Social service offices as a point of entry into substance abuse treatment for poor South Africans

Nadine Harker Burnhams,Bronwyn Myers,Siphokazi Dada

doi:10.1186/1747-597x-7-22

Abstract

BackgroundIn South Africa, district social service offices are often the first point of entry into the substance abuse treatment system. Despite this, little is known about the profile of people presenting with substance-related problems at these service points. This has a negative impact on treatment service planning. This paper begins to redress this gap through describing patterns of substance use and service needs among people using general social services in the Western Cape and comparing findings against the profile of persons attending specialist substance abuse treatment facilities in the region.MethodsAs part of a standard client information system, an electronic questionnaire was completed for each person seeking social assistance. Data on socio-demographic characteristics, the range of presenting problems, patterns of substance use, perceived consequences of substance use, as well as types of services provided were analysed for the 691 social welfare clients who reported substance use between 2007 and 2009. These data were compared against clients attending substance abuse treatment centres during the same time period.ResultsFindings indicate that social services offices are used as a way of accessing specialist services but are also used as a service point, especially by groups under-represented in the specialist treatment sector. Women, people from rural communities and people with alcohol-related problems are more likely to seek assistance at social service offices providing low threshold intervention services than from the specialist treatment sector.ConclusionsThe study provides evidence that social services are a point of entry and intervention for people from underserved communities in the Western Cape. If these low-threshold services can be supported to provide good quality services, they may be an effective and efficient way of improving access to treatment in a context of limited service availability.

Highlights

In South Africa, district social service offices are often the first point of entry into the substance abuse treatment system
Despite some limitations, this study provides good evidence that social service offices are a point of entry into the substance abuse treatment sector and a point of intervention for people with substance use problems from poor communities in the Western Cape province of South Africa
Findings suggest that these social service offices, conveniently located in each major district of the province, help people from poor communities overcome many of the documented structural barriers to accessing care for substance use disorders

Summary

Introduction

In South Africa, district social service offices are often the first point of entry into the substance abuse treatment system. The first South African Stress and Health Study, a nationally representative study, found The burden that these disorders place on the health and welfare system of South Africa is compounded by high levels of unmet substance abuse treatment needs, within poor South African communities [3]. The roots of these unmet treatment needs are located in the inequitable spread and limited availability of substance abuse treatment services across South African communities This is mainly because race was a major determinant of access to health and social resources (including substance abuse treatment) in apartheid South Africa [4,5], with White South Africans having better access to public services than Coloured (people of mixed race ancestry) or Black African South Africans. Geographical apartheid contributed to poor access to services and poverty, with Black African and Coloured South Africans forced to live in peri-urban township areas (with few economic opportunities) located considerable distances from White, economically advantaged, urban areas [4,5,7]

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