Help-seeking by substance dependants presenting to healthcare professionals in the Free State Province
AbstractIntroduction. Current data regarding treatment needs in South Africa
for substance dependence are based on admissions to specialised
treatment centres. The data therefore do not include patients
presenting to independent healthcare workers and state hospitals.
Aim. The aim of this study was to investigate help-seeking behaviour
for substance dependence disorders from the perspective of healthcare professionals at various levels of the referral chain in the Free State Province.
Design. A descriptive study was performed.
Setting. Treatment environments in the Free State Province accessible
to substance-dependent persons served as the study setting.
Participants. General practitioners, private psychiatrists, prescribing
healthcare professionals at state hospitals and treatment centres,
and non-prescribing therapists responsible for the management of
substance-dependent persons, were considered for participation.
Measurements. A questionnaire was used to determine the level
of help-seeking experienced by the participants regarding various
classes of psycho-active substances.
Findings. The presentation of alcohol, cannabis, opioid,
benzodiazepine, ecstasy, cocaine and inhalant dependency at general practitioners, private psychiatrists, treatment centres and non-prescribing therapists was compared. Different patterns of help seeking
for substance dependence from the various professional groups were detected. Regarding alcohol dependence, 40.3% of private general medical practitioners reported being confronted with alcohol dependence at least once per month, compared with 100% of treatment centre representatives and private psychiatrists, 70.6% of state hospitals and 53.8% of non-prescribers. State hospitals reported the highest frequency for contact with cases of cannabis dependence, compared with the other professional groups, while psychiatrists reported the highest contact with cases involving benzodiazepine, cocaine and ecstasy. Therapists reported a higher level of contact with inhalant dependence, while this group virtually never presented at general practitioners and private psychiatrists.
Conclusion. Help-seeking data can be used in conjunction with
other data, such as treatment demand data, to inform and adapt
policies and practice. Variations in the manifestation of help-seeking
behaviour at various groups may be important pointers to conditions
that influence help-seeking, and should therefore be investigated
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