Barriers in the access to alcohol treatment in outpatient clinics in urban and rural community.

OBJECTIVES The aim of the study was identification of the barriers making it notably more challenging to access clinics in urban and rural communities. METHODS The method, which was used in this study adopts the qualitative research perspective. The research tool was an interview with a standardized list of desired information. The interviews were conducted with alcohol dependent patients and therapists. 64 interviews were performed in two outpatient clinics located in Warsaw, and in rural area. RESULTS Respondents identified similar barriers for the clinics located in Warsaw and in the rural community. Those were: shame associated with seeking help, waiting time for stationary support, meeting intensity, and general clinic condition. Barriers identified by respondents from Warsaw were associated with long waiting time for outpatient treatment and individual appointment, therapeutic offer excluding deaf and mentally ill individuals from the therapy, and unattractive program requiring complete abstinence. Barriers in access to treatment spotted by the respondents from the rural community related to the lack of anonymity of treatment associated with too low number of clinics in the district, lack of choice in terms of preferred facility, commutation time and costs, as well as no inter-institutional cooperation. CONCLUSIONS The barriers identified in the study were similar to the ones specified in the research conducted in Poland in the 1990s, and at the end of first decade of 21st century. Barriers were psychological in character and had the form of internal withdrawal and anxiety to start treatment. Certain structural barriers were indicated as well.