Mental health articles

substance use treatment centers and services Women face unique obstacles to treatment, encountering barriers at both personal and system levels that keep them from accessing services, including fear of losing custody of their children, guilt, lack of transportation and child care, and unemployment. Treatment that provides comprehensive services and support is associated with increased rates of abstinence, better overall health, and improved parenting skills whereas treatment that is limited to addressing substance use alone may contribute to a higher potential for relapse.The provision of integrated treatment to meet these needs is a key factor in engagement, retention, decreased substance use, improved functioning, and increased client satisfaction .Gender-specific factors influencing treatment and recovery include relationships and the family, high prevalence of trauma, and co-occurring mental health disorders. CSAT’s Comprehensive Treatment Model describes elements of care that are categorized as follows: (1) Clinical treatment services which are necessary to address the medical and biopsychosocial issues of addiction, (2) Clinical support services which assist clients in their recovery, and (3) Community support services which are outside of treatment but available within a community support system for clients .While services that address the full range of needs should be provided to all women, mothers deserve increased attention to their unique roles as parents, and their children also require services and supports. Among women with substance use disorders, the most frequent source of referral to treatment was self-referral followed by the criminal justice system and other community referrals, including child protective services .Furthermore, referral or involvement with the criminal justice system or child protective services is associated with longer lengths of treatment.Children are a significant factor influencing treatment engagement, retention, and outcomes, and regaining or reestablishing the role of primary caregiver can be a major motivating force for women. Beginning in the 1980s and 1990s, an increasing number of programs were developed to specifically provide treatment to mothers with substance use disorders, helped by SAMHSA’s Pregnant and Postpartum Women and their Infants (PPWI) Grant Program, the Residential Women and Children (RWC), and the Pregnant and Postpartum Women (PPW) Demonstration Program which provided funding to many projects in the 1990s. Evaluation of these programs found that women reported decreased substance use and adverse pregnancy outcomes, reduced criminal involvement, and improved retention of custody.While more programs have recognized the need for treatment that addresses women’s specific substance abuse-related needs, considerable variability remains in both outpatient and residential treatment settings. No universally accepted definition for what constitutes substance abuse programming for women exists. In addition to substance abuse counseling, programs for women often incorporate one or more of the following: (1) services intended to increase access such as child care or transportation, (2) services addressing specific needs of women such as prenatal and mental health care, HIV risk reduction, and trauma services, and (3) services provided in a women-only setting.Comprehensive treatment has been shown to be highly effective, offering advantages over traditional substance use treatment, in decreased substance use, increased program retention, decreased prenatal and birth complications, and positive psychosocial outcomes. The following components were particularly correlated with improved outcomes: (1) child care, (2) prenatal care, (3)women-only programs, (4) supplemental services and workshops for women, (5) mental health treatment, and (6) comprehensive programming.Genderspecific, or women-only, treatment has been shown to be highly effective, particularly when incorporating prenatal and/or child care, with improved outcomes in substance use, mental health, employment, birth outcomes, and physical health . Niv and Hser found that women in gender-specific programs had a greater severity of problems, including substance abuse, medical conditions, and psychiatric illness, but were more likely to receive services with better drug and legal outcomes at follow-up compared to women in mixed programs. Additionally, women are more likely than men to use services available in comprehensive programsand more likely to benefit from them.

Tags: substance use