Met and unmet needs of service users with substance use disorders: a latent class analysis.

Abstract

Purpose: People with substance use disorders (SUD) have multiple associated health and social conditions that may lead to unmet needs, even among those receiving professional support. Furthermore, the fragmented nature of care provision may also contribute to unmet needs. Therefore, we assessed the needs of service users with SUD and identified their need profiles and their determinants. We aimed to identify possible gaps in care that were likely to hamper recovery pathways and to examine whether the care supply was tailored to users' needs.

Methods: A convenience sample of 562 service users with SUD drawn from diverse mental health services in Belgium, including specialised services for SUD, were assessed using the Camberwell Assessment of Needs- Short Appraisal Schedule (Patient version). Additional indicators, including social integration, substance use behaviours, service utilisation, and well-being, were also collected. A Latent Class Analysis was performed to identify need profiles.

Results: Three classes of need profiles were identified. The largest class comprised 40% of the sample and included individuals with few needs. The second class encompassed 35% of the sample and represented those whose needs were mainly met by professionals. The third class, accounting for 25% of the sample, included individuals with many unmet needs. Across classes, company, intimate relationships, and sexual expression were the most reported unmet needs. Poor social integration and subjective well-being were associated with more needs, either met or unmet. Females (OR = 2.76, p = 0.025), and those using social services (OR = 2.54, p = 0.022), homecare and outreach services (OR = 3.683, p = 0.003) were more likely to report met needs. In contrast, using multiple substances was associated with unmet needs (OR = 3.87, p = 0.008). There was no significant association between need profiles and the use of specialised services for SUD.

Conclusion: Needs of people with SUD go beyond substance use and encompass social relationships. Although no major differences in need profiles were observed based on service utilisation, social integration and interpersonal relationships deserve greater attention from the perspective of the personal recovery of people with SUD.