This master’s thesis addresses the life courses of people with dual diagnoses, their experiences of treatment in institutions (psychiatric hospitals and prisons), and their experiences of treatment in high-threshold residential programs in the community. In the theoretical part, I first explore different perspectives on addiction and dual diagnoses, describe the characteristics and criticisms of institutional treatment and community-based treatment, and then present the differences between the medical model and the community model and explain the principles of normalization. During my volunteer work, I noticed that some people with dual diagnoses were treated multiple times in hospitals and repeatedly included in community-based programs. I became interested in their life courses and in their experiences of treatment in institutions and in the community. The research uses a mixed-methods approach, combining qualitative and quantitative methods. I conducted 15 questionnaires and five interviews. The sample is non-probability and convenience-based. The questionnaires and interviews were carried out in two therapeutic communities for people with addictions and co-occurring mental health problems: the community of the Društvo Projekt Človek and the community of the Zavod Pelikan – Karitas. The research is small-scale and exploratory, and is therefore not representative. Based on the questionnaires, I gained insight into the number of hospitalizations over the life course of individuals, which I presented using timelines. Through the interviews, I obtained longer descriptions, narratives, and the interviewees’ views on these forms of treatment in institutions and in the community. The collected data show that the life courses of people with dual diagnoses are often marked by multiple hospitalizations, and sometimes also by multiple episodes of community-based treatment. Emergency hospitalizations are common, involving ambulance services or the police. Treatment without consent is rare. Interviewees reported both positive and negative experiences with hospitals, with positive experiences predominating. Relationships with hospital staff were mostly described as good or adequate, with only two distinctly negative experiences mentioned. The interviewees described the therapeutic communities of the Zavod Pelikan – Karitas and the Društvo Projekt Človek differently from hospitals. The results show that they are satisfied with the support provided in therapeutic communities, and they described relationships with staff and with other residents as good, and ordinary. Therapeutic communities also offer a wider range of activities than institutions. Meaningful work represents an important part of rehabilitation in community-based settings. As institutions, as well as individual wards or units within them, differ greatly from one another, and as therapeutic community programs also differ considerably, it is not possible to simply conclude that treatment in therapeutic communities is more in line with the principles of normalization than treatment in institutions.
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