Standard Description of Adicction Services in Andalusia (Spain) to inform service planning

Andalusia's social and health administration is developing a new Strategic Plan for Mental Health and Addictions. The diagnosis of the current service provision faced challenges related to defining meaningful study units (commensurability issue) and addressing the diversity of care within the same administrative typologies (terminological issue). This communication aims to describe and classify addiction services, analysing their provision in Andalusia (2023) while overcoming both methodological issues.

The Description and Evaluation of Human Services and Directories (DESDE) system was applied to describe and classify addiction services based on their main activities. The study included public access and specialised services, encompassing both general and specific diagnoses, from the social, health, and justice sectors. Service managers completed a questionnaire with key information. The analyses included calculating availability, capacity, and workforce rates per inhabitant.

Andalusia held 181 main types of care delivered across 179 care units provided by 96 providers, including public agencies and not-for-profit organisations. When considering mental health services, addiction services comprised approximately 25% of the total. Nine different types of care were used to describe these services. Services were targeted to any addiction (n=170), offenders (n=11), and specific diagnoses such as alcohol and gambling. The services delivered outpatient care (69%), residential/hospital care (24%), daycare (4%), and accessibility to care (3%). The placement capacity was 607 beds and 430 daycare places. The services employed over 900 professionals, predominantly including social workers, instructors, clinical psychologists, and physicians.

While most services were described with only one type of care, indicating precise functions, some services within the same administrative typology delivered different care. Thus, administrative typologies should be defined more clearly to prevent care inequities. Furthermore, the availability of community residential care should be increased. The service classification provided an accurate and helpful picture of the provision to inform and support the new plan.