Qualitative description of outreach and engagement in perinatal substance treatment in Finland

Abstract Background Women with perinatal substance problems experience barriers to care if they do not disclose their health problems. They have specific early intervention needs, they endure societal stigma, and both substances and mental health issues influence the manner how they navigate within support and treatment systems. Early interventions for women with perinatal substance problems are under-researched contexts. Methods We studied an early intervention program designed and aimed at reaching out to pregnant women and mothers with small children, which includes outreach and low threshold elements. The data consist of online written narratives from 11 workers involved in the program and feedback from 504 families in the recovery process comprised of 228 open-ended answers. The data were analyzed with a thematic analysis. Results The programs are characterized by flexibility and the implementation of new methods to approach families. The themes for enhancing relationships and engagement within outreach and low threshold programs are: Acceptance and attitude: a sensitive approach of approval; flexibility within strictness to allow for diversity and individuality; availability and space to ensure calmness in a trustful atmosphere; negotiating via doing to build connections; and everyday life changes: imagining recovery. Conclusions To enhance building connections between workers and women in need of intervention, the entire family situation needs to be acknowledged. Fathers’ or partners’ continuing substance abuse and women’s weak status in a world of substance abuse may make it difficult for women to enter and engage in treatment. One suggestion is to ensure long-term SUD treatment can be initiated during pregnancy. Many families will profit from outreach and low threshold services, so that they will not need to even enter long-standing recovery programs. By informing and messaging about substance-abuse services, for example on social media and other platforms, knowledge about such services will reach those in need. In addition, providing professionals with anti-stigma training and the general public with information about services and SUD treatment may mitigate the stigma related to substance-abuse treatment.