Sore spots in addiction service provision: professionals’ and experts’ views on a changing field
Ammattilaisten ja asiantuntijoiden tilannearviointi muuttuvasta kentästä
Keywords:
substance use and addiction services, health and social services reform, health and social care professionals, welfare systems, welfare state, welfare society, accountabilityAbstract
The Finnish substance use and addiction service field is in a state of transition. In this study, we map how professionals in this field evaluate its current state. The results point to two sore spots in the realization of the service system’s responsibilities. These pertain to: (i) the internal systemic division of roles and tasks and adherent conflicts, and (ii) the accessibility of services and the preparedness of the system. The participants saw that it is especially important to ensure the functioning of the system through multi-professionalism, to secure a suitable role division between actors and sectors, to balance corrective and preventive services with an emphasis on prevention, and to be aware of and take into account the risk of service fragmentation. In the concluding discussion, we summarize our views on how the principles of welfare state accountability underpin the participants’ reasoning concerning the value of welfare pluralism and the readiness of the system to deal with tensions between universalism and particularism. By emphasizing fairness and possible competition between social and health perspectives, the participants identified a role for the substance use and addiction service field in terms of shifting the responsibility from the individual to the service structures.
