The essay's aim was to see which attitudes county council's and municipality representatives had about themes like: collaboration and competence in the work around double diagnosed persons. Its objective was to zero in on the attitudes of the representatives regarding a coallocated collaboration project in Stockholm. Also, it sought to find out what attitudes the representatives had about the other representatives attitudes concerning the above mentioned themes. A number of attitudes were presented during the qualitative interviews with the representatives, highlighting which attitudes seemed strongest. Then the interviews were analyzed using meaning condensation and then set against the theory of social representations. The analysis showed that before work with the target group starts, there’s a need for synchronization of the different representatives involved in the collaboration project. It would help bridge those organisations existing cultural differences, which otherwise, creates conflicts within the personnel group. Lastly, the analysis also indicated that the majority of the county council's representatives were in a weak position vis-à-vis the municipality representatives. However, when it comes to the double diagnosed group, it came to the attention of everyone involved in the project that collaboration is critically important.

The main purpose of this qualitative study was to describe clients’ descriptions of the professional role case manager and how it relates to the job description provided from a project in which both case managers and clients were participating. Both what case managers do and are expected to do were explored. The project involved case management in the purpose to strengthen and enhance the care and quality of life for clients who are dually diagnosed. Interviews were conducted with five clients and the result was analyzed with theoretical concepts from role theory. The clients’ descriptions of the case manager corresponded fairly well to the job description and former studies that have captured client descriptions. The role of the case manager was described as being available, flexible, outreach oriented, motivating, supportive, committed, giving immediate assistance and doing a lot of tasks. Furthermore as someone who activates the clients, goes by car, represents, clarifies, co-ordinates and should work professionally and individual-based.

Bakgrund Prevalensen hos barn med diabetes typ I och den samtidiga förekomsten av celiaki varierar i studier mellan 2,4-16,4 %. Celiaki och diabetes typ I kräver båda en noggrant kontrollerad kost. Det tycks finnas få studier som undersöker hur kombinationen av de två olika kosterna fungerar i praktiken. Syfte Att utforska hur föräldrar till barn med dubbeldiagnosen celiaki-diabetes upplever att kosten fungerar. Metod En kvalitativ metod användes i form av skrivna berättelser, insamlade via ett webbaserat formulär. Informanterna var 26 föräldrar till barn i åldrarna 3- 16 år med dubbeldiagnosen celiaki-diabetes. Berättelserna analyserades med kvalitativ innehållsanalys. Resultat Informanterna upplevde att det var svårare att få maten att fungera då de hade båda sjukdomarna att ta hänsyn till och att dubbeldiagnosen krävde ständig planering av måltider. Föräldrarna upplevde bristande kunskap i omgivningen, exempelvis hos personal inom skola och restaurang. Det fanns små möjligheter att spara tid och pengar och matutbudet var ofta begränsat, särskilt vad gäller produkter med lågt glykemiskt index. Upplevelser av att vara till besvär och ett bristande bemötande från omgivningen kunde förstärka känslan av att inte vara som alla andra. Slutsats Svårigheterna att lita på omgivningens kunskaper kring de två kostbehandlingarna försvårade följsamheten till kosten och begränsade barnens sociala liv. Upplevelserna av bristande bemötande och förståelse i omgivningen kunde förstärka känslan av att inte vara som alla andra och att vara till besvär. Därför finns ett behov av utbildning riktad till skol- och restaurangpersonal för ökad kunskap och förståelse. Mer material rörande matlagning anpassat till dubbeldiagnosen skulle också underlätta, både för barnens familjer och omgivningen. Den ständiga planeringen begränsade vardagen och föräldrarollen påverkades till att bli mer kontrollerande vilket skulle kunna försvåra för föräldrarna i att lotsa barnet till mer självständighet. Utbudet av glutenfria specialprodukter med lågt glykemiskt index var begränsat, framförallt vad gäller bröd. Därmed finns ett behov av en vidare produktutveckling. / Background The prevalence of both coeliac disease and diabetes type I in the pediatric population varies between 2.4-16.4 %. Both diseases demand a strictly controlled diet A limited number of studies are investigating the practical implementation of the two diets. Objective To investigate parent’s experiences of the diet, when having a child with both coeliac disease and diabetes type I. Method A qualitative method was used in form of narratives, collected through a web based form. The informants consisted of 26 parents, having a child of age 3-16 years, diagnosed with both coeliac disease and diabetes type I. Qualitative content analysis was used to analyze the narratives. Result Difficulties were experienced by the informants considering the practical implementation of the two diets. The double diagnosis demanded frequent planning. Lack of knowledge in the surroundings was experienced, for example in staff at school and restaurants. The possibilities of saving time and money were limited and there were limitations also in the food supply, especially gluten-free products with low glycemic index. Due to experience of inconvenience and negative treatment from their surroundings, the feelings of being different were enhanced. Conclusion Difficulties in trusting others knowledge regarding the diet lead to compliance issues and put restraint to the children’s social life. Perceptions of lack of treatment and understanding in the surroundings could enhance the feeling of not being like everyone else and being a nuisance. A need for education aimed at staff in schools and restaurants exists to increase knowledge and understanding. More materials regarding cooking with the double-diagnosis are desirable. Constant planning lead to limitations in the daily life and the parenting role became more controlling, which could create difficulties when guiding the child into independence. Also the supply of gluten-free products with low glycemic index is limited and need further development.

