Improving access to hard-to-reach services: a soft entry approach to drug and alcohol services for rural Australian Aboriginal communities.

Australian Aboriginal communities are concerned about drug- and alcohol-related harms in their communities. There are a significantly higher proportion of substance problems experienced by Aboriginal Australians than non-Indigenous Australians. Ways to address these problems are limited by racial barriers to mainstream services, especially in the rural context. Soft entry was an approach designed to increase Aboriginal Australians' access to Drug & Alcohol (D&A) services. The approach was designed to put control over when and how D&A interventions were delivered in the hands of the community and individuals within it by giving them ready access to a human services worker with specialist knowledge. Quantitative and qualitative evaluation methods found that soft entry substantially increased the number of Aboriginal and non-Aboriginal women accessing drug and alcohol services. It fundamentally shifted the power relationship between counselors and community, providing opportunities to develop a non-stigmatizing trustful rapport to facilitate discussion of harmful substance use. The challenges for drug and alcohol counselors were the slow unpredictability of the approach and the need for highly skilled and responsive communication techniques. However, the factor most likely to improve access to services, once trust is developed, is regular and frequent attendance at the service delivery site.