ABSTRACT
Aim: Minimum Pricing for Alcohol (MPA) was enacted in Wales on March 2nd 2020. During the legislative process (i.e. consultation and parliamentary discussion), concern was expressed about the possibility of some drinkers switching to using other substances in response to any rise in the cost of alcohol. This paper reports on findings from a study which explored these pre-implementation concerns and how the policy was shaped. Method: The research involved surveys (n=193) and interviews (n=87) with drinkers (predominantly harmful or treatment seeking) and providers of services. Survey responses were detailed, thus when combined with the interviews, provided a wealth of qualitative data, which are drawn upon in this paper. Results: The findings highlight an expectation that most drinkers would respond to the new policy with adaptations of their coping mechanisms to maintain alcohol use at pre-legislative levels. This was either by switching alcohol products and adjusting their lifestyle to maintain an affordable drinking habit or developing new behaviours to manage additional costs. A small group of those with previous experience of drug use were identified as likely to switch from using alcohol to some other substances. Conclusions: Prior to the legislation being implemented awareness of the detail of the policy was found to be low, and the perceptions of increased potential harm for certain groups, including switching, were linked to concern about a lack of treatment capacity.
ABSTRACT
Cognitive Impairment (CI) screening is recommended for those engaged in harmful levels of alcohol use. However, there is a lack of evidence on implementation. This paper explores the barriers and facilitators to CI screening experienced across a service specifically for older drinkers. The findings draw on data gathered as part of an evaluation of a multilevel programme to reduce alcohol-related harm in adults aged 50 and over in five demonstration areas across the United Kingdom. It is based on qualitative interviews and focus groups with 14 service providers and 22 service users. Findings are presented thematically under the section headings: acceptability of screening, interpretation and making sense of screening and treatment options. It is suggested that engagement with CI screening is most likely when its fit with agency culture and its purpose is clear; where service providers have the technical skills to administer and discuss the results of screening with service users; and where those undertaking screening have had the opportunity to reflect on their own experience of being screened. Engagement with CI screening is also most likely where specific intervention pathways and engagement practices can be accessed to respond to assessed need.
Subject(s)
Cognitive Dysfunction , Mass Screening , Adult , Aged , Alcohol Drinking , Cognitive Dysfunction/diagnosis , Delivery of Health Care , Humans , Middle Aged , Qualitative Research , United KingdomABSTRACT
This paper presents findings from a pilot research project to explore the significance and availability of mental health services in the medium of Welsh in Wales, UK. Based on small-scale research with Welsh-speaking mental health service users this article argues that being bilingual can be a significant factor in the complex biopsychosocial matrix that underpins mental health problems amongst Welsh speakers. It also argues that the destructive effects of linguistic oppression, and the difficulties of second language communication for mental health service users, are such that an appropriate health and social care response in Wales involves providing services in a user's preferred language. Service users' views about the current state of bilingual service provision in Wales are presented, which suggests that insufficient attention is being paid to the linguistic needs of Welsh speakers. Eight principles are proposed for mental health service policy and practice in Wales.
