Reducing service barriers to people with dual diagnosis in Norway

Abstract

In the following, we examine how and why service provision changes. We argue that the role of service providers as a result of the Norwegian Action Plan for Mental Health has evolved to be characterized more by advocacy than by maintaining barriers. Furthermore, dominant public policy instruments shape the choices they make. The analysis is conducted within a theoretical framework of characteristics of service provision and governance policy instruments. It is based on interviews with providers of home-based services to people with severe substance abuse and mental health problems and other employees involved from local authorities and specialist services. The analysis shows that the use of legislation has established a new role of coordination for the service provider, which is strongly based on clients’ right to services. The use of organizational tools like the purchaser-provider model has given the service provider the opportunity to promote additional services for clients. Furthermore, processes of decentralization of services for people with substance abuse and mental health problems have changed the role and function of the service providers.

Keywords

• service provision
• substance abuse and mental health problems
• health and social services
• policy instruments