One of the largest problems facing society today is substance abuse. The individuals that face this issue are able to receive services from several agencies, whether they need medical health care, mental health care, or drug or alcohol rehabilitation services. They are also able to receive services in all three areas if the individual requests it. (Samet, Friendmann, & Saitz, 2011). While seeking these services, some individual may face the burden of not having health insurance, lack of funds and transportation, or providers may lack the ability to make the best referrals for the individuals.
For instance, if a man with a history of methamphetamine abuse who has been incarcerated is released from prison, he may not have family nearby that can house him, may have no where to turn if there is no agency that can take him and house him. In his case, he will need to secure treatment in an inpatient substance abuse program that will be aggressive enough to help him with his addiction. This will help alleviate him being on the street in search of food, water and shelter which is state in Maslows Hierarch of Needs (Woodside, 2011).
In recent studies, it has been shown that approximately two thirds of homeless adults would meet the criteria for substance dependency. An additional 20 percent of homeless persons meet the criteria for having severe mental illnesses. Many of these individuals have received dual diagnoses, suffering from substance abuse and also having a mental illness. (Krogel et. Al, 1999).
Not only can these clients suffer from substance abuse and mental illness, there can be many other issues they face. Physical disabilities, homelessness, and health issues can be rampant among individuals. Different situations can be the cause of these issues, such as environmental influence or societal changes (Samet, Friedmann, & Saitz 2001). Traditionally, providers would only focus on the issues which are specific to their scope of practice, however, when treating the whole client it is important to remember these issues can go hand in hand. In order to treat one of the issues, a provider must look at how the client got to the point where they are. Treatment, then, would need to be from all models so it would be effective (Samet, Friedmann, & Saitz 2001). For this to take place appropriately, all providers would need to work together with effective and extensive to treat all aspects of issues the client is facing.
If this is not executed correctly, the client cannot succeed and may fall through the cracks, or wind up in the same place they were in previously. For example, the gentleman discussed earlier that was incarcerated and has a substance abuse issue may suffer from a mental illness as well as a substance abuse issue. In this instance, a primary provider would need to find a provider who works with addictions, and a provider who works with mental health. Together, the three professionals would need to form a plan with the client and communicate with every party involved in order for the treatment to be effective. If the primary provider could not provide a professional for the substance abuse and a professional for the mental health, the client could easily fall back into old habits and lose all progress that may have been made. This could result in the client injuring himself or another person, additional jail time, or even death.
The gentleman in this example gives us a perfect example of where the treatment provider has been previously aware of issues concerning the client and is able to find the resources and agencies needed to make the community referrals. Unfortunately, there is a commonality that each treatment provider is faced with a client that only has one single issue. However, in this example, the client has more than one issue ranging from substance abuse to mental illness to homelessness. The provider will then need to determine if the client will need additional assistance with other issues that may be outside our scope of practice. For example, if the provider is working in a substance abuse treatment program the primary focus is helping the client to stop using drugs and/ or alcohol. As the client is no longer supposed to use substances or drink, the client can no longer reside in an environment where substances and/or alcohol are being used; this can become a trigger for the client and risk the clients sobriety and recovery. This client is now homeless and will need assistance with housing.
As the client continues in sobriety the treatment provider may notice that the client appears to be struggling with mental health issues that have not been previously diagnosed; this client will now need to be referred to a mental health provider for further evaluation and possible medication management. The provider has been made aware of these arising situations through communication and effective listening skills while interacting with the client in the group and individual therapy process. The provider will need to be aware of the clients verbal and non-verbal cues as the clients affect may be incongruent with the current situation. The provider will also need to be aware of the clients cultural issues as treatment may cause the client to have stigmatization within his or her family unit. The treatment provider will also have to work with resistant clients, clients who are over demanding, and clients that are unmotivated.
Often times these clients have hidden issues that need to be uncovered and addressed in order to move forward in their recovery process. Working with these clients can be a difficult process however if the provider can find a way of working with these clients in non-traditional manners we will help to uncover these issues and move them forward in their recovery process. Working with clients who have substance abuse issues is a very challenging job that poses many challenges not only for the client, but also for the treatment provider.
We have chosen to work in a field that is extremely broad and which spans across many scopes of practice. Our clients face a wide range of issues that can be ever changing. Our jobs as Human Services workers will be to help identify and treat these clients and their individual needs to improve the clients level of functioning within the community and his or her family unit needs to provide the client with the best treatments and solutions.
Samet, J, MD, Friedman, P, MD, Saitz, R, MD (2001). Benefits of Linking Primary Medical Care and Substance Abuse Services: Patient, Provider, and Social Perspectives. http://archinte.jamanetwork.com/article (Retrieved on 8 April 2013). Koegel, P, Ph.D, Sullivan, G, MD, Burnam, A, Ph.D, Morton, S, Ph.D, Wenzel, S, Ph.D. (1999). Utilization of Mental Health and Substance Abuse Services Among Homeless Adults in Los Angeles. http://journals.lww.com/lww-medicalcare (Retrieved on 8 April 2013). Woodside, M. (2011). An Introduction to Human Services, 7e. www.ecampus.phoenix.edu (Retrieved on 7 April 2013).