The narrative is a functional skill and a means for sharing stories which consist of a single event or events causally related to the individual’s past, present, and future. In this study we aimed to explore the narratives of a voiceless population in society and in research: adults with a dual diagnosis of intellectual disability (ID) and a mental health problem (MHP). Our operative goals were to explore the meaning of their lives as people with a dual diagnosis, their quality of life, and their aspirations for the future. The core questions of the study were: which type of disability is assimilated in their identity: ID, MHP, or both? What is their perception regarding their quality of life in the present and their horizon for the future? Our study was based on the three functions (the directive personal identity, a social function, and a directive/problem-solving function) of the Autobiographical Memory Model. We analyzed semi-structured interviews of twelve adults (aged 31-60) with mild-moderate ID and an MHP using mixed qualitative and quantitative methods. The findings yielded four themes: personal identity, directive problem-solving function, current quality of life, and future orientation. Wilcoxon analysis indicated that the MHP is more prominent in the participants’ personal identities. Thus, people with a dual diagnosis cannot bear the burden of two disabilities. The medical staff still exhibits a medical approach. Social theories such as the Multidimensional Insight Model, Stigma Theory, the Social Inclusion Model, and the Future Time Perspective Theory can serve as explanations.


life stories, mixed-methods, persons with a dual diagnosis, intellectual disability, mental health problem, identity, quality of life, future orientation

Author Bio(s)

Professor Hefziba Lifshitz is the head of the MA Program in Intellectual Disability (ID) offered by the Education faculty, Bar-Ilan University, Ramat-Gan, Israel. She is also the head of the Baker Research and Promotion Center of Toddlers and Children with Developmental Disabilities, where toddlers and children with ID attend the university to learn reading and math skills. In addition, she is a Lois Alberto Machado Research Chair on Cognitive Modifiability and Human Development. Within this framework, she initiated the Empowerment – Ozmot Project: Three stages of inclusion in the academic world of students with ID. This innovative project is the first in Israel in which students with ID study for a BA degree. Please direct correspondence to hefziba@013net.net or hefziba.lifshitz@biu.ac.il

Ayelet Shahar is a Ph.D. student in the Education Faculty of the BIU. She is a director of employment, knowledge, and supervision in community residence for persons with dual diagnosis of ID and mental health problems.


The author expresses here deep appreciation to the 12 students with ID and MHP who participated in this study

Publication Date


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