Consumer participation in identifying barriers to Ohio's adolescent alcohol and drug treatment services

Problem. Recent research indicates a need for consumer participation in program decision-making and allocation of public funds. Traditionally, funding for social service programming relied on input from public administrators, policy makers, and the providers themselves; consumers were not necessarily included in this process. This study tests the implicit assumption that public "professionals" or "experts" have the knowledge and can adequately address the needs of the consumer. The question addressed is, "does consensus exists among the stakeholders who participated in Ohio's Adolescent Substance Abuse Treatment Coordination Project?";Methods. The survey concentrated on perceptions of Ohio's adolescent alcohol and drug treatment and the identification of treatment system gaps. The stakeholders are: the (1) Treatment providers (2) Referral agencies, and (3) Families of youth who received Adolescent Alcohol and Drug Treatment services. The sample was composed of 182 family respondents, 103 treatment provider respondents, and 321 referral agency respondents.;Findings. In this study, the assumption that the treatment provider and referral agency stakeholders are the 'experts' and know consumer perceptions of alcohol and drug treatment barriers was not supported. Analysis of Variance (ANOVA) results indicate that there is not consensus among consumers, treatment providers, and referral agencies. In addition, when all the barriers were regressed in a Structural Equation Model the results show that there are significant differences in the perceptions of treatment barriers between the consumers and the referral and provider groups. Treatment providers and consumers agree on only two barrier issues and referral agencies and consumers do not agree on any issues. These findings indicate that consumers offer a different perspective than the other stakeholders and therefore should be an active participant in the decision-making process.;Recommendations. The Ohio Department of Alcohol and Drug Addiction Service has the bureaucratic responsibility to examine the treatment issues identified by the stakeholders. ODADAS should conduct exploratory activities to develop policy and programs to meet the consumer need. Consumers should have a voice in the creation of a coordinated system of adolescent substance abuse services that are accessible and available to Ohio families.