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Introduction: Pregnant women and mothers experiencing substance use disorders (SUD) face unique barriers to accessing health care services, and many avoid antenatal care out of fear of social and legal sanction. Mothers' groups are a worldwide practice that women with SUD generally exclude themselves from due to fear of judgement and feelings of guilt and inadequacy. Specific mothers' groups for women with SUD may provide a biopsychosocial approach to SUD treatment and facilitate greater healthcare access. This study examines the experiences of women and health care providers involved in a mothers' group for substance using women in Sydney, Australia. Aims and Methods: The study examined the experiences of participants in, and providers of, a mothers' group designed specifically for women with SUD and lead by a multidisciplinary team. Two existing qualitative data sources were analysed to examine staff and consumer perceptions of the mothers' group. One study involved qualitative interviews conducted with 38 healthcare professionals involved with women with SUD. The other study aimed to provide an understanding of drug using women's health care engagement and involved interviews with 13 women and 12 healthcare providers. NVivo was used for thematic coding using deductive and inductive codes. Key Findings: The analysis identified four themes: (i) positive engagement with healthcare, (ii) ability to provide childcare in an informal setting, (iii) the provision of education and parenting skills and (iv) opportunity for harm reduction. The study found that both healthcare workers and women valued the relaxed, safe, non-judgmental environment the mothers' group provided which enabled a more flexible and casual way for women to engage with health and community services as well as inferred a sense of trust in the system. The mothers' group also delivered an additional avenue for early intervention or harm reduction by providing a safe place for women to talk about their treatment progress and to raise any concerns. This outlines the importance of a mothers' group specifically for women with SUD, particularly regarding healthcare access for both mother and child and managing the challenges of nuanced harm reduction messages in the context of parenting. Conclusions: The multi-faceted aspect of the mothers' group allowed support to be provided at a time when these women are extremely vulnerable. The playgroup was found to facilitate ongoing contact with healthcare services and enhanced social connections for the women. It is a unique environment highly suitable for this group of women. [ABSTRACT FROM AUTHOR]

Introduction: People with histories of illicit drug use often have myriad unmet health and psychosocial issues and many live in profound social disadvantage. Fear of stigmatisation, of being perceived as undeserving and unworthy citizens, and historic and systemic discrimination of those engaged in socially stigmatised and criminalised behaviour, create barriers to social and health services for people who use drugs. In light of these service barriers, health services are increasingly focusing on offering more consumer appropriate and integrated care services. A health justice partnership (HJP) model is one such model which involves the provision of legal services within a health service. Aims, Objectives, Theory or Methods: This study focused on such a partnership located at a drug treatment clinic within a major inner-city hospital in Sydney, Australia. Intake files were analysed to examine characteristics of clients accessing the service and clients' experience and satisfaction with the service was gleaned through in-depth qualitative interviews. With clients' consent, HJP solicitor provided an overview of clients' legal records and the research team reviewed clients' medical records (2017-2018). Convenience sampled interviews were also conducted with clients who had used the HJP. Highlights or Results or Key Findings: Between December 2014 and May 2018, 427 clients presented to the HJP. Most clients were women (79%) and Aboriginal people were overrepresented (39%). Clients presented for a range of reasons including child protection issues (27%), family law (17%), tenancy issues (15%), debt and fines (12%) or family and domestic violence (8%). Disadvantaged clients were over-represented and thus the service was accessed by the key target groups. Qualitative interviews with 12 clients (eight females and four males aged 28-52) revealed mutual respect, trust and honesty; accessibility and flexibility; and continuity-of-care as key aspects of HJP success identified by clients. Legal privilege - the ability to seek help without risk of mandatory reporting - was also an important feature of the service. Other benefits included personal self-belief, earlier intervention, de-escalation of legal issues, skills for operating in other health and mainstream services, and positive social, material and health outcomes, directly and indirectly, related to the legal issue being addressed. Conclusions: The HJP was highly accessed by disadvantaged clients. These clients were seeking justice in the areas influencing their social determinants of health including child protection, housing and debt related issues and the service was able to provide non-judgmental compassionate care in a flexible and accessible manner. Implications for applicability/transferability, sustainability, and limitations: Drug treatment services appear to be excellent homes for HJPs, and especially beneficial for people who use drugs as immediate concerns about illegality may take precedence over health concerns. However, findings pertain to consumers experiences with solicitors operating within a drug treatment service, so caution should be applied to generalisations. [ABSTRACT FROM AUTHOR]