Thresholds in a low-threshold setting: An empirical study of barriers in a centre for people with drug problems and mental health disorders
Thresholds in a low-threshold setting: An empirical study of barriers in a centre for people with drug problems and mental health disorders
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DOI：
10.1016/j.drugpo.2012.08.002
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发表时间：
2013-05-01
影响因子：
4.4
通讯作者：
Skatvedt, Astrid Helene
中科院分区：
文献类型：
--
作者：
Edland-Gryt, Marit;Skatvedt, Astrid Helene
背景：为患有精神健康障碍的吸毒者提供的一些服务可以被描述为低门槛服务。这些措施的目的是使那些无法向更高级别的服务机构寻求帮助的人能够更容易地获得帮助。在这项研究中，我们探讨了什么样的阈值是经历了客户在一个低门槛centre.Methods：人种学实地工作，包括参与者观察，个别访谈和焦点小组访谈的客户和工作人员在低门槛中心的最脆弱的吸毒者在奥斯陆。我们的分析与其他研究一致，表明以下三个阈值很重要，在为患有精神健康障碍的吸毒者提供的服务中也是如此：登记门槛、资格门槛和有效门槛。除此之外，我们认为第四个门槛对这一群体也很重要：信任的门槛。在我们研究的低门槛中心，我们观察到，对于客户来说，跨越信任的门槛似乎是随后能够跨越其他门槛以获得所需帮助的重要先决条件。我们认为，关注这四个门槛可以提高我们对客户获得服务的理解。我们还建议，恢复的过程可能会得到改善，如果更多的关注给予客户experiences.Conclusion的障碍：信任的阈值似乎是特别重要的人患有药物问题和精神健康障碍。这些结果对实践和政策都有影响，因为如果认真考虑，更多的客户可以获得他们需要的服务。对这一群体的服务可以通过关注第四个门槛来改善：信任。(C)2012爱思唯尔有限公司版权所有。
Background: Some services for drug users with mental health disorders can be characterised as low-threshold services. These aim at making help easily accessible for people who are not able to request help from services at higher levels. In this study we examine what kind of thresholds are experienced by clients at a low-threshold centre.Methods: Ethnographic field work, including participant observation, individual interviews and focus group interviews with clients and staff in a low-threshold centre for the most vulnerable drug users in Oslo were employed.Results: Our analyses agree with other studies in showing that the following three thresholds are significant, also in services for drug users with mental health disorders: the registration threshold, the competence threshold and the threshold of effectiveness. In addition to these, we suggest that a fourth threshold is of importance for this group: the threshold of trust. In the low-threshold centre we studied, we observed that for the clients, crossing the threshold of trust seemed to be an essential precondition for subsequently being able to cross the other thresholds in order to receive the help they need. We suggest that focus on the four thresholds can improve our understanding of clients' access to services. We also suggest that processes of recovery may be improved if increased attention is given to the barriers that clients experience.Conclusion: The threshold of trust seems to be particularly important for people suffering from drug problems and mental health disorders. The results have implications both for practice and policy because if taken seriously into consideration, more clients could access the services they need. Services for this group may be improved by focusing on the fourth threshold: trust. (C) 2012 Elsevier B.V. All rights reserved.