Transcript Problematic alcohol use and traveller men

Problematic Alcohol Use
and Traveller men.
Marie Claire Van Hout
M.Sc Addiction Studies
M.Sc Health Promotion
The Travellers
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The Traveller Community'' have been identified “as
people with a shared history, culture and traditions
including, historically, a nomadic way of life on the
island of Ireland” (Joyce, 2002:9).
The number of Travellers in Ireland has increased
somewhat over the last three decades, but they remain
a minority proportion of the total population (0.6%)
(Census, 2006).
The Traveller Community
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The Traveller community are particularly vulnerable to
problematic alcohol use often exacerbated by
experiences of discrimination, marginalisation, social
exclusion, poor educational attainment, inadequate
housing, compromised health and poverty (Fountain,
2006).
The Traveller culture once offered some resilience to
drug and alcohol misuse, in terms of strong family
networks and anti drug attitudes (Joyce, 2006).
Increasing levels of alcohol abuse and problematic drug
use among Travellers is reported, and occurs in
conjunction with the merging of Traveller communities
with “settled” or mainstream communities.
Travellers and Sustance Use
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There is a dearth of national and regional information
regarding the Travellers and their levels of alcohol and
drug use, due to the lack of ethnic identifiers in health
reporting systems and difficulties in engaging with
Traveller communities.
Localised surveys indicate that male Travellers exhibit
higher levels of both alcohol and drug use, than
Traveller females, and that the Traveller community
report lower levels of drug use than the general
population (NACD, 2007).
Research Design
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The research was part of a large scale funded regional
needs analysis on Travellers and substance use in the
west of Ireland (Western Regional Drugs Task Force,
2009).
The research was qualitative and involved 4 focus
groups with Traveller men (n=19) in the west of
Ireland.
A predevelopment research phase of several months
was conducted in order to build trust and commitment
among the Traveller halting sites in the west.
Research Design
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A peer accompanied approach was conducted whereby
a Traveller male recruited and facilitated the focus
group, in order to garner trust and cooperation with the
researcher.
The focus groups explored themes relating to Traveller
culture and alcohol use, prevalence and patterns of use,
attitudes to alcohol, awareness of alcohol related harm,
current patterns of alcohol use, motives for use,
perceptions of risk, experiences of addiction services
and primary healthcare programmes.
Data Analysis
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A thematic analysis using Nvivo explored the
information gained within the context of illustrative
conversation segments and discussed areas of similar
and contrasting opinions.
The analysis is strongly grounded in the research
information garnered.
The Traveller Perspective
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Traveller culture is traditionally very religious and
religious celebrations (weddings, funerals) are often the
context for heavy drinking and drug use.
Whilst the Traveller men recognised the negative
impact of alcohol abuse on themselves, and their
families, they found that due to high levels of boredom,
depression and stress, they were unable to curb their
alcohol use.
Some Travellers suggested that while they are aware of
Travellers who may have a ‘drink problem’, others
would be ashamed to admit that they have a problem
with alcohol.
The Traveller Perspective
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Almost 100% of Travellers accessing treatment services
in the region were reported to be male, presenting with
alcohol dependency, only attending once or twice and
usually in the advent of a court case.
Alcohol dependency is commonly dealt with inside the
Traveller community, using religion (prayers) and home
detoxification without medical supervision.
Residential and group counselling programmes are
difficult for Traveller men to engage with, in terms of
their difficulties to integrate with members of the
settled community.
The Traveller Perspective
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Addiction and counselling services are also deemed
lacking in culturally appropriate information, cultural
sensitivity and cultural acceptance from health
professionals.
It appears that Traveller culture is dissipating as this
ethnic group assimilates within the “settled” community
and this fragmentation has contributed to compromised
resilience against problematic alcohol and illicit drug
use.
Potential Interventions
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Potential alcohol dependency interventions offering
most promise, include brief interventions of 4-6 weeks
used to engage with and up skill the Traveller men with
alcohol education and counseling skills, and this was
deemed to contribute to improved peer led education
and support within the male Traveller community, and
improved pathways to accessing health and community
services.
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"Travellers listen best to a Traveller"
Conclusion
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Preventative and treatment efforts for problematic
alcohol use in Travellers must incorporate a gender
specific Traveller led approach, as Travellers remain an
excluded group in Irish society.
Services must take into consideration the needs of
Travellers in terms of their life experiences, their
culture, illiteracy, feelings of discrimination and
difficulties engaging with treatment modalities.
“Travellers and settled people working together ... Has to come from
everyone.”
“Travellers accessing services need to be reassured there is
an understanding of their culture and an acceptance of it.”