Access to substance abuse treatment services for black South Africans: findings from audits of specialist treatment facilities in Cape Town and Gauteng: original article

Abstract

Background: The increased demand for substance abuse treatment has led to concern about the accessibility of existing services to black South Africans. To date, research has not examined the accessibility of services, even though access has been shown to impact on retention and treatment outcomes.

Method: Cross-sectional audits of substance abuse treatment facilities were conducted in Cape Town (2002) and Gauteng (2003). Data on client characteristics, facility characteristics, and service delivery characteristics were collected using the Treatment Services Audit questionnaire.

Aims: To describe the extent to which substance abuse treatment services are accessible to black clients and the extent to which facilities target barriers that restrict black clients from accessing substance abuse treatment.

Results: At both sites, black clients are under-represented at treatment facilities. Private non-profit, outpatient facilities serve the highest proportion of black clients. Compared to private for-profit and state facilities, private non-profit facilities are the most likely to provide services that address the logistical, cultural and linguistic barriers that restrict black clients from accessing treatment. Outpatient facilities are more likely than inpatient facilities to address these barriers.

Conclusions: Based on the above findings, a number of recommendations are made to improve the accessibility of treatment services for black clients, such as establishing state outpatient treatment facilities and addressing the indirect costs associated with treatment.

Key Words: Alcohol, Public policy, Evidence-based intervention strategies

South African Psychiatry Review Vol.8(1) 2005: 15-19