What role does employment play in dual recovery? A qualitative meta-synthesis of cross-cutting studies treating substance use treatment, psychiatry and unemployment services

Purpose: The role of employment in dual recovery from mental illness and substance use is scarcely addressed in previous studies and a deeper understanding of this issue is needed. The purpose of this paper is to cast further light on the conditions that either facilitate or block the road to employment for dually diagnosed people (DDP) and how these conditions could either promote or hinder recovery. Design/methodology/approach: Drawing on the principles laid out by health researchers Sandelowski and Barroso (2007), the study is designed as a qualitative meta-synthesis comprising a systematic literature search, a critical assessment of the identified studies and an integrative synthesis of the articles’ findings. Findings: The synthesis outlines that the findings from the seven identified studies show a recovery process in which unemployed, DDP are becoming employed people – or where there is an attempt to restore their status as working persons – and how this process is driven or hindered by personal, interpersonal and systemic facilitators or barriers. Research limitations/implications: The synthesis adds nuances to the understanding of employment in dual recovery processes and suggests that unconnected means of, and goals for, intervention among these individuals and systems might reduce the chances of DDP obtaining and maintaining a job. Originality/value: The paper calls for more advanced research and policy on the multiple – and often contradictory – aspects of gaining and maintaining employment as part of dually diagnosed persons’ recovery.