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

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• To ensure that clients have access to detoxification services, the availability ofdetoxification services within the public health services sector needs to be prioritised.This is important, as access to detoxification is a major barrier to treatment entry.• Facilities should be encouraged to incorporate health risk-reduction interventions intotheir treatment programmes. These interventions should focus on HIV prevention(i.e. reducing substance use-related sexual risks) and harm reduction interventions forinjection drug users.• The number of staff providing mental health services (such as psychologists andpsychiatrists) needs to be increased. Funding needs to be made available for thispurpose.Unmet medical needs• All clients should be assessed for co-occurring health disorders and health-relatedrisks, such as risk for HIV and other infectious disease.• Research, which examines the extent to which clients at outpatient facilities haveunmet mental health needs, should occur as a matter of urgency. If there are unmetmental health needs at these facilities, interventions should focus on improving accessto ancillary mental health services at outpatient facilities.Case management• While it is not always financially feasible to provide on-site access to ancillary andmental health treatment services, facilities should be encouraged to provide eitherdirect on-site access or indirect access via referral to agencies specialising in mentalhealth-related problems.• Where facilities do not directly provide access to ancillary services, a casemanagement approach should ensure that clients receive the ancillary services asplanned. The role of the case manager should be to ensure that clients are linked toexternal service providers and that they are able to access these services.80
• Another way of ensuring (indirect) access to ancillary services is through precontractingexternal service providers to ensure that they are available to provideancillary services when these services are required.To address barriers to treatment entry for underserved groups• Awareness should be raised among treatment providers about the importance ofaddressing barriers to treatment entry for clients from historically underserved groups.Logistic and affordability barriers• Logistic barriers to treatment can be addressed through the indirect costs associatedwith treatment (e.g. transport and child care). These indirect costs may preventpoorer clients from seeking treatment.• Although it is not feasible to provide transport services to all poor clients, transportrelatedbarriers can be ameliorated by ensuring that new services are geographicallyaccessible to poor communities. One way of meeting this standard is through theintroduction of mobile outpatient services that travel from community to communityrather than being purely facility-based.Awareness barriers• Awareness-related barriers should continue to be addressed among vulnerable anddisadvantaged communities.• To facilitate this, facilities should be encouraged to employ dedicated outreachworkers who can focus on raising awareness of services and distributing informationand materials among at-risk communities.• Although headway has been made in improving awareness of substance abuse,facilities need to give increased attention to outreach in inner city areas.Cultural and linguistic barriers• Cultural and linguistic barriers to treatment entry, engagement and retention amongBlack/African clients should be addressed as a matter of urgency, especially in theNorthern Cape.81
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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
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audit substance abuse treatment fac
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2.8.3. Further data considerations
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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 and 74: these barriers appears to significa
Page 75 and 76: appropriate services for Black/Afri
Page 77 and 78: clients progress post-treatment, an
Page 79: • The number of state facilities
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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