Audit of Substance Abuse Treatment Facilities in ... - SA HealthInfo

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treatment facilities in Cape Town (Myers & Parry, 2003); Gauteng (Myers, 2004) andGauteng and KwaZulu-Natal (Myers & Fakier, 2007). If inequities in treatment serviceutilisation are to be addressed, these barriers need to be targeted as a matter of urgency.4.3.3. Targeting barriers to treatment retention: The appropriateness of servicesIn South Africa few facilities provide age, gender and culturally sensitive treatmentprogrammes (Myers & Parry, 2003; Myers, 2004). This is a concern as the absence ofappropriate services for groups such as women and cultural minorities and concernsabout the cultural and gender appropriateness of services have been identified as barriersto substance abuse treatment utilisation (Appel et al., 2004; Tucker, Vuchinich, &Rippens, 2004). The following sections describe the extent to which treatment facilitiesprovide culturally, gender and age-sensitive treatment services.Cultural and linguistic appropriateness of servicesConcerns about the cultural and linguistic appropriateness of South African treatmentservices have also been an obstacle to treatment retention for clients from underservedgroups, particularly Black/African substance abusers. This study found that although allfacilities report providing treatment programmes in multiple languages, a smallerproportion of facilities provide counselling that is culturally-appropriate, use culturallyappropriateassessment tools, and translate programme materials into multiple languages.These factors potentially inhibit Black/African persons from being retained in treatment,with Black/African clients being more likely to remain in facilities that provide culturaland linguistically appropriate services. Although treatment facilities may serve a higherproportion of Black/African clients because they attempt to ensure that their services areculturally and linguistically appropriate, it is also possible that certain facilities examinethe appropriateness of their services because a high proportion of their clientele areBlack/African. To fully understand these findings, further investigation into therelationships among demographic profile, treatment needs, and factors facilitatingtreatment retention for recipients of substance abuse treatment is required.In summary, this study suggests that the demographic profile of persons seekingtreatment may influence whether facilities provide culturally and linguistically74
appropriate services for Black/African substance abusers. This is in keeping with findingsfrom previous audits of substance abuse treatment facilities (Myers & Parry, 2003;Myers, 2004; Myers & Fakier, 2007).Gender appropriateness of servicesAlthough substance abuse treatment services are under-utilised by women (Myers, Parry,& Plüddemann, 2004), few facilities in Free State, Limpopo, Mpumalanga, North Westand Northern Cape provide services aimed at addressing some of the barriers that preventwomen from engaging and being retained in treatment. These barriers include limitedresources to arrange for independent childcare (Booth & McLaughlin, 2000), and the lackof women-sensitive treatment programmes that focus on the special needs of women(such as domestic violence and sexual assault) (Booth & McLaughlin, 2000).This study found that although three quarter of facilities report providing genderappropriateand sensitive counselling services, a smaller proportion of facilities provideservices that address women’s issues (such as trauma and violence) and use genderappropriate assessment tools. Only 1 facility (in Mpumalanga) provides womenfocused/women-onlytreatment services. Only half of the facilities provide staff withspecial training in gender-related issues that may be pertinent to treatment (such asdomestic violence). It should be noted that even though facilities may report theprovision of women-sensitive services, this lack of training in gender-related issues mayaffect the extent to which these services effectively address gender-specific issues, andultimately the retention of female substance abusers in treatment.While these findings represent an improvement on findings from previous audits ofsubstance abuse treatment facilities in Gauteng (Myers, 2004), they are still cause forconcern as previous research has identified treatment facilities’ failure to have a gendersensitivetreatment approach as a factor that limits female clients engagement andretention in treatment (Booth & McLaughlin, 2000). In addition, these findings highlightthe need to provide treatment staff with training on topics such as domestic violence,victimisation, and trauma that may be pertinent to female substance abusers as well as theneed to provide staff with training on gender-sensitive treatment approaches.75
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Alcohol & Drug Abuse Research UnitM
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3.1.2 Treatment facility profile by
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4.3 Targeting barriers to treatment
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EXECUTIVE SUMMARYA cross-sectional
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services to historically underserve
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use, reductions in criminal activit
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Despite high levels of substance ab
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Despite the apparent availability o
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treatment services provided. At pre
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use disorders whose physical and em
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delivery, treatment retention, and
Page 23 and 24: audit substance abuse treatment fac
Page 25 and 26: 2.8.3. Further data considerations
Page 27 and 28: Figure 1. Inpatient intensity of ca
Page 29 and 30: Since there is a large overlap betw
Page 31 and 32: the total client population (χ = 4
Page 33 and 34: Figure 7.Comparison of race profile
Page 35 and 36: services per month ranges from 13 t
Page 37 and 38: 3.4.1. Characteristics of staff at
Page 39 and 40: supervision. In contrast, a much sm
Page 41 and 42: In terms of client record-keeping,
Page 43 and 44: Core findings:• Compared to the p
Page 45 and 46: using 12-step approaches, 75.0% rep
Page 47 and 48: Figure 16. Proportion of treatment
Page 49 and 50: 3.7. ADDRESSING BARRIERS TO TREATME
Page 51 and 52: Table 11. Proportion of facilities
Page 55 and 56: Figure 20.Proportion of substance a
Page 61 and 62: 3.9.2. Monitoring of clients’ pro
Page 65 and 66: PART 4: DISCUSSION OF KEY FINDINGSW
Page 67 and 68: previous audits of specialist subst
Page 69 and 70: small proportion of South African d
Page 71 and 72: high levels of substance use among
Page 73: these barriers appears to significa
Page 77 and 78: clients progress post-treatment, an
Page 79 and 80: • The number of state facilities
Page 81 and 82: • Another way of ensuring (indire
Page 83 and 84: • The age appropriateness of serv
Page 85 and 86: REFERENCESAllard, S.W., Tolman, R.M
Page 87 and 88: Myers, B., & Fakier, N. (2007). Rep
Page 89: Zule, W.A., Lam, W.K., & Wechsberg,
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