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Perceived unmet need and barriers to care amongst street‐involved people who use illicit drugs
Author(s) -
Hyshka Elaine,
Anderson Jalene Tayler,
Wild T. Cameron
Publication year - 2017
Publication title -
drug and alcohol review
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.018
H-Index - 74
eISSN - 1465-3362
pISSN - 0959-5236
DOI - 10.1111/dar.12427
Subject(s) - medicine , mental health , odds ratio , logistic regression , socioeconomic status , odds , population , confidence interval , health care , family medicine , psychiatry , gerontology , environmental health , pathology , economics , economic growth
and Aims Research on perceived unmet need for care for mental health and substance use problems focuses on general populations to the detriment of hidden populations. This study describes prevalence and correlates of perceived unmet need for care in a community‐based sample of street‐involved people who use illicit drugs and identifies barriers to care.Design and Methods A sample of 320 street‐involved people who use drugs participated in a structured, interviewer‐assisted survey in Edmonton, Canada. The survey included the Perceived Need for Care Questionnaire, which assessed unmet need for care for mental health and substance use problems across seven service types. Logistic regression examined the associations between perceived unmet need, extent of socioeconomic marginalisation and problem severity. Barriers underlying unmet service needs were also examined.Results Most (82%) participants reported unmet need for one or more services during the past year. Odds of reporting one or more unmet needs were elevated amongst participants reporting substantial housing instability (adjusted odds ratio = 2.37; 95% confidence interval 1.19–4.28) and amongst participants meeting criteria for drug dependence (adjusted odds ratio = 1.22; 95% confidence interval 1.03–1.50), even after adjustment for sociodemographic covariates. Structural, rather than motivational barriers were the most commonly reported reasons underlying unmet service needs.Discussion and Conclusion Street‐involved people who use drugs experience very high rates of perceived unmet need for care for mental health and substance use problems. General population studies on perceived unmet need are insufficient for understanding needs and barriers to care in hidden populations. [Hyshka E, Anderson JT, Wild TC. Perceived unmet need and barriers to care amongst street‐involved people who use illicit drugs. Drug Alcohol Rev 2017;36:295–304]