“I just feel like a constant mistake” How do young people with mental health problems and substance use manage difficult emotions?: An IPA study

This study explores the way young people who experience both substance use and mental health problems make sense of their emotion management. Research shows that this group experience poorer outcomes than peers who report only one of the two issues, citing emotion regulation difficulties as a perpetuating factor. With literature showing that this group of young people do not feel understood or that their needs will be met by services, Interpretative Phenomenological Analysis (IPA) was utilised to gain a deeper insight into their lived experience of difficult emotion. Six young people (18 and under) who experienced both substance use and mental health problems were recruited and interviewed regarding their experience of managing emotion. The overarching Grouped Experiential Themes were as follows; 1) Hear my experience: Overwhelming emotional lives, 2) The past is always present, 3) Coping with the present and the past - Emotion management strategies. The findings showed that management of emotion did not exist in a vacuum. The experience of emotion in the present occurred within the context of the past. Adversity and unmet needs, in particular the need for attachment, impacted on the sense of self and world view. All of which influenced the development of managing emotion. Whilst substance use was mentioned as an emotion management strategy, the participants mental health that included their current overwhelming emotion experience and their emotion history appeared to be the priority in the transcripts. This suggests the participants mental health was their biggest concern when managing distress. Implications for Counselling Psychologists and other mental health practitioners is discussed