Posted by MHW on December 19, 1998, at 12:02:59
In reply to Dual Diagnosis, posted by Carol Palmer on December 8, 1998, at 19:50:27
> Any psychopharmalogical tips for the dual diagnosis client? My caseload 80-95% dually diagnosed.
Great question (I have no tips). I was a Mental Health Worker/Counselor for a year w/ dual diagnosis clients in a facility with high turnover, and found that literally 90% of them would get the "schizoaffective" catch-all diagnosis. As I got to know the client, I usually found this diagnosis inaccurate, and when this was discussed with whoever their doc-of-the-moment was, they usually agreed. The worst problem was that most low-income clients, because they were bounced around amoung doctors who hardly got to know them, would rack up all sorts of heavy-duty meds, (even clients as young as 19 or 20!), and again, if I talked to the current psychiatrist, they would often agree and reduce the meds. And I'm just a lowly MHW without a degree!!
I'm sure this is somewhat true of all low-income mental health clients, but I think dual diagnosis clients are especially victim to misdiagnosis and over-medication because many doctors still don't take into consideration just HOW MANY mentally ill people are chemically dependent and how often they are NOT going to volunteer the info/admit that they are!
poster:MHW
thread:1518
URL: http://www.dr-bob.org/babble/19981201/msgs/1644.html