Counselling for alcohol problems in primary care in Forth Valley--an innovative approach?

To explore the implications of establishing a voluntary sector provided alcohol counselling service within a Primary Care setting in Forth Valley Health Board area, and to evaluate the potential of such a project.

Analysis of routinely held information and postal questionnaire survey.

North and South Local Health Care Co-operatives, Forth Valley Primary Care NHS Trust in conjunction with Central Scotland Council on Alcohol (CSCA).

Users of counselling service and local general practitioners.

General practitioners referred a total of 349 people with 284 attending for counselling. Survey of a sample of 80 service users achieved a 45% response rate. Of those who responded a majority (89%) said that the health centre location was an important factor in their ability to use and therefore benefit from the service. Accessibility, quality and confidentiality of the counselling service were important factors determining ability to attend and benefit from counselling. The survey of local general practitioners achieved a 69% response. The majority (96%) of general practitioners reported the service to be either extremely valuable or very helpful. General Practitioners listed 3 major benefits as confidentiality, accessibility and cost effectiveness. A significant minority of general practitioners (24%) reported that they were unaware that the service existed. Compared with other routine CSCA counselling services people's reported alcohol consumption was some 18% higher in those referred to the primary care based counselling service. At review, four weeks later, the average reported alcohol consumption had decreased considerably. People using the counselling service reported that the service helped them reduce their alcohol consumption, improve their general health and their personal relationships.

This project has demonstrated that a voluntary sector agency can work closely and successfully with primary care services in establishing counselling services for those with alcohol problems. Early evaluation would point towards success in terms of reducing reported levels of drinking and improved health. Local general practitioners indicated their support for continued development of this type of service provision.