Addressing “Diseases of Despair”: A Data-Driven Approach to Enhance Preventive Social Work with Risky Substance Users

Research Problem and Specific QuestionsThe high rate of substance-use mortality among young adults in Sweden has drawn comparisons to the "Deaths of Despair" phenomenon in the US.

By leveraging Addiction Severity Index (ASI) assessments conducted by social workers, this project aims to enhance our understanding of ‘diseases of despair’—including both hospitalization and mortality related to substance-use.

Our objective is to identify key determinants of these ‘diseases’ and analyse their dynamic interaction across different client groups.

By uncovering these underlying dynamics, we aim to improve the preventive efficacy of ASI assessments.Data and MethodThe project links ASI assessment data with registry data.

First, we investigate trends and turning points in the progression of diseases of despair within both the general population and the ASI-assessed cohort.

Then, through Delphi-type workshops with frontline social workers, we identify precursors to diseases of despair within emotional, cognitive, behavioural, and biosomatic domains, using ASI assessment data.

Factor analyses and structural equation modelling (SEM) are applied to investigate how these ‘domains of despair’ interact and influence the risk of ‘diseases’ across different client groups.

Last, we employ survival analysis and SEM moderated mediation analysis to assess the relationship between of our domain indicators and the diseases of despair.Societal Relevance and UtilizationThis project is committed to translating theoretical advancements into practical improvements in social work practices by incorporating the real-world experiences of social workers.

Our collaborative approach involves engaging social workers in identifying empirical indicators of despair domains in ASI-data and in final Delphi-type workshops on how to integrate our research findings into assessment routines effectively.

This dual engagement strategy, facilitated by our key partner Råbe & Kobberstad AB (developers of the NetKlient software used in the ASI assessments), aims to foster practical innovations enhancing the effectiveness of ASI assessment routines.Plan for Project RealizationA multidisciplinary team from Umeå University and the University of Denver, with expertise in social work and public health, will carry out this three-year project.

The collaboration with social workers and IT specialists will enhance the team’s diverse expertise and bridges the gap between academic research and practical application.