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

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Improving the cultural, gender and age appropriateness of servicesCultural and linguistic appropriateness of services• The cultural and linguistic appropriateness of services needs to be improved.• Linguistic factors can be addressed through offering treatment services in a number oflanguages (when the clients served speak a number of languages), employingmultilingual staff as members of the clinical/treatment team, employing Africanlanguage-speaking therapists, and ensuring that treatment programme materials areavailable in a number of languages.• Training programmes should also be developed that increase the cultural sensitivity ofexisting treatment programmes and materials. For example, these trainingprogrammes can explore the cultural meanings and understandings associated withalcohol and drug use and substance use disorders.Gender appropriateness of services• The proportion of women treated at existing treatment facilities needs to be improved.• The extent to which existing services are sensitive to the needs of female substanceabusers needs to be improved.• This can be addressed through offering treatment services for women-only andthrough the provision of counselling services that are sensitive to the multiple needsof female substance users, including the need for interventions relating to sexualabuse histories, domestic violence and PTSD.• Training programmes should also be developed that increase the gender sensitivity ofexisting treatment programmes and materials. For example, these trainingprogrammes can explore the multiple needs of substance using women, key barriersto their treatment process, and effective treatment strategies for women.Age appropriateness of services• The extent to which existing services are age and developmentally appropriate foradolescents and young people needs to be examined.82
• The age appropriateness of services can be improved through adapting programmesdirected for adults to the developmental needs of young people as well as throughintroducing evidence-based treatment models that target adolescents specifically, suchas multisystemic family therapy (NIDA, 2006).• In order to ensure the appropriateness of services for young people, facilities shouldalso be encouraged to include family members in the treatment process. This can bedone by providing family reunification services as well as by providing familyfocusedcounselling services.To improve treatment service planning and delivery through research andmonitoring and evaluation activitiesNational audit• As part of the monitoring of the quality of substance abuse treatment services, and toensure that facilities endorsed by the state deliver adequate and appropriate services, anational treatment audit should be conducted on a regular basis (at least once everytwo years).• Findings from this national audit should be used to inform decision-making about (i)the allocation of funding and other resources to existing facilities and (ii) thedevelopment of new services. This decision-making should be informed by the extentto which facilities provide services to historically underserved groups.National prevalence study of substance use disorders and unmet treatment need• To prevent duplication of services and enable maximisation of scarce resources, anational survey examining the prevalence of substance use disorders and theprevalence of unmet need for substance abuse treatment services should be conductedon a regular basis (at least once every two years). Findings from this survey will helpidentify underserved communities where there is the greatest need for services andfacilitate the rational allocation of new treatment resources.83
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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
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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 and 80: • The number of state facilities
Page 81: • Another way of ensuring (indire
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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