People with severe mental illness and co-occurring substance abuse are an especially vulnerable group in society as health care for those is shared between municipality and county council. There is an associated health need of this target group so the interaction of the social services and the psychiatric care is of great importance. However, there are shortcomings in this interaction with results in that people with dual diagnosis do not always receive adequate care. Diverse knowledge and explanatory models may create problems for the interaction as they include different ways to define, understand, explain and deal with a problem. The purpose of this study was to examine how the interaction between the social service addiction treatment and the psychiatric care is, concerning people with dual diagnosis, focusing on how their respective knowledge and explanatory models affect the interaction. The study was conducted in a county where we interviewed seven people in the social services addiction treatment and the psychiatric care. We used qualitative interviews conducted with the help of a semi-structured variant. The theoretical perspectives that were applied in the study were the theories of; interaction, science- and knowledge-based controversies, and some concepts from the new institutionalism. We concluded that interactions occur in various forms and at a high level of ambition between the social services addiction treatment and the psychiatric care in regards to people with dual diagnosis. We also concluded that the diverse professional knowledge and explanatory models affects the interoperability through the creation of theoretical controversies. / Personer med en allvarlig psykisk sjukdom och ett samtidigt missbruk är en extra utsatt grupp i samhället då vården för dessa delas mellan kommun och landsting. Det föreligger ett kombinerat vårdbehov för denna målgrupp vilket medför att en samverkan mellan socialtjänstens missbruksvård och psykiatrin är av stor vikt. Dock föreligger brister i denna samverkan vilket medför att personer med dubbla diagnoser inte alltid erhåller adekvat vård. Skilda kunskaps- och förklaringsmodeller kan skapa problem för samverkan då de inkluderar olika sätt att definiera, förstå, förklara och hantera ett problem. Syftet med denna studie var att undersöka hur samverkan mellan socialtjänstens missbruksvård och psykiatrin sker kring personer med dubbeldiagnos, med fokus på hur deras respektive kunskaps- och förklaringsmodeller påverkar samverkan. Studien utfördes i ett län där vi intervjuade sju personer inom socialtjänstens missbruksvård och psykiatrin. Vi använde oss av kvalitativa intervjuer som utfördes med hjälp av den semistrukturerade varianten. De teoretiska utgångspunkter som tillämpades i studien var teorier om; samverkan, vetenskaps- och kunskapsbaserade kontroverser samt vissa begrepp ur nyinstitutionalismen. Vi drog slutsatsen att samverkan mellan socialtjänstens missbruksvård och psykiatrin kring personer med dubbeldiagnos sker i olika former och på en hög ambitionsnivå. Vi drog även slutsatsen att verksamheternas skilda kunskaps- och förklaringsmodeller påverkar samverkan genom att det uppstår teoretiska kontroverser.

Verksamheten Spindeln i Västerås vänder sig till personer med så kallad dubbeldiagnos, människor med psykisk sjukdom och samtida missbruksproblematik. Syfte med denna studie var att söka kunskap om vad klienterna med så kallad dubbeldiagnos på verksamheten Spindeln upplevde som meningsfull sysselsättning, samt om verksamheten Spindeln bidrog till att klienterna upplevde sig inneha någon form av meningsfull sysselsättning. Empirin insamlades genom kvalitativa semistrukturerade intervjuer med fem klienter från Spindeln. De teorier som behandlades var känslan av sammanhang (KASAM), stigma samt socialt kapital. Dessa teorier användes till att tolka empirin tillsammans med tidigare forskning inom området psykisk sjukdom och meningsfull sysselsättning. Studiens resultat visade på betydelsen av att ha något att göra om dagarna, att meningsfull sysselsättning innebar en sorts trygghet i vardagen som medförde struktur och mening. Att ha ett socialt sammanhang att delta i var även det av mycket stor vikt enligt studiens deltagare samt en strategi för att undvika att hamna i psykos. Meningsfull sysselsättning var mycket individuellt och varierade beroende på respondenternas livssituation i relation till ålder, sjukdom, erfarenhet och visioner. Resultatet visade att Spindelns verksamhet upplevdes som meningsfull av deltagarna. / The activity Spindeln in Västerås is a project that attempts to deliver daily occupation for clients with dual diagnosis, people diagnosed with a mental disorder and a contemporary substance abuse. The purpose of this bachelor thesis was to gain knowledge about what Spindeln's dual diagnosis clients experience as meaningful occupation. The purpose was also to examine if Spindeln contributes to making its clients experience meaningful occupation.  The empirical material was based on qualitative and semi-structured interviews with five clients of Spindeln. The conceptual framework was based on concepts such as sense of coherence (SOC), stigma and social capital. This theories was used mainly to interpret empirical material together with earlier research regarding mental disorder and meaningful occupation. The findings of the study indicated that meaningful daily occupation was very important for dual diagnosis patients because it provides them with a feeling of safety which led to structured and meaningful days. Also the study indicated that having social connection to participate in, and a strategy to avoid a state of psychosis, was of great importance to the clients at Spindeln. Meaningful occupation turned out to be highly individual depending on variables such as age, disease, experiences and visions. The findings also indicated that Spindeln was meaningful according the clients.