Treatment Barriers to Social and Health Care Services from the Standpoint of Female Substance Users in Finland

Abstract

This qualitative study discusses barriers affecting female substance user’s treatment access to welfare services. The study consisted of seven group discussions and three individual meetings with 13 women in Helsinki, Finland. Institutional ethnography was used as the theoretical framework for the study. The research questions are: (a) What treatment barriers do women face?, (b) What reasons are there for them not receiving services?, and (c) How do the ruling relations coordinate women’s experiences? Women faced multiple barriers affecting their access to services. They could be interpreted as being: determined by the service system, such as a difficulty in meeting the various criteria in order to be granted access to services; determined by the lack of trust; or determined by personal choices. The study suggests that the service system should be organized according to the needs of the service users. Future research is needed to address the questions such as how social and health care services could better co-operate, and how the different sectors of the service system could break down the institutional barriers.

Keywords:

• Women
• substance abuse
• service system
• institutional ethnography

Notes

1 For more information: http://alueuudistus.fi/en/frontpage; https://www.thl.fi/en/web/social-welfare-and-health-care-reform.

2 The information letter given to women was as follows: “My aim is to consider the social and health care system with the help of your experiences. It does not matter if you have not used these services for a while, you can still take part in XX-project. If you have needed services from doctors or social workers (for example) at some point in your life, but for some reason you had not sought support, you are just the right person to help me with my study. I would like to hear why you do not seek or receive support from the system. If you use some services (e.g. Vinkki [the Drop-In Needle Exchange program], health care centre, or social work office), I would like to hear why you use those services and what experiences of them you had. How have you been treated, what has gone well and what perhaps not so well?”

3 All names are pseudonyms. Slashes refer to breaks in the speech, a short break is shown as one slash, /, and two slashes, //, mean a longer break of over one second. Empty parentheses, ( ), refer to unclear speech. Square brackets, [ ], between speakers show overlapping speech between speakers, while within the text they show implied concepts that might be necessary in order to follow the direction of the speech. The discussions were conducted in Finnish. The extracts have been translated into English in a manner allowing for the original form to be preserved as much as possible.