Challenges to providing quality substance abuse treatment services for American Indian and Alaska native communities: perspectives of staff from 18 treatment centers

BMC Psychiatry

Douglas Novins¹  Alexandra Fickenscher¹  Ashley Raleigh-Cohn¹  Rupinder Legha² 

[1] Centers for American Indian and Alaska Native Health, University of Colorado Anschutz Medical Campus, Mail Stop F800, Nighthorse Campbell Native Health Building, 13055 E. 17th Ave., Aurora, CO 80045, USA;Department of Psychiatry, University of Colorado, 13001 E. 17th St., MSF546, Building 500, Aurora, CO 80045, USA

关键词: Organizational case studies;    Health services research;    Substance abuse treatment centers;    North American;    Indians;   

Others  :  1123500
DOI  :  10.1186/1471-244X-14-181

 received in 2014-03-15, accepted in 2014-06-10,  发布年份 2014

【 摘 要 】

Background

Substance abuse continues to exact a significant toll, despite promising advancements in treatment, and American Indian and Alaska Native (AI/AN) communities remain disproportionately impacted. Understanding the challenges to providing quality substance abuse treatment to AI/AN communities could ultimately result in more effective treatment interventions, but no multi-site studies have examined this important issue.

Methods

This qualitative study examined the challenges of providing substance abuse treatment services for American Indian and Alaska Native (AI/AN) communities. We conducted key informant interviews and focus groups at 18 substance abuse treatment programs serving AI/AN communities. Seventy-six service participants (21 individuals in clinical administrative positions and 55 front-line clinicians) participated in the project. Interview transcripts were coded to identify key themes.

Results

We found that the challenges of bringing effective substance abuse treatment to AI/AN communities fell into three broad categories: challenges associated with providing clinical services, those associated with the infrastructure of treatment settings, and those associated with the greater service/treatment system. These sets of challenges interact to form a highly complex set of conditions for the delivery of these services.

Conclusions

Our findings suggest that substance abuse treatment services for AI/AN communities require more integrated, individualized, comprehensive, and longer-term approaches to care. Our three categories of challenges provide a useful framework for eliciting challenges to providing quality substance abuse treatment in other substance abuse treatment settings.

【 授权许可】

   
2014 Legha et al.; licensee BioMed Central Ltd.

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