The Office of the Assistant Secretary for Planning and Evaluation (ASPE) within the U.S. Department of Health and Human Services published a brief that identifies, summarizes, and provides possible solutions for key challenges rural communities face in regards to the intersection of parental substance use and child welfare. The research team conducted a literature review, interviewed subject-matter experts (SMEs) from relevant fields, and reviewed relevant gray literature and articles recommended by SMEs and ASPE staff. Rural communities have a significantly higher per capita opioid overdose rate than urban areas as well as higher rates of methamphetamine use. Rural communities also have less capacity to treat substance use disorders, and treatment is further complicated by the increased rate of polysubstance use. Rates of poverty and unemployment are widespread in many rural areas, which increases the risk for both substance use and child maltreatment and further exacerbates the complexity and issues in providing successful treatment. This brief highlights the differences between rural and urban areas, key issues communities face, and potential strategies agencies can employ to improve their services to parents and families affected by substance use disorders. Some of the challenges included the following:
*Limited resources to provide services, including fewer peer-recovery support and family-centered programs, workforce and provider shortages, and a lack of wraparound services
*Limited insurance access and coverage of services
*Rural economics, transportation, and technology limits
*Difficulties with collaboration and information sharing due to informal practices
*Stigma and misinformation compounding problems and willingness to access services
The brief emphasizes the need for better access to services and provides the following potential solutions to offset the barriers rural communities face:
*Increase the local service array to include more family-centered and in-patient treatment options.
*Invest in workforce training and hiring to enhance existing services, including salary adjustments and student loan waivers.
*Co-locate services to alleviate transportation barriers and increase collaboration.
*Implement family drug treatment courts to promote collaboration and improve family outcomes.
*Provide guidance and training on how to share information across service providers.
*Leverage flexible funding to increase parental access to treatment services.
A forthcoming brief will feature promising models for addressing the needs of parents with substance use issues who are engaged in the child welfare system and live in rural communities.
To learn more, read Challenges in Providing Substance Use Disorder Treatment to Child Welfare Clients in Rural Communities.