A. PREVENTION AND EDUCATION: SUPPORTING FAMILIES AND YOUNG PEOPLE
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Supporting families through prevention and early intervention programs
6.1 That the most effective measure for preventing alcohol related harm is supporting families to be strong and effective. This will do three things:
6.1.1 prevent adults abusing alcohol
6.1.2 assist young people to make wise choices about alcohol
6.1.3 assist early intervention in cases of developing misuse by family members.
Programs supporting effective parenting, such as Families First, be provided as a fundamental platform for long term prevention of alcohol related harm.
6.2 Parenting support be provided to identified vulnerable families as a preventive measure for abuse of alcohol and other drugs. |
Government Response
The Government recognises the importance of supporting families and effective parenting to reduce problems associated with alcohol misuse through prevention, education and intervention strategies.
Key Government prevention and intervention strategies are currently assisting families, parents and young people, including:
§ Families First which helps parents give their children, aged 0-8, a good start in life (Rec. 4.17)
§ Vulnerable Families Project which supports first-time families of children aged 0-5 years (Rec. 4.17)
§ Primary Connect which works with vulnerable primary school children and their families (Rec. 6.10)
§ Better Futures strategy which focuses on vulnerable young people aged 9-18 years and their families (Rec. 6.10)
§ Centre for Parenting and Research established by the Department of Community Services to develop parenting resources, promote community awareness of positive parenting practice and conduct research (Recs. 6.26 and 6.28)
§ Schools as Community Centres which improves support for families with young children up to eight years old (Rec. 2.30)
§ Strengthening Communities Unit in the Premier’s Department which helps communities and families
§ Community Solutions and Crime Prevention Strategy which funds crime prevention initiatives in targeted local communities, including community based initiatives that assist vulnerable families and young people
§ Getting it Together scheme to help vulnerable young people to engage with employment, education, training and in some cases reconnect with family (Rec. 6.11)
§ Department of Community Services trial projects in two locations to support families with drug and alcohol using adolescent children (Rec. 6.4)
§ Community Services Grants Program which provides for youth and family support projects (Rec. 6.11).
The role of General Practitioners, pharmacists and other frontline workers in helping families to address alcohol related problems will also be strengthened through improved training on alcohol and drug use (Recs. 3.3-3.5, 4.22, 7.3-7.8 and 7.20).
Specific alcohol related initiatives targeting families are also being implemented (Recs. 1.10, 1.11, 2.19, 2.22, 2.23, 2.30, 3.13, 4.17, 7.8, 8.21, 8.49 and 8.50).
In addition, under the Commonwealth/State Strengthening and Supporting Families Coping with Illicit Drug Use Measures of the National Illicit Drug Strategy, NSW is implementing a number of initiatives. These include information services, training for families and carers of people with serious drug and alcohol problems and community based services which deal with such families, a dual diagnosis information kit, and targeted initiatives for specific population groups.
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Evaluation of education programs for parenting around alcohol use
6.3 All education programs for parenting and alcohol use have a strong evidence base for both the content and delivery mechanism. Existing research on ‘what works’ must be utilised. |
Government Response
The Government recognises that research and evaluation of projects is important for assessing performance and informing future planning. The Government’s plans in relation to research and monitoring of alcohol related parenting programs are outlined at Recommendations 1.10, 1.11 and 2.20. The new Alcohol Information and Education Taskforce will assess existing strategies, in order to identify appropriate approaches or models for parenting information on alcohol use (Rec. 1.3).
Reporting and evaluation of programs generally and their impact in reducing alcohol related problems is addressed at Recommendations 2.2 and 2.4. Information on supported research directions are outlined at Recommendations 6.26, 6.27 and 6.28.
