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

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• At the point of entry into the treatment system, all clients should beassigned to a case manager responsible for ensuring that clients are ableto access services at each step in the referral process, without fallingthrough the cracks.• Interventions targeting delays in accessing treatment should attempt toreduce the administrative and bureaucratic requirements for admissioninto non-profit treatment settings. Such interventions should attempt toreduce waiting periods for social work reports, the number of reportsrequired from professionals and complex eligibility requirements that arenot evidence-based.6.4.5.2. Interventions targeting resource-related barriersResource-related barriers (particularly capacity issues) need to be addressed inthe non-profit treatment sector as these contribute to perceptions that effectivetreatment services are not available as well as fears about treatment – both ofwhich have been shown to restrict treatment utilization. To address thesecapacity issues, we argue for:1. Increased funding for the non-profit substance abuse treatment sector• In order to expand capacity to provide treatment services to HDCs,treatment service providers and community groups should mobilize andadvocate both the state, private foundations, and donor agencies forincreased funding for both new and existing non-profit substance abusetreatment facilitieso The development of new facilities and the expansion of existingfacilities should be developed based on a proper assessment ofsubstance-related treatment needs in the Cape Town metropoleo A thorough substance-related treatment needs assessment inHDCs needs to be conducted in order to avoid duplication ofservices and to ensure adequate service coverage across themetropole.131
o To ensure objectivity, this needs analysis should be conducted byan organization or individuals without vested interests in specificcommunities or treatment-related organizations.• The allocation of increased funding for the provision of substance abusetreatment services should be contingent on the following:o A percentage of the funding should be ear-marked for free beds ortreatment slots for indigent clientso Funding should only be allocated to facilities/organizations thatcomply with state regulations regarding substance abuse treatmentfacilities (see below), including minimum norms and standards fortreatment services.o Funding should only be allocated to facilities/organizations thatemploy appropriately qualified staffo Funding allocation should be guided by the extent to whichtreatment facilities use evidence-based treatment models andtreatment outcomes• Increased funding also needs to be allocated to capacity developmentinitiatives for CBOs and other treatment service providers who areunregistered and/or employ unqualified “addiction counsellors”, and/or donot yet meet current standards governing treatment service provision.Funding for capacity development initiatives should be contingent on thefollowing:o Capacity-development activities should only be provided by suitablyqualified individualso All training courses should by accredited with the HealthProfessions Council and provide attendees with continuousprofessional development pointso Training courses should also be accredited with SAQA132
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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
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4.4.4.4. Predictors of “community
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• In historically disadvantaged c
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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
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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 and 126: 6.4. RECOMMENDATIONSBased on study
Page 127 and 128: • As findings suggest that female
Page 129 and 130: • While the affordability of trea
Page 131: To address these barriers, we argue
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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Access to substance abuse treatment in the Cape Town metropole ...

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