This document discusses barriers to treatment services for special populations. It identifies two dimensions of barriers: internal barriers related to an individual's perceptions and beliefs, and external barriers involving socio-cultural, environmental, and systemic factors. Internal barriers include stigma, motivation, and privacy concerns. External barriers involve issues with transportation, childcare, homelessness, discrimination, and biases within healthcare and treatment agencies. The document recommends that providers evaluate for biases in diagnosis, consider cultural and spiritual influences, and ask key questions about a client's substance abuse, mental health, cultural, social, and medical issues to provide more inclusive treatment.

1. AODA Special
Populations
Barriers & Bias in Treatment Services

2. Barriers to Treatment Services
What is a barrier? – Characteristics or events that
restrain or serve as an obstacle to treatment
Dimensions
Internal
External
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3. Internal Barriers
Perception
Motivation
Stigma
Recognition of use
Beliefs
Opinions of others
Privacy concerns
Fear of the unknown
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4. External Barriers
 Socio-cultural-environmental factors
 Transportation
 Childcare
 Homelessness
 Communication
 Legal system
 Discrimination
 Health care system
 Options
 Access
 Agency characteristics
 Access & biases
 Treatment style
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5. Bias in Services
Evaluation concerns
Bias & mis/under/over diagnosing
Culture bound syndromes & spiritual influences
Substance abuse providers: What to do?
Review records & clinical information
5 key questions
 Were substance abuse issues included?
 Were MH issues included?
 Were cultural/spiritual issues included?
 Were social/environmental stressors noted?
 Am I aware of necessary medical issues?
Collaborative contact

6. Provider Interventions
Recognition of types of barriers and bias and their
influence on clients
Role of advocacy with barriers
Intervention at clinician level
Intervention at agency level
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