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A mixed method study exploring similarities and differences in general and social services-specific barriers to treatment-seeking among individuals with a problematic use of alcohol, cannabis, or gambling
Karolinska Institutet, Sweden; Region Stockholm, Sweden.
Karolinska Institutet, Sweden; Region Stockholm, Sweden.
Marie Cederschiöld University, Department of Social Work.ORCID iD: 0000-0003-2416-0124
Karolinska Institutet, Sweden; Region Stockholm, Sweden.
2024 (English)In: BMC Health Services Research, E-ISSN 1472-6963, Vol. 24, no 1, article id 970Article in journal (Refereed) Published
Abstract [en]

Introduction: The treatment gap for addictive disorders is one of the largest in health care. Several studies have investigated barriers to treatment for different addictive disorders, but very few studies conducted have explored whether the barriers differ depending on substance or behavior or if they are common among all addictive disorders. In Sweden, addiction care is provided both by the healthcare and social services, where the latter is common, but also less popular. To our knowledge, there are no studies exploring whether the barriers are different depending on where the treatment is given.

Aim: The aim was to thoroughly explore both which general and social services-specific barriers to treatment that are common, which barriers that differs, and how the barriers are described among individuals with a problematic use of alcohol, cannabis and/or gambling.

Method: A mixed method convergent parallel design was conducted. For the quantitative measures, surveys including the validated Barriers to Treatment Inventory as well as questions regarding barriers in the Swedish multi-provider landscape, were collected from individuals with a problematic use of alcohol (n = 207), cannabis (n = 51), and gambling (n = 37). In parallel, 17 semi-structured interviews from the same population were conducted and analyzed with thematic analysis. Thereafter, the quantitative and qualitative data was compared, contrasted, and at last, interpreted.

Results: The quantitative data showed that the largest general barriers in all groups were privacy concern and poor availability, and the largest barriers for seeking help from the social services was stigma, unawareness of what is offered, and fear of consequences for all groups. The qualitative data resulted in five general barriers: stigma, ambivalence, accessibility, fear of consequences, and lack of knowledge about addiction and its’ treatments, and three barriers specifically towards social services: social services reputation, fear of meeting acquaintances, and lack of knowledge. The themes were developed from data from all groups, but different aspects of the themes were mentioned by different groups.

Conclusion: There are details and aspects that differentiates both the general and social service-specific barriers to treatment between individuals with a problematic use of alcohol, cannabis, and gambling, but in large they perceive similar barriers.

Place, publisher, year, edition, pages
2024. Vol. 24, no 1, article id 970
Keywords [en]
Barriers to treatment, Addiction, Social services, Alcohol, Cannabis, Gambling
National Category
Social Work
Research subject
Människan i välfärdssamhället, Socialt arbete
Identifiers
URN: urn:nbn:se:esh:diva-11153DOI: 10.1186/s12913-024-11304-5ISI: 001296582600005PubMedID: 39174983OAI: oai:DiVA.org:esh-11153DiVA, id: diva2:1923170
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2021–02066Karolinska InstituteAvailable from: 2024-12-20 Created: 2024-12-20 Last updated: 2025-01-27Bibliographically approved

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Ekström, Veronica

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