This licentiate thesis discusses everyday life and turning points in the recovery processes of persons with co-occurring psychiatric disabilities and addiction. People with co-occurring psychiatric disabilities and addiction tend to be a vulnerable group in society, often needing extensive and collaborative care. Viewed from the lens of social work, it is crucial to gain more knowledge about these persons’ everyday lives, living conditions, and turning points in relation to recovery processes. The aim of this thesis is to explore how people with experiences of living with co-occurring psychiatric disabilities and addiction experience their everyday lives and how they narrate turning points in their recovery processes. Using a narrative method, twelve persons were interviewed about their experiences. The analysis was performed using theory of the everyday life, the normative and structural aspect (article I) and recovery theory, the holistic and individual aspect, and turning points (article II).

The first article explores the everyday life experiences of persons with co- occurring psychiatric disabilities and addiction. A central finding is the participants’ understanding of the co-occurring psychiatric disabilities and addiction as a continuous interaction between the two conditions – which we term a unity. The participants stories contain narratives about vulnerability during the life course. Childhood experiences concern dysfunctional family relationships in everyday life, absence of a parent, and physical and psychological violence. Stories about adulthood depict other aspects of vulnerability such as unstable employment and financial problems, disrupted everyday routines, and homelessness. Due to the co-occurring conditions and the consequences, everyday routines – sleep, food, and household tasks – are negatively affected. The findings suggest that these persons’ everyday life experiences, starting as early as childhood, have consequences for how their adulthood is structured, where the co-occurring psychiatric disabilities and addiction play a central role in their present everyday life, affecting various aspects of it.

The second article explores the occurrence of turning points in the recovery processes of persons with co-occurring psychiatric disabilities and addiction. The findings suggest turning points as developing starting points, where the analysis further revealed two functions of turning points: to initiate and to restart recovery processes. We term turning points that initiate recovery processes new starts and turning points that restart recovery processes re-starts. An essential finding is that turning points have developed through crucial changes in participants’ recovery (life) processes, contributing to personal progress, improved mental health, and reduced or ended addiction. Such crucial changes relate to individual, environmental and structural aspects. The individual aspects concern developing insight where the individual’s own person or body is perceived as a prerequisite for change. The environmental and structural aspects of developing insight include the notion that compulsory care is perceived as a contributor for change. Other important dimensions of recovery processes are also highlighted, such as relationships to children and partners, employment, and cooperation with professionals.

This thesis broadens the understanding of the everyday lives and turning points in recovery processes through persons’ experiences of living with co- occurring psychiatric disabilities and addiction. It further emphasizes the necessity of a holistic perspective, including persons’ life experiences, living conditions, values, and goals in order to understand their life situations and how their insight can develop. One of the most significant thesis findings is the importance of timing in these persons’ lives. Here, timing includes both the “right” time – offering support when persons require it – and the “right” way – considering specific wishes of persons about their treatment, in order to recognize and support persons with co-occurring psychiatric disabilities and addiction.