HD47 - The Implementation of Women's Substance Abuse Programs in Virginia

  • Published: 1993
  • Author: Department of Mental Health and Mental Retardation and Substance Abuse Services
  • Enabling Authority: House Joint Resolution 389 (Regular Session, 1991)

Executive Summary:
Background

This study of substance abuse prevention and treatment services provided for women in Virginia was executed in response to House Joint Resolution 389, which directed the Commissioner to "scrutinize" these services. The study consists of

• a review of the issues as discussed in scientific treatment literature;

• a discussion of the study methods and results;

• a discussion of the implications of the study;

• recommendations for future action.

Programs or services were considered to be "specialized services," i.e., specifically designed to address the needs of female clients if they possessed one or more of the following .characteristics:

• Counselors trained to work with women's issues in treatment;

• Same gender treatment activities, such as group therapy with all female clients;

• Specialized outreach activities designed to provide education on women's issues and connect women to treatment resources in the community;

• The provision of child care for women participating in treatment. Issues

A review of the literature and the study itself yielded several major identifiable issues which should be addressed by the community services boards and the Department:

Issues related to appropriate prevention and treatment:

• Training is needed for community services board staff to promote women as a priority population;

• Access to and availability of intensive residential treatment need to improve, particularly in settings which include and accommodate women with dependent children;

• Programs should include educational and vocational services geared to assist women in becoming economically independent;

• Training in basic life skills should be provided to help women become self-sufficient, such as budgeting, learning to access community resources, goal-setting and problem-solving;

• Physical and sexual abuse are frequently reported by women seeking substance abuse treatment;

• Improved outreach services are needed to identify women at-risk for substance abuse or in need of treatment services;

Issues related to parenting:

• The study identified child care as the most significant barrier keeping women from seeking treatment services;

• The fear of losing custody of dependent children prevents some women from seeking needed treatment for substance abuse;

Issues related to community support

• Existing community resources need to be more effectively coordinated to assist these women in accessing necessary resources;

• Geographic distance and lack of transportation prevent many women from participating in available treatment;

• Many women lack appropriate housing in safe, drug free environments;

• Poor access to health care is a major problem for medically indigent women, and is especially critical for pregnant women who abuse substances and the children of women abusing substances;

Study Methods and Findings

The study was conducted by Department staff, utilizing both a written questionnaire and an interview of community services boards concerning services provided to women during State Fiscal Year 1991. All of the 40 community services boards submitted data to the study. Of the 75,516 admissions to substance abuse treatment services (emergency, inpatient, outpatient, day support, residential), 21,873, or nearly 29 percent, were women. Of these women, 4,159 received "specialized" services designed specifically to meet the needs of women. Compared to the general population of the state, women of color were over-represented (34%), especially in services designed to treat persons with more severe substance abuse problems.

The study found, however, that a limited spectrum of specialized services for women were widely available. Access to the services (i.e., the ability of the women to utilize the service adequately) is limited by the barriers listed previously. In addition, the state lacked several specialized services, especially specialized residential services.

The study revealed that 32 community services boards expended a total of $3,326,812 on services specifically designed to meet the needs of women, indicating that specialized services are widespread. Twenty-seven CSBs report that specialized services for women are a priority in long-range plans submitted to the Department for inclusion in its Comprehensive Plan process.

Several community services boards reported attempts to initiate specialized services to women; however, the services were poorly utilized, possibly due to lack of training for staff and collaboration with other appropriate community agencies. In FY '91 an estimated total of $14,562,176 was expended to provide services to women in both specialized and non-specialized services.

Finally, information concerning referral patterns was collected. CSBs utilize local health departments extensively for testing and treatment of sexually transmitted diseases (especially HIV/AIDS) and for nutrition programs. Nearly all of the CSBs reported making referrals to early intervention services for mothers whose newborns may have been exposed to alcohol or other drugs in utero. Many CSBs also reported providing training to other community agencies regarding services to substance abusing women.

Recommendations

The study concentrated on identifying the availability and accessibility of substance abuse services specifically designed to address the needs of women. Although the substance abuse prevention and treatment needs of women are the responsibility of the Department of Mental Health, Mental Retardation and Substance Abuse Services, many of the barriers to receiving treatment could be remedied by enhanced collaboration with other state agencies. Similarly, many of the support services necessary for stable recovery from substance abuse are provided by other state agencies. The Department therefore recommends that the Subcommittee request the Secretary of Health and Human Services to respond to the study by coordinating the identification of appropriate resources for the 1994-96 budget, including a specific plan of action to address the needs identified in the study. This plan would:

• quantify the need for specific types of essential services throughout the Commonwealth;

• identify the agency resources responsible for addressing the identified need;

• provide cost estimates for implementation;

• describe strategies for implementation, including geographic distribution of prevention and treatment modalities, specific services to be provided, and timetables,

• and would be assembled in collaboration with representatives of other relevant state agencies, the Virginia Association of Community Services Boards, and other stakeholders.