Public defence: Oda Woll Naug

Oda Woll Naug is defending her thesis for the degree philosophiae doctor (PhD) at the University of South-Eastern Norway.

She has pursued the PhD program in Person, Health and Society at the Faculty of Health and Social Sciences, Department of Nursing and Health Sciences.

You are invited to follow the trial lecture and the public defence.

Note: The defence will take place at Western Norway University of Applied Sciences, campus Bergen.

• Link to the dissertation will come here.

Summary

People with co-occurring substance use and mental health disorders (co-occurring disorders) often have extensive and complex needs, yet many do not receive the help they need. In her PhD thesis, Oda Woll Naug shows how mental health services are shaped by a disease logic. To receive help, patients must fit into specific diagnostic categories and function in the “right way” within the system. Naug’s research demonstrate how this contributes to reinforcing inequalities in healthcare – even when the goal is inclusion and support.  
Through interviews with patients and staff in mental health and substance use services in a large Norwegian municipality, Naug examines how services work in everyday practice. She shows that injustice does not stem from a lack of willingness to help, but from how help is organised and understood.

• A key finding is the double-edged nature of diagnosis. Psychiatric diagnoses can provide explanation and open doors to services, but at the same time lead to stigma, alienation and an increased risk of coercion. Patients often describe the psychiatric diagnosis as more burdensome than the substance use disorder, particularly in terms of self-understanding and the kind of help they receive.
• Naug also shows how self-responsibility is closely linked to how services are organised. To obtain and keep help, patients are expected to be motivated, insightful, cooperative and preferably abstinent. Those who struggle the most risk being defined as “too demanding” or “too ill” for available services, while at the same time being considered “too well” to receive more comprehensive help elsewhere. As a result, they are shifted between services without receiving a stable offer.
• Naug points out that deinstitutionalisation – the dismantling of large psychiatric institutions – has created new challenges. Instead of long stays in one place, many now experience short, fragmented stays and frequent moves between different services. This makes it difficult to build stable relationships and ensure continuity of care over time.

The findings have implications for how municipalities plan and design services for people with co-occurring substance use and mental health disorders, and point to the need for more flexible arrangements that reach those who currently do not fit in anywhere.

The PhD project is carried out in collaboration with two larger research projects at the Centre for Care Research, led by USN and HVL.