Abstract: The Impact of COVID-19 on Service Delivery to Individuals Using Substances in the Child Welfare System: A Qualitative Case-Study of Providers (Society for Social Work and Research 27th Annual Conference - Social Work Science and Complex Problems: Battling Inequities + Building Solutions)

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The Impact of COVID-19 on Service Delivery to Individuals Using Substances in the Child Welfare System: A Qualitative Case-Study of Providers

Schedule:
Thursday, January 12, 2023
Hospitality 2 - Room 444, 4th Level (Sheraton Phoenix Downtown)
* noted as presenting author
Uwe Wernekinck, MSW, MSc, PhD Student, Ohio State University, Columbus, OH
Elinam Dellor, PhD, Senior Researcher, Ohio State University, Columbus, OH
Bridget Freisthler, Ph.D., Associate Dean for Research, Ohio State University, Columbus, OH
Background and Purpose: With a 28.5% increase in overdose deaths in 2021, the COVID-19 pandemic exacerbated the already existing opioid crisis. Opioid use remains rampant in some states, including Ohio. Parents with an open child welfare case experience disproportionate rates of substance use issues. While some research has examined the effects of the COVID-19 pandemic on the child welfare system, it has mainly focused on issues related to child maltreatment reporting rates or permanency. There is a lack of qualitative research examining how the COVID-19 pandemic has affected individuals’ addiction recovery in this setting and the delivery of services to support them. To fill this gap, the objectives of this qualitative case-study were 1) to explore how the COVID-19 pandemic impacted addiction recovery of individuals with an open child welfare case, and 2) to examine how service delivery in the context of the child welfare system was affected during the height of the pandemic.

Methods: The study’s sample included seven service providers (three recovery peer mentors, three supervisors, one caseworker) linked with the Enhancing Permanency in Children and Families (EPIC) project, a quasi-experimental intervention study targeting substance use outcomes in the child welfare system in rural Ohio. Using convenience sampling, EPIC service providers were recruited via email in the summer of 2021 using the project’s listserv. A total of seven in-depth semi-structured interviews were conducted via Zoom. The sample was predominantly female (85.7%). All participants identified as White. Close to half of the sample (42.9%) was in addiction recovery themselves. Interviews were first transcribed verbatim and then analyzed with NVivo using grounded theory.

Results: Data analysis revealed that the coronavirus pandemic had detrimental effects on individuals’ substance use recovery. Providers described that they were seeing a surge in mental health symptoms and overdoses, increases in loneliness and isolation, and greater need for treatment yet diminished access to behavioral health services. The pandemic underscored already existing barriers related to transportation, housing, finances, and internet access. In terms of service delivery, the COVID-19 pandemic caused drastic changes to the setting and the quality in which addiction treatment services were provided. Providers were forced to engage with parents either virtually or outside. Participants also noted that the virus was commonly used as an excuse to not engage with services. However, there were also positive ramifications, such as providers finding creative new ways to engage with families or attendance rates of case review meetings increasing due to telehealth.

Conclusions and Implications: Interviews with providers revealed that the height of the COVID-19 pandemic created challenging circumstances for individuals receiving as well as professionals providing services targeting substance use problems in the child welfare setting in rural Ohio. The isolation resulting from the stay-at-home-orders was mentioned as one of the most serious obstacles for individuals’ addiction recovery. The study raises important practice question on how families facing addiction can best be supported in a safe yet effective way during future public health emergencies, particularly in the times of the opioid epidemic.