Occupational therapy interventions for substance-related disorders in the public primary health care sector in the city of Johannesburg.

Abstract

Introduction: Substance-related disorders pose significant intersecting health and social challenges in South Africa. The 2023 Prevention of and Treatment for Substance Use. Disorders Policy emphasizes involving service users in intervention planning, integrating support groups, and incorporating vocational rehabilitation. However, occupational therapy interventions for substance-related disorders in primary health care settings remain unclear. Methods: An exploratory qualitative study investigated substance-related disorder interventions provided by occupational therapists in the City of Johannesburg’s public primary health care facilities. Purposive heterogeneous sampling was used to select eighteen participants consisting of occupational therapists (n=8), multidisciplinary team members (n=6) and service users (n=4). Semi-structured interviews were audio-recorded, written, transcribed verbatim and thematically analysed. Results: Six themes emerged: (1) Individualised approaches to substance-related disorder interventions, (2) Campaigns and screenings, (3) Barriers to service delivery, (4) socioeconomic and contextual influences on substance use, (5) Service users’ experiences with occupational therapy, and (6) Proposed solutions for improved substance-related disorder interventions. Conclusion: Despite challenges in South African public health services—such as underfunding, resource limitations, and staff shortages—occupational therapists in primary health care settings provide numerous occupation-based interventions for substance related disorders. These interventions address occupational performance in individual and group settings, with gardening groups being the most common form of group intervention. Implications for practice: The findings suggest that occupational therapy interventions for substance-related disorders primarily focus on leisure, education, work, psychoeducation, coping skills development, and referrals to learnerships. However, health promotion and substance-related disorder prevention are often underemphasised, with the primary focus remaining on addressing physical ailments. The findings align with the 2008 Prevention of and treatment for Substance Abuse Act, which suggests that occupational therapists, as mental health practitioners, should focus on increasing awareness, prioritising substance abuse campaigns and screenings, and fostering collaboration within multidisciplinary teams.