Have the problems gotten worse?

An analysis of how social workers and clients estimate the client's problems and need for help in the areas of mental health, alcohol and drugs over a 14-year period

Abstract

Changing patterns of addiction, increased psychiatric comorbidity pose new challenges for the social service. As part of systematizing the work of assessing and investigating the need for help for people with alcohol or drug problems, Addiction Severity Index is recommended. This descriptive quantitative study examines and compares how social workers and clients estimate the extent of a client's problem in three areas: mental health, alcohol and drugs and that, based on interviewer and client estimates, account for whether the problems are estimated differently over time, from 2003 to 2017. The study includes ASI material for 15,005 people whose need for help for alcohol or drug problems has been investigated and assessed by the social services in 40 Swedish municipalities. The study shows that both clients and social workers estimate an increased problem level for the ASI domains mental health and drugs. For alcohol, the trend is the opposite or unchanged. Overall, interviewer as well as client estimates indicate an increased need for help and support for problems related to mental health and drug use, while the need for help and support for problems related to alcohol is unchanged or decreases over time among social service clients.