Drug Treatment Services for Ethnic Communities in Victoria, Australia: An examination of cultural and institutional barriers

Abstract

Under-representation of ethnic minorities at drug treatment services represents under-utilisation rather than a lower need. To explore barriers to drug treatment among ethnic communities we undertook a comprehensive review of international and Australian literature to identify problems their members experience upon the discovery of illicit drug use in their community, how drug treatment is addressed and challenges for improved drug treatment outcomes. The concepts and themes derived from the literature were then compared with our research findings from key informant interviews and consultations with non-illicit drug-using spokespersons from eight ethnic communities in Victoria, Australia. Intense shame and loss of face linked to illicit drug use was common in ethnic communities and as a consequence seeking help for drug treatment was fraught with difficulties. Accessing drug treatment services often occurred following a crisis, but a sense of despair and confusion often prevailed owing to a lack of knowledge of available assistance. Even when treatment services were accessed most key informants and ethnic communities viewed them as culturally insensitive, inflexible and with language barriers that obstructed the flow of effective information. Understanding of the ethnic family ethos was of pivotal importance but frequently ignored by treatment services, contributing to the exclusion of ethnic communities from appropriate assistance. Ethnic communities need to be assisted to participate in drug issue discussions and community development strategies in order for their utilisation of drug treatment services to be improved.

Perceived Barriers to Treatment in a Community-Based Sample of Illicit-Drug-Using African American Men and Women

“…These findings suggest that one of the most common barriers to treatment engagement across gender is the belief that treatment is not needed. It is plausible that an individual's lack of motivation to seek and/or receive help to treat substance use may be rooted in feelings of shame, which in turn provoke defensive mechanisms that lead to denial of problem severity and the need for treatment (Reid, Crofts & Beyer 2001). Overall, African American men and women did not differ in their perceptions on why they were not in treatment.…”

Cultural and family contexts for help seeking among clients with cannabis, other drug and mental health issues

“…The open admission of illicit drug use and personal problems does not countenance well with many of the traditions of CALD communities (Amodeo, Robb, Peou, & Tran, 1996;D'Avanzo, 1997;Fish & Harris, 1997;Reid et al, 2001;Zane & Kim, 1994). For this reason, illicit drug use and mental health are issues generally dealt with within the extended family unit (Reid et al, 2001).…”

“…Many authors have identified an increased level of social stigma attached to illicit drug use and mental health issues among CALD communities relative to non-CALD communities. Reid, Crofts, and Beyer (2001) observed that ''illicit drug use in ethnic communities is often associated with denial, shame, stigma, loss of face within the community, and as a consequence, a high level of unwillingness to tell others of personal problems''. The open admission of illicit drug use and personal problems does not countenance well with many of the traditions of CALD communities (Amodeo, Robb, Peou, & Tran, 1996;D'Avanzo, 1997;Fish & Harris, 1997;Reid et al, 2001;Zane & Kim, 1994).…”

“…Reid, Crofts, and Beyer (2001) observed that ''illicit drug use in ethnic communities is often associated with denial, shame, stigma, loss of face within the community, and as a consequence, a high level of unwillingness to tell others of personal problems''. The open admission of illicit drug use and personal problems does not countenance well with many of the traditions of CALD communities (Amodeo, Robb, Peou, & Tran, 1996;D'Avanzo, 1997;Fish & Harris, 1997;Reid et al, 2001;Zane & Kim, 1994). For this reason, illicit drug use and mental health are issues generally dealt with within the extended family unit (Reid et al, 2001).…”

Reducing cultural barriers to substance abuse treatment among Asian Americans: A case study in New York City

“…Indeed, past research has reported that underrepresentation of ethnic minorities at substance abuse treatment services tends to indicate underutilization rather than a lower need (Kiyoko, 1998;Reid, Crofts, & Beyer, 2001). This study attempted to probe the following questions:…”