title: Access barriers to substance abuse treatment for persons with disabilities: an exploratory study.
abstract: Research in substance abuse (SA) treatment has demonstrated that persons with disabilities (PWDs) are at substantially higher risk for SA than persons without disabilities. Despite their higher risk, PWDs access SA treatment at a much lower rate than persons without disabilities. Using the Behavioral Model for Vulnerable Populations as a research framework, we identified reasons for differences in access to SA treatment for Medicaid-eligible adults with disabilities in Oregon through a multiphase study. Analyses of demographic and referral source data, along with interviews with key state agency representatives, adults with disabilities, and treatment program personnel, helped identify barriers to SA treatment access. These barriers are reflected as attributes of PWDs, contextual variables that enable or impede access, recognition of the need for SA treatment, and characteristics of treatment services. The findings suggest needed policy and practice changes to increase access rates for PWDs. They provide direction for future research.
authors.affiliation: Oregon Health and Science University, Portland, OR 97207, USA. krahng@ohsu.edu
authors.forename: Gloria
authors.initials: G
authors.lastname: Krahn
authors.forename: Nancy
authors.initials: N
authors.lastname: Farrell
authors.forename: Roy
authors.initials: R
authors.lastname: Gabriel
authors.forename: Dennis
authors.initials: D
authors.lastname: Deck
mesh_terms: D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D003156:Community Mental Health Services / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D017144:Focus Groups; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008484:Medicaid; D008875:Middle Aged; D020380:Needs Assessment / Q000706:statistics & numerical data; D009922:Oregon; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012944:Social Support; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000534:rehabilitation*; D014481:United States