Social service offices as a point of entry into substance abuse treatment for poor South Africans
Tóm tắt
In South Africa, district social service offices are often the first point of entry into the substance abuse treatment system. Despite this, little is known about the profile of people presenting with substance-related problems at these service points. This has a negative impact on treatment service planning. This paper begins to redress this gap through describing patterns of substance use and service needs among people using general social services in the Western Cape and comparing findings against the profile of persons attending specialist substance abuse treatment facilities in the region. As part of a standard client information system, an electronic questionnaire was completed for each person seeking social assistance. Data on socio-demographic characteristics, the range of presenting problems, patterns of substance use, perceived consequences of substance use, as well as types of services provided were analysed for the 691 social welfare clients who reported substance use between 2007 and 2009. These data were compared against clients attending substance abuse treatment centres during the same time period. Findings indicate that social services offices are used as a way of accessing specialist services but are also used as a service point, especially by groups under-represented in the specialist treatment sector. Women, people from rural communities and people with alcohol-related problems are more likely to seek assistance at social service offices providing low threshold intervention services than from the specialist treatment sector. The study provides evidence that social services are a point of entry and intervention for people from underserved communities in the Western Cape. If these low-threshold services can be supported to provide good quality services, they may be an effective and efficient way of improving access to treatment in a context of limited service availability.
Tài liệu tham khảo
Herman AA, Stein DJ, Seedat S, Heeringa SG, Moomal H, Williams DR: The South African Stress and Health (SASH) study: 12-month and lifetime prevalence of common mental disorders. S Afr Med J. 2009, 99: 339-344.
Stein DJ, Seedat S, Herman A, Moomal H, Heeringa SG, Kessler RC, Williams DR: Lifetime prevalence of psychiatric disorders in South Africa. The British Journal of Psychiatry. 2008, 192: 112-117. 10.1192/bjp.bp.106.029280.
Myers B, Louw J, Pasche S: Inequitable access to substance abuse treatment services in Cape Town, South Africa. Substance Abuse Treatment, Prevention, and Policy. 2010, 5: 28-10.1186/1747-597X-5-28.
World Health Organisation: Apartheid and health. 1983, World Health Organisation, Geneva
Marks S, Andersson N: Issues in the political economy of health in South Africa. Journal of Southern African Studies. 1987, 13: 179-186.
Myers B, Louw J, Fakier N: Alcohol and drug abuse: removing structural barriers to treatment for historically disadvantaged communities in Cape Town. International Journal of Social Welfare. 2008, 17: 156-165. 10.1111/j.1468-2397.2007.00546.x.
Myers B, Pasche S, Adam M: Correlates of substance abuse treatment completion among disadvantaged communities in Cape Town, South Africa. Substance Abuse Treatment, Prevention, and Policy. 2010, 5: 3-10.1186/1747-597X-5-3.
Temmingh H, Myers B: Clinical treatment of substance use disorders in South Africa. Substance use and abuse in South Africa. Edited by: Ellis G, Stein D, Thomas K, Meintjies E. 2011, Insights From Brain and Behavioural Sciences, Cape Town: UCT press, 329-366.
Coovadia H, Jewkes R, Barron P, Sanders D, McIntyre D: The health and health system of South Africa: hisotrical roots of public health challenges. The Lancet. 2009, 364: 817-834.
Hunter M: Beyond the male-migrant: South Africa’s long hisotry of health geography and the contemporary AIDS pandemic. Health and Place. 2010, 16: 25-33. 10.1016/j.healthplace.2009.08.003.
Burnhams NH, Myers B, Fakier N, Parry C, Carelse J: Establishing a computerized substance abuse surveillance system for district social workers in the Western Cape Province, South Africa: Methods, successes and challenges. Drugs: Education, Prevention, and Policy. 2011, 18: 40-46. 10.3109/09687630903505519.
Parry C, Bhana A, Pluddemann A, Myers B, Siegfried N, Morojele N, Flisher AJ, Kozel N: The South African Community Epidemiology Network on Drug Use (SACENDU): description, findings (1997–1999) and policy implications. Addiction. 2002, 97: 969-976. 10.1046/j.1360-0443.2002.00145.x.
Myers B: Report on Audit of Substance Abuse Treatment Facilities in Cape Town, 2002. 2002, Medical Research Council, Parow, Cape Town
Dada S, Parry C, Plüddemann A, Bhana A, Bachoo S, Fourie D: Alcohol and Drug Abuse Trends: July - December 2010 (Phase 29). 2011, Medical Research Council, Cape Town
Myers B, Louw J, Pasche SE: Gendered barriers to substance abuse treatment utilization among disadvantaged communities in Cape Town, South Africa. African Journal of Psychiatry. 2011, 14: 146-153.
Myers B, Fakier N, Louw J: Stigma, treatment beliefs, and substance abuse treatment use in historically disadvantaged communities. African Journal of Psychiatry. 2009, 12: 218-222.
Toner P, Hardy E, Mistral W: A specialized maternity drug service: Examples of good practice. Drugs: education, prevention and policy. 2008, 15: 93-105. 10.1080/09687630601157816.
Greenfield S, Brooks A, Gordon S, Green C, Kropp K, McHugh K, Lincoln M, Hien D, Miele G: Substance abuse treatment entry, retention, and outcome in women: A review of the literature. Drug and Alcohol Dependence. 2007, 86: 1-21. 10.1016/j.drugalcdep.2006.05.012.
May P: The epidemiology of fetal alcohol syndrome and partial FAS in a South African community. Drug and Alcohol Dependence. 2007, 88: 259-271. 10.1016/j.drugalcdep.2006.11.007.
Babor T, Higgins-Biddle J, Saunders J: MG: Alcohol Use Disorders Identification Test (AUDIT) Guidelines for Use in Primary Care’. 2001, Department of Mental Health and Substance Dependence, World Health Organisation, Geneva
WHO ASSIST Working Group: The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST): development, reliability and feasibility. Addiction. 2002, 97: 1183-1194. 10.1046/j.1360-0443.2002.00185.x.