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Non-national clients in Belgian substance use treatment


Purpose
Substance use treatment (SUT) among migrants and ethnic minorities is an underresearched domain in European countries, although preliminary studies point out disparities in treatment use and access compared to general populations. This paper aims to identify the main characteristics of and the types of services solicited by non-nationals in Belgium.


Design/methodology/approach
This paper compares the types of SUT services used by Belgian and non-national clients. Second, the referral source for Belgian and non-national clients is considered. Third, the study compares the client characteristics of Belgian and non-national clients. This descriptive analysis is based on aggregated data sets in the European treatment demand indicator (TDI) registry including all Belgian treatment episodes between 2012 and 2014.


Findings
Non-national clients were more often located in outpatient SUT and were less often referred by general practitioners and hospitals, compared to Belgian clients. Third-country clients appear to have lower socioeconomic statuses (education, employment, housing) than Belgian clients. Non-national youngsters and third-country females appear to be underrepresented in Belgian SUT compared to their presence in the general population. The gender gap is larger among third-country clients than among Belgian clients.


Research limitations/implications
These associations between nationality and solicited services, gender, education, employment, housing and referral document treatment gaps among some non-nationals that require special attention in targeted treatment. In the European context, further research is needed on better monitoring migration background in the European TDI registries.


Practical implications
The overrepresentation of non-nationals in low-threshold opioid substitution treatment services and their underrepresentation in high-threshold residential services requires an in-depth analysis of the core goals of these respective services. Residential services, for instance, should consider how a dominant focus on speech therapy hampers access to treatment for these populations and how access for these populations could be enhanced by modifying or diversifying methods in treatment.


Originality/value
To the best of the authors’ knowledge, this is the first paper that analyses the national indicator in a European TDI data set.
