Mind the gap: What is the difference between alcohol treatment need and access for Aboriginal and Torres Strait Islander Australians?
Alcohol-related harms cause great concern to Aboriginal and Torres Strait Islander (Indigenous) communities in Australia as well as challenges to policy makers. Treatment of alcohol use disorders forms one component of an effective public health response. While alcohol dependence typically behaves as a chronic relapsing condition, treatment has been shown to be both effective and cost-effective in improving outcomes. Provision of alcohol treatment services should be based on accurate assessment of treatment need.



In this paper, we examine the likely extent of the gap between voluntary alcohol treatment need and accessibility. We also suggest potential approaches to improve the ability to assess unmet need.



Existing methods of assessing the treatment needs of Indigenous Australians are limited by incomplete and inaccurate survey data and an over-reliance on existing service use data. In addition to a shortage of services, cultural and logistical barriers may hamper access to alcohol treatment for Indigenous Australians. There is also a lack of services funded to a level that allows them to cope with clients with complex medical and physical comorbidity, and a lack of services for women, families and young people. A lack of voluntary treatment services also raises serious ethical concerns, given the expansion of mandatory treatment programmes and incarceration of Indigenous Australians for continued drinking. The use of modelling approaches, linkage of administrative data sets and strategies to improve data collection are discussed as possible methods to better assess treatment need. [Brett J, Lee K, Gray D, Wilson S, Freeburn B, Harrison K, Conigrave K. Mind the gap: what is the difference between alcohol treatment need and access for Aboriginal and Torres Strait Islander Australians? Drug Alcohol Rev 2016;35:456-460].
University of Sydney, Sydney, Australia.|Drug Health Services, Royal Prince Alfred Hospital, Sydney, Australia.
Jonathan
J
Brett
Discipline of Addiction Medicine, University of Sydney, Sydney, Australia.
K S Kylie
KS
Lee
National Drug Research Institute, Curtin University, Perth, Australia.
Dennis
D
Gray
Aboriginal Drug and Alcohol Council, Adelaide, Australia.
Scott
S
Wilson
Drug and Alcohol and Mental Health Unit, Aboriginal Medical Service Cooperative Ltd, Sydney, Australia.
Bradley
B
Freeburn
Aboriginal Health and Medical Research Council of NSW, Sydney, Australia.
Kristie
K
Harrison
Drug Health Services, Royal Prince Alfred Hospital, Sydney, Australia.|Sydney Medical School, University of Sydney, Sydney, Australia.
Katherine
0000-0002-6428-1441
K
Conigrave
D000437:Alcoholism / Q000628:therapy*; D001315:Australia; D065246:Culturally Competent Care; D003469:Culture; D006297:Health Services Accessibility / Q000458:organization & administration* / Q000592:standards; D006301:Health Services Needs and Demand / Q000458:organization & administration* / Q000592:standards; D006303:Health Services, Indigenous / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D058996:Quality Improvement; D000095283:Australian Aboriginal and Torres Strait Islander Peoples
aboriginal; alcohol; indigenous; treatment services