De Ruysscher Clara, Magerman Jürgen, Goethals Ilse, Chantry Mégane, Sinclair Deborah L, Delespaul Philippe, De Maeyer Jessica, Nicaise Pablo, Vanderplasschen Wouter
Department of Special Needs Education, Ghent University, Ghent, Belgium.
EQUALITY//ResearchCollective, HOGENT University of Applied Sciences, Ghent, Belgium.
Front Psychiatry. 2024 Jul 12;15:1344020. doi: 10.3389/fpsyt.2024.1344020. eCollection 2024.
Persons with substance use disorders (SUD) make up a considerable proportion of mental health care service users worldwide. Since 2010, Belgian mental health care has undergone a nationwide reform ('Title 107') aiming to realize a mental health care system that fosters more intensive collaboration, strengthens the cohesion and integration across and between different services, and is more responsive to the support needs of all service users. Although persons with SUD were named as a prioritized target group, how this reform impacted the lives and recovery journeys of persons with SUD remains understudied. This study aims to investigate how persons with SUD, regardless of whether they have co-occurring mental health issues, experience the accessibility of mental health care in light of the 'Title 107' reform.
Data were collected by means of in-depth interviews with a heterogeneous sample of persons with SUD (n=52), recruited from five regional mental health networks in Belgium. In-depth interviews focused on experiences regarding (history of) substance use, accessibility of services and support needs, and were analyzed thematically.
Five dynamic themes came to the fore: fragmentation of care and support, the importance of "really listening", balancing between treatment-driven and person-centered support, the ambivalent role of peers, and the impact of stigma.
Despite the 'Title 107' reform, persons with SUD still experience mental health care services as 'islands in the stream', pointing to several pressing priorities for future policy and practice development: breaking the vicious cycles of waiting times, organizing relational case management, tackling stigma and centralizing lived experiences, and fostering recovery-promoting collaboration.
物质使用障碍（SUD）患者在全球心理健康护理服务使用者中占相当大的比例。自2010年以来，比利时的心理健康护理进行了一项全国性改革（“第107条”），旨在建立一个促进更紧密协作、加强不同服务之间的凝聚力和整合，并更能响应所有服务使用者支持需求的心理健康护理系统。尽管SUD患者被列为优先目标群体，但这项改革如何影响SUD患者的生活和康复历程仍未得到充分研究。本研究旨在调查SUD患者，无论他们是否同时存在心理健康问题，如何根据“第107条”改革来体验心理健康护理的可及性。
通过对从比利时五个区域心理健康网络招募的52名SUD患者的异质样本进行深入访谈来收集数据。深入访谈聚焦于物质使用（史）、服务可及性和支持需求方面的经历，并进行了主题分析。
五个动态主题凸显出来：护理和支持的碎片化、“真正倾听”的重要性、在治疗驱动和以人为本的支持之间取得平衡、同伴的矛盾角色以及耻辱感的影响。
尽管有“第107条”改革，但SUD患者仍将心理健康护理服务体验为“溪流中的孤岛”，这指出了未来政策和实践发展的几个紧迫优先事项：打破等待时间的恶性循环、组织关系性病例管理、应对耻辱感并集中生活经历，以及促进促进康复的协作。
