Exploring mental health versus specialized addiction services: who chooses what? An analysis of the Belgian treatment demand register

Thursday, 24 November, 2022 - 09:00 to 19:30

Abstract

Despite the frequency of co-occurring substance use disorder (SUD) and mental illness (MI), addiction and mental health services have developed in parallel in many European countries, including Belgium. This fragmentation of the treatment offer contributes to limited continuity of care and capacity to address the specific needs of people with SUD.

Since visitations to care institutions are socially influenced, both addiction and mental health services could have not only different care approaches but could also address socially differentiated subpopulations. Therefore, we investigated if drug use habits alone explain the disparity between patient profiles of these two care sectors and to what extent individual social-demographic/socio-economic characteristics play a role as well.

Data from year 2019 of the Belgian Treatment Demand Indicator were used to perform multivariate analyses on socio-demographic data and drug use patterns. Logistic regression evaluated the weight of each variable. A decision tree classifier was used to graphically represent the links between explicative variables and the choice of care sector type.

Patients with SUD treated in addiction services are younger, more likely to be men, and to live in precarious conditions (e.g. without any personal income or unstable accommodation) compared to patients treated in mental health services, all other factors being equal (p-value<0.05).

Having problems with other substances than alcohol, especially opiates, cocaine, and stimulants, also substantially increases the probability of choosing a specialized addiction service.

This analysis contributes to identifying the obstacles in the treatment pathways for SUD between the two sectors. It highlights the necessity to enhance the accessibility to mental health services for people with social difficulties and other addictions than alcohol. It also demonstrates the interest in adapting the care offer to patients’ characteristics, for example by implementing addiction programs targeted to women’s needs in mental health services.

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