in the proportion who enrolled within a year after their first dual diagnosis contact. Finally, our analyses show a slight increase in the number of adolescents and young adults with dual diagnosis above 16 years of age who had completed primary school (9^th grade) during the study period.

Objective: Homelessness is a significant social issue in developed countries, linked to high rates of substance use, psychiatric disorders, and chronic somatic health conditions, which contribute to premature mortality. Despite Denmark's comprehensive welfare system, marginalized groups, including people in homelessness, face barriers to accessing healthcare, resulting in increased use of acute care services and poorer health outcomes compared to the general population. This study examines the health burden and mortality of some of Denmark's most marginalized individuals by analyzing registry data from users of a low-threshold healthcare service placed at the open drug scene in Copenhagen, Denmark. Methods: This retrospective cohort study spans seven years (2009-2015). The study includes 1,242 individual health service users identified through patient records from the low threshold service linked with demographic, educational, and healthcare utilization data from Danish registries. No approval from the Danish Research Ethics Committees for the Capital Region was needed since only national registers were used. Results: The population was predominantly male with a median age of 42 years. Most participants were of ethnic Danish origin and had low educational attainment. This study revealed high morbidity, with significant proportions of the population affected by somatic diseases, psychiatric disorders, and substance use disorders, including 56% with Dual Diagnosis and 53% with Dual Diagnosis and somatic disease (Triple Diagnosis). Analysis of mortality showed 158 deaths, predominantly among males, with substance use-related causes and cardiovascular diseases being the leading causes of death. The mean age at death was 47.3 years, with a notable proportion occurring at a relatively young age. Conclusion: Our study reveals a high prevalence of both somatic and psychiatric disorders among the shelter health clinic users. Findings indicate that they are in a similar or often poorer health state than Danish shelter users overall, with a high prevalence of dual diagnoses alongside chronic somatic diseases (Triple Diagnosis) and early disease onset. This highlights the need for targeted support and the implementation of primary prevention measures to slow disease progression and improve healthcare access.

This article aims to describe the time trend in number of dual diagnosis patients treated in the psychiatric system in Denmark from 2000 to 2017.We calculated the share of patients with dual diagno...

In the continuous work to reduce the use of coercion in psychiatric care, attention in Denmark has especially been directed towards mechanical restraint. While the use of mechanical restraint is cu...

Objective Evidence from real-world integrated dual diagnosis treatment programs is limited. In 2017 we decided to establish the REDD-PAC cohort with the aim to provide more in-depth information regarding the effect of integrated treatment. Methods The REDD-PAC cohort includes more than 2,500 patients with dual diagnosis that have been treated at an in-patient department specializing in the integrated treatment of both psychiatric illness and substance use disorder in Denmark in the period from 2002 to 2017. The collected data included information on diagnosis as well as patient-completed questionnaires regarding anxiety, depression, self-worth, and use of substances. Data regarding medications prescribed and administered, weight, height, and blood pressure were also included. Results The primary diagnosis was psychosis spectrum disorder (37.0%), followed by affective disorders (18.8%). More than two-thirds of the patients were male, and most patients had a weak connection to the labor market and basic schooling. Patients were generally very motivated for treatment. Conclusions Further linking the data to Danish national register data makes it possible to follow individual trajectories pre- and post-admission as well as to access complete follow-up data regarding long-term outcomes, e.g., use of health services, mortality, morbidity, crime, and social circumstances. This article describes both the overarching aims of the REDD-PAC cohort and the basic diagnostic and sociodemographic characteristics of the cohort.