Big Words and Small Things: The Contradictory Nature of Hope

Abstract

Objective: Hope is central to recovery in mental health and substance use problems. People experiencing co-occurring mental health and substance use problems often have to settle for inadequate services that do not meet their needs. This study explored practitioners’ experiences and descriptions of hope in relation to their encounters with persons experiencing co-occurring mental health and substance use problems. Research Designs and Methods: We conducted semi-structured in-depth interviews with eight practitioners from the mental health and substance abuse field. The interviews were transcribed verbatim and analyzed using thematic analysis. Results: Hope was described as pivotal but seemed to receive little attention in the practitioners’ daily practice. Three themes were generated through the data analysis: “It’s vital, but we don’t talk about it,” “Complex and basic,” and “Community, alone.” Conclusions: The participants’ descriptions of hope are as complex as those from other contexts. At first glance, hope seems paradoxical, but we suggest perceiving it in terms of unifying contradictions. Substance (ab)use and stigma are intertwined with hope and despai r. It is important to create space and leeway for both practitioners and service users, where the complexity of hope, life, and the challenges that go along with them can coexist.