Substance Use, Service Provision, Access & Utilization among Foreign-Born Communities in the United States: A Mixed Methods Study.

The prevalence of substance use among the foreign-born has gained increasing attention. Cumulative migration stressors - including historical trauma, violence, family separation, and poverty - present challenges to human service systems wherein services may not adequately meet the needs of these groups. Objectives: This study explores the challenges and realities of substance use, substance use service provision, and delivery of services among the increasingly diverse immigrant population using multiple perspectives. This study is based on data from a larger mixed methods study that assessed the human service landscape pertaining to the immigrant population in a mid-western region of the United States. Methods: This transformative mixed methods study used a community based participatory research approach. Data were collected from human service providers (HSPs), informal service providers, and local community leaders through surveys (n = 64), in-depth interviews (n = 23), and six focus group discussions (n = 48). A weaving approach was used to integrate findings from quantitative and qualitative data. Results: Participants recognize substance use as an issue that needs immediate attention among increasingly diverse immigrant communities. Community members and human service organizations identified several emergent themes including patterns and occurrence of substance use, barriers to care, and proposed system changes. Conclusions: Given that only 28% of responding organizations list substance use as part of their core services, the need for organizational collaborations with a focus on culturally responsive evidence-based services is proposed.