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Information and education for families and young people to reduce alcohol
6.4 Education be provided on responsible use of alcohol and the consequences of irresponsible use of alcohol. This should:
6.4.1 acknowledge that alcohol is a drug with potentially deleterious effects
6.4.2 be in developmentally (age) appropriate modules
6.4.3 support those who choose not to drink alcohol
6.4.4 commence from an early (primary school) age
6.4.5 engage both parents and children and use both school and home settings eg. Fact Packs
6.4.6 be targeted to Indigenous and culturally and linguistically diverse groups in culturally effective ways
6.4.7 be targeted to specific gender groups (eg. adolescent males) where appropriate
6.4.8 be universally accessible in New South Wales
6.4.9 include easily accessible information on where to get help.
6.6 Given the importance of parenting to the health and wellbeing of young people, the NSW Government should develop and implement a state-wide, culturally relevant program that informs parents about normal adolescent development and behaviour, and supports them in parenting adolescents effectively. |
Government Response
Over the next four years, coordinated community alcohol information programs about safe and responsible drinking will be undertaken by a range of NSW agencies and non-government organisations. The Alcohol Education and Information Taskforce will oversight these programs (Rec. 1.3).
Current and proposed Government action concerning education and information for families, parents and young people about the harms of alcohol abuse is outlined in response to similar recommendations (Recs. 1.2, 1.10, 1.11, 2.19, 2.22 and 2.23).
The Department of Community Services will undertake new research on ways to improve support for parents and carers in managing alcohol abuse within the family setting. This research will be promoted through the Department’s website and will form the basis for a range of initiatives to provide information and support to families.
A special project will also be trialled in two locations by the Department of Community Services in 2004/2005 to support families with drug and alcohol using adolescent children. A mix of family support and adolescent/family counselling will be provided to families where young people are at risk of problems associated with using alcohol and drugs. Families with young people (aged 10-17 years) contemplating leaving home or who have recently left home will be targeted. One of the trials will assist Aboriginal families.
Education modules on drug and alcohol are provided in both primary school and high school. All materials and programs are developed to be appropriate for the age and development of students (Rec. 1.11). Schools can assist in enhancing the protective factors that build resilience and lessen the impact of adverse events through Personal Development, Health and Physical Education (PDHPE) program, mentoring programs, transition programs and mental health programs. See responses to Recommendations 2.28 and 2.29 relating to school based responses.
Education on alcohol and its misuse targeted at Indigenous communities will include a new information and education program for families and carers of people with an alcohol or drug problem in Aboriginal communities in New South Wales. New resources will be delivered in 2004 through culturally appropriate channels (Rec. 1.12).
The Department of Education and Training will continue to support the implementation of the Healing Time resources in government primary and secondary schools. The resources provide culturally appropriate drug education to engage students, particularly Aboriginal students, staff and the school community. Professional learning workshops are planned for Western New South Wales, New England and North Coast regions during 2004 to support the implementation of Healing Time Stage 4 (Years 7-8).
School based information targeted at culturally and linguistically diverse families and students will also be supported by initiatives outlined in Recommendations 1.10 and 1.11.
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Peer support for young people at risk
6.5 Consideration be given to establishing peer support mechanisms for young people at personal risk or impacted by family alcohol abuse, including state based, community based and school based programs. |
Government Response
Peer support mechanisms are being implemented and expanded including state-wide, community and school based programs (Rec. 1.11).
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Supporting families coping with alcohol related problems
6.7 In supporting families to cope with alcohol related issues it is recognised that these issues can arise in any family - not just where identified risks are present. All affected families need to be supported by strategies that:
6.7.1 help develop coping skills and resilience
6.7.2 provide resources that give information about the dependency cycles and also treatment options
6.7.3 encourage care and respite for families and carers
6.7.4 provide effective crisis intervention. |
Government Response
The Government recognises helping families in times of crisis can be a key to successfully preventing alcohol abuse and its effects in the long-term. In particular, the Department of Community Services has a growing focus on a prevention and early intervention framework.
Through the Department of Community Services Early Intervention Program, and other related programs, the Government funds many projects which support families, particularly families which may be at risk of drug and alcohol problems. These include:
§ Family Support Services funded by the Department of Community Services with over $20 million per annum, which work with vulnerable families including those with drug and alcohol dependency issues to develop coping skills, improve parenting skills, provide information about treatment options and encourage care and treatment for families and carers Two examples are the Intensive Family Based Support Services for Arabic families in Bankstown, and the Walla Mulla Family Support Service in Kings Cross and Woolloomooloo (Rec. 8.49).
§ The Families First strategy (Rec. 4.17) which provides early intervention support to families with children from 0 to 8 years of age. Sixty-one family worker services are funded under this Strategy across New South Wales.
§ The Intensive Family Preservation Service which aims to prevent disintegration of Aboriginal families in times of crisis and where child protection concerns exist. New services are being established in Bourke and Wollongong.
§ One hundred new caseworkers who will be allocated in 2003/2004 and 2004/2005 to increase capacity within the Department of Community Services out-of-home care services.
§ The Vulnerable Families Project which supports first time families, where there are a number of vulnerabilities, including parents with alcohol misuse issues and where the child may be at risk of entering the child protection system (Rec. 4.17).
§ Programs funded under the NSW Aboriginal Family Health Strategy which respond to family violence, sexual assault and child abuse issues in Aboriginal communities (Recs. 8.50, 8.65 and 8.66).
§ The Training Programs for Families and Carers of Drug Users project which has been developed under the National Commonwealth/State Strengthening and Supporting Families Coping with Illicit Drug Use Measures of the National Illicit Drug Strategy for launch in 2004. Resources include a workers’ kit, a take-away kit for families and carers and other material. Familiarisation training of up to 425 generalist workers across all Area Health Services will be delivered by the Centre for Community Welfare Training.
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Preventing domestic violence, family violence and sexual assault
6.8 Misuse of alcohol is linked to high levels of domestic violence, family violence and sexual assault and serves to reinforce pre-existing patterns of abuse. Consideration should be given to:
6.8.1 development of women’s leadership programs designed to combat alcohol abuse and family and domestic violence
6.8.2 undertaking research designed to explore the intersection of sexual assault, domestic violence and alcohol abuse
6.8.3 piloting an alcohol rehabilitation service including anger management counselling targeted at families experiencing domestic violence
6.8.4 developing guidelines for government and non-government workers for supporting children whose parents are affected by alcohol abuse and domestic violence
6.8.5 requiring that the protection and developmental needs of young children are paramount in situations where there is a conflict between the needs of the alcohol or substance abusing carers and those of the child
6.8.6 exploring the further development of locally based community controlled programs such as night patrols which are supported by appropriate ancillary services
6.8.7 refocusing, where possible, current NSW violence prevention strategies, such as the NSW Strategy on Violence Against Women to early intervention and prevention
6.8.8 developing preventative programs that recognise the impact of domestic and family violence on the crucial developmental stage of pregnancy
6.8.9 identifying and implementing the most effective models of service delivery to respond to family violence and sexual assault (eg. co-located Police-DoCS domestic violence teams). |
Government Response
This recommendation is being addressed in the following ways:
Women’s leadership programs to combat alcohol abuse in domestic and family situations are promoted by the Office for Women, and by projects funded by the NSW Strategy to Reduce Violence Against Women.
Research concerning domestic and family violence has been conducted by both the Office for Women and the Attorney General’s Violence Against Women Specialist Unit. Government commitments in this area are outlined in the NSW Action Plan for Women, the Strategic Framework to Advance the Health of Women and the Violence Against Women strategy. (See www.agd.nsw.gov.au/cpd.nsf/pages/vawsu_index and www.women.nsw.gov.au/publications/publica2.html)
Counselling and support and initiatives for families affected by domestic violence are outlined in Recommendations 8.63-8.67 and 9.34.
Most perpetrators are men and programs to increase support for interventions for male perpetrators, including anger management programs, are outlined in Recommendation 8.67.
Guidance for workers supporting children whose parents are affected by alcohol abuse and domestic violence is outlined in the NSW Domestic Violence Interagency Guidelines, the NSW Health Domestic Violence Policy, the NSW Health Frontline Procedures for the Protection of Children and Young People, and the NSW Health Neonatal Abstinence Guidelines.
These guidelines will be further supported by the finalisation of NSW Health Interagency Guidelines for the Early Intervention, Response and Management of Drug and Alcohol Misuse which are expected to be released to health services, other agencies, and the NGO sector later this year.
Protection of children where there is a conflict between the needs of the alcohol or substance abusing carers and those of the child is covered by the Children and Young Persons (Care and Protection) Act 1998 and the NSW Health Frontline Procedures for the Protection of Children and Young People.
The Education Centre Against Violence also provides a range of specialised training, consultancies and resource development for NSW Health and government and non-government workers who provide services to adults and children who have experienced sexual assault, domestic and family violence. The Centre is developing an Aboriginal Communities Protecting Children Project with the NSW Commission for Children and Young People. The project includes development of a child protection community education manual and an interagency pool of skilled workers.
NSW Health has also established the Physical Abuse, Emotional Abuse and Neglect of Children (PANOC) services - specialist services for children (and their carers) that have experienced abuse.
Night patrols and community programs are being expanded (Recs. 8.54, 9.27 and 9.28).
Over the next four years the Attorney General’s Violence Against Women Specialist Unit and the NSW Health Education Centre Against Violence will be asked to give particular focus to violence prevention strategies concerning domestic and family violence (Rec. 8.66).
The Government will continue to support prevention programs to reduce the impact of domestic and family violence on the crucial developmental stage of pregnancy, including:
§ Under NSW Health Domestic Violence policy, domestic violence screening for all drug and alcohol facilities and antenatal services is to be implemented over the next year.
§ NSW Health is developing an antenatal screening tool that will include screening for alcohol and drug use. This will be used in all public maternity hospitals at the 20 week antenatal visit.
§ Through Area Health Services, models are being developed to visit families in their homes, starting antenatally. One example is the Aboriginal Home Visiting Service in the Macarthur area that provides ante and post natal support to Aboriginal families who are expecting a new baby.
For additional information on pregnancy screening standards see Recommendation 4.12.
Models for service delivery that respond to family violence and sexual assault are outlined in Recommendations 8.63-8.67 and 9.30-9.34.
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Strengthening families through education and employment opportunities
6.9 Develop ways of supporting individuals to maximise the chances of gaining access to educational and meaningful employment opportunities, as these are fundamental to family capacity building. |
Government Response
Supporting people, particularly young people, to build protective factors through better education and job opportunities is an important component of a number of NSW Government programs. To assist young people to access educational and employment opportunities through schools, the Department of Education and Training funds School to Work Planning programs, Careers Expos, Summer Schools and Vacation Schools for senior students.
Other programs for young people who are vulnerable to dropping out of school are currently being implemented:
§ Bridging the Gap, a cross sectoral program in St Mary’s supporting young people aged 14-16 years who are at risk of dropping out of school or who have left school prior to completing Year 10.
§ Central Coast Connect Program involving local community agencies providing career planning and guidance to support young people at-risk in their transitions from school to work, or further education and training.
§ After Hours HSC Coaching supporting Aboriginal and educationally disadvantaged students in the senior years of schooling.
§ Homework Plus providing homework centres for young people in selected districts as part of the Youth Partnership with Arabic Speaking Communities project.
§ Coordinators Equity Projects (five projects) across the State assisting schools develop and implement innovative programs for young people at-risk.
§ Links to Learning which develops local partnerships to provide a range of ‘next-step’ options for young people when they finish their Links to Learning activities.
§ The Gateways Program Community and Learning Network - all secondary schools in the Fairfield area use case management approaches for those 12-17 year old students who are at risk of not completing Year 12.
See also Recommendation 2.29.
In addition, the Pre-employment Skills Training and Mentor Support Program (PST) assists clients of Juvenile Justice who are subject to a supervised court order, and assists access to relevant education, training and employment.
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B. PROTECTING YOUNG PEOPLE: REDUCