Exploring barriers and facilitators to addressing hazardous alcohol use and AUD in mental health services: a qualitative study among Dutch professionals

IF 3.7 2区医学 Q1 SUBSTANCE ABUSE

Addiction Science & Clinical Practice Pub Date : 2024-09-09 DOI:10.1186/s13722-024-00497-z

Nathalie Kools, Andrea D. Rozema, Fieke A. E. van den Bulck, Rob H. L. M. Bovens, Jolanda J. P. Mathijssen, Dike van de Mheen

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Abstract

Hazardous alcohol use and alcohol use disorder (AUD) are highly prevalent among clients in mental health services, yet significant gaps remain in the adequate assessment of alcohol use and provision of appropriate alcohol interventions. The aim of this study was to conduct an exploration of (i) alcohol intervention elements used in mental health services and (ii) professionals’ reported barriers and facilitators in identifying and intervening with hazardous alcohol use and AUD. Qualitative data were obtained by conducting semi-structured interviews among a purposive sample of 18 professionals from 13 different Dutch mental health services organizations (i.e., five integrated mental health organizations with addiction services, five mental health organizations without addiction services, and three addiction services organizations without mental health services). Transcripts were qualitatively analyzed using inductive thematic analysis. Identified alcohol intervention elements included conducting assessments, brief interventions, treatment, referrals of clients, collaborations with other parties, and providing information to professionals. Professionals mentioned nine barriers and facilitators in the identification and intervention with hazardous alcohol use and AUD, including three aspects of professionals’ behavior (i.e., professionals’ agenda setting, knowledge and skills, and attitudes), actions related to identification and intervening, client contact, collaboration with other parties, and three factors in a wider context (i.e., organizational characteristics, organizational resources, and governmental aspects). Although diverse alcohol intervention elements are available in Dutch mental health services, it remains unclear to what extent these are routinely implemented. To better address hazardous alcohol use and AUD in mental health services, efforts should focus on enhancing alcohol training, improving collaboration with addiction services, providing appropriate tools, and facilitating support through organizational and governmental measures.

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探索心理健康服务中解决危险饮酒和 AUD 问题的障碍和促进因素：对荷兰专业人员的定性研究

危害性饮酒和饮酒障碍（AUD）在心理健康服务对象中非常普遍，但在充分评估饮酒情况和提供适当的酒精干预措施方面仍存在很大差距。本研究旨在探讨 (i) 精神健康服务中使用的酒精干预要素，以及 (ii) 专业人员报告的识别和干预危险饮酒和 AUD 的障碍和促进因素。通过对来自荷兰 13 家不同精神健康服务机构（即 5 家提供成瘾服务的综合精神健康机构、5 家不提供成瘾服务的精神健康机构和 3 家不提供精神健康服务的成瘾服务机构）的 18 名专业人员进行半结构式访谈，获得了定性数据。我们采用归纳式主题分析法对记录誊本进行了定性分析。确定的酒精干预要素包括进行评估、简短干预、治疗、客户转介、与其他各方合作以及向专业人员提供信息。专业人员提到了识别和干预危险饮酒和 AUD 的九个障碍和促进因素，包括专业人员行为的三个方面（即专业人员的议程设置、知识和技能以及态度）、与识别和干预有关的行动、与客户的接触、与其他各方的合作，以及更广泛背景下的三个因素（即组织特征、组织资源和政府方面）。尽管荷兰精神卫生服务机构提供了多种酒精干预措施，但这些措施的常规实施程度仍不明确。为了更好地应对精神健康服务机构中的危险饮酒和 AUD 问题，应重点加强酒精培训，改善与成瘾服务机构的合作，提供适当的工具，并通过组织和政府措施促进支持。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Addiction Science & Clinical Practice Psychology-Clinical Psychology

CiteScore

3.90

自引率

10.80%

发文量

审稿时长

28 weeks

期刊介绍： Addiction Science & Clinical Practice provides a forum for clinically relevant research and perspectives that contribute to improving the quality of care for people with unhealthy alcohol, tobacco, or other drug use and addictive behaviours across a spectrum of clinical settings. Addiction Science & Clinical Practice accepts articles of clinical relevance related to the prevention and treatment of unhealthy alcohol, tobacco, and other drug use across the spectrum of clinical settings. Topics of interest address issues related to the following: the spectrum of unhealthy use of alcohol, tobacco, and other drugs among the range of affected persons (e.g., not limited by age, race/ethnicity, gender, or sexual orientation); the array of clinical prevention and treatment practices (from health messages, to identification and early intervention, to more extensive interventions including counseling and pharmacotherapy and other management strategies); and identification and management of medical, psychiatric, social, and other health consequences of substance use. Addiction Science & Clinical Practice is particularly interested in articles that address how to improve the quality of care for people with unhealthy substance use and related conditions as described in the (US) Institute of Medicine report, Improving the Quality of Healthcare for Mental Health and Substance Use Conditions (Washington, DC: National Academies Press, 2006). Such articles address the quality of care and of health services. Although the journal also welcomes submissions that address these conditions in addiction speciality-treatment settings, the journal is particularly interested in including articles that address unhealthy use outside these settings, including experience with novel models of care and outcomes, and outcomes of research-practice collaborations. Although Addiction Science & Clinical Practice is generally not an outlet for basic science research, we will accept basic science research manuscripts that have clearly described potential clinical relevance and are accessible to audiences outside a narrow laboratory research field.