Att upprätta en insats för hela människan, inte enbart för en kategori - En vinjettstudie om missbrukshandläggares resonemang kring ansvarsfördelning och samverkan mellan socialtjänst och psykiatri

Sammanfattning: For many years, the management and treatment of people who suffer from comorbidity between substance abuse and mental illness have been a great challenge for both social services and psychiatry. As early as the second half of the 20th century there have been ongoing discussions concerning problematic aspects of the division of responsibilities and collaboration between the central authorities. The aim of this study is to explore how professionals within substance abuse services for adults can reason about the division of responsibilities between psychiatric care and addiction care, and about the collaboration between the organizations. The study was conducted with the help of vignette-based, semi-structured interviews with eight different social workers in substance abuse. The respondents’ answers were analyzed on the basis of Michael Lipsky’s theory about the street-level bureaucrats’ discretion and autonomy, Andrew Abbott’s theory of jurisdictional claims, and Berth Danermark’s perspective on model-power and autonomy, and then linked to previous research within the area. The results show that collaboration within the work with clients who suffer from comorbidity is fraught with several difficulties. In addition, the results illustrate that respondents generally consider the division of responsibilities between the organizations to be obscure when collaborating with clients with compound needs. With assistance from a thematic analysis, a number of interesting views emerged. One conclusion that can be drawn from the study is the need for a common organization that works on the basis of common legislation.