Access to substance abuse treatment in the Cape Town metropole ...

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treatment should attempt to enhance social support for treatment withinfamilies and communities. Families and concerned community membersshould be provided with and encouraged to share information relating tothe signs and symptoms of substance use disorders and treatment optionswith individuals who have substance use disorders.• Findings also point to the impact of community and environmental factorson awareness of when and where to seek substance abuse treatment. Asenvironments characterised by better access to basic services, moreinfrastructure, and less disadvantage seem to enable awareness ofsubstance abuse treatment services, interventions should:o Focus on providing more informational and tangible support interms of resource materials to more disadvantaged and deprivedneighbourhoods.o Attempt to strengthen positive social networks in neighbourhoodscharacterised by high levels of disorder and disruption. Thesesupportive networks can act as an informational resource foraccessing substance abuse treatment services.6.4.2. Recommendations for interventions that address geographicalaccessibility barriersBased on the finding that the geographical accessibility of treatment services is astrong predictor of whether persons from HDCS utilize substance abusetreatment, we make several recommendations for improving the accessibility ofexisting services:• Given that the state’s failure to assess the substance abuse treatmentneeds of HDCs and gaps in treatment service coverage has led to anuneven dispersion of treatment resources; a starting point for developinginterventions that address geographical accessibility barriers would be amapping of treatment need and existing treatment services in the CapeTown metropole.125
• As findings suggest that female substance abusers from HDCs experiencegreater barriers relating to the geographical accessibility of treatmentservices than males, interventions to reduce distance to nearest treatmentcentre and lengthy travelling times to treatment should focus especially onpoor women.o These interventions should address the underlying factors thatcontribute to this gender difference such as women having morecompeting financial needs, lower incomes and more affordabilitybarriers. These income issues impact on women’s ability to affordpublic transport to treatment and leads to more difficult commutes.o Interventions should consider providing women with vouchers forpublic transport to treatment facilitieso As an alternative, treatment facilities may wish to considertransporting female clients to and from the facility in order toaddress this barrier to treatment engagement.• Findings also suggest that geographical accessibility barriers aresignificantly higher in Black/African communities than Colouredcommunities in the Cape Town metropole. These socio-demographicdifferences highlight the need for interventions that target geographicalaccessibility barriers amongst women and Black/African persons withsubstance use disorders specifically.• Innovative low-cost, geographically accessible interventions could includethe use of mobile outpatient clinics located within Black/Africancommunities.o These clinics could be moved within and between communities ona regular basis, and as such would reduce both the distancesrequired to travel and the costs associated with travelling totreatment services located at permanent facilities.126
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Access to substance abuse treatment
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CONTENTSINTRODUCTION ..............
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5.4. SUMMARY.......................
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al., 2004; Reddy et al., 2003; Shis
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1.3. IS ACCESS TO SUBSTANCE ABUSE T
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1.4.2. Racial disparities in the ne
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illegally and are unregulated by th
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CONCEPTUAL MODELThis study’s conc
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presenting problems and ability to
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need for services is the most immed
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This study focuses specifically on
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METHOD3.1. STUDY AIMS & OBJECTIVESA
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the researcher to explore possible
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esidential areas from each of the s
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3.3.2.4. Data collection: controlsF
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o Problem recognition, Desire for h
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Table 1.Domains and measures compri
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The 19-item MOS-SSS measures functi
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information on the accessibility of
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RESULTS: PHASE ONE4.1. VARIABLES AS
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efficacy to stop using drugs for mo
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(Table 6). Effect sizes were large
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were 2.4 times more likely to not a
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esteem scales (Table 9). Stigma als
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Table 10.Logistic regression coeffi
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4.2.2. Model 2: Predisposing variab
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poverty scale, and the variable “
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of the model increased significantl
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controls had greater self-efficacy
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and R1000 per month than their fema
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subjects earning less than R500 per
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and race (Table 16). This indicates
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were 3 times more likely to earn le
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(which are higher for Black/African
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substance use or remain abstinent d
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monetary needs rise, subjects repor
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with improved awareness of services
Page 75 and 76: 4.4.4.4. Predictors of “community
Page 77 and 78: • In historically disadvantaged c
Page 79 and 80: RESULTS: PHASE TWODuring qualitativ
Page 81 and 82: 5.1.1.3. Government’s responses t
Page 83 and 84: “Part of the government's agenda
Page 85 and 86: putting extra strain and pressure o
Page 87 and 88: The impact of availability and affo
Page 89 and 90: availability of affordable services
Page 91 and 92: completed a hospital-based detoxifi
Page 93 and 94: “I have thirty beds that are unus
Page 95 and 96: “I don't see it amongst the bona
Page 97 and 98: going to be a good day. So, yes it
Page 99 and 100: in the fourth week they relapse, it
Page 101 and 102: esponses to treatment, in part, are
Page 103 and 104: • Awareness of appropriate treatm
Page 105 and 106: This perception is prevalent in Col
Page 107 and 108: substance abuse problem - without a
Page 109 and 110: o These community influences are lo
Page 111 and 112: 6.2.1. Awareness of substance abuse
Page 113 and 114: informational support can improve a
Page 115 and 116: salient for low-income groups who h
Page 117 and 118: diminishing self-efficacy and motiv
Page 119 and 120: self-efficacy and negative percepti
Page 121 and 122: 6.3. TREATMENT SYSTEM FACTORS ASSOC
Page 123 and 124: This study found that limited resou
Page 125: 6.4. RECOMMENDATIONSBased on study
Page 129 and 130: • While the affordability of trea
Page 131 and 132: To address these barriers, we argue
Page 133 and 134: o To ensure objectivity, this needs
Page 135 and 136: egistration process should gather i
Page 137 and 138: REFERENCESAday, L.A., & Awe, W.C. (
Page 139 and 140: First, MB; Spitzer, RL; Gibbon, M;
Page 141 and 142: Myers, B., & Parry, C.D.H. (2005).
Page 143 and 144: Ross, M.W., Williams, M.L., Timpson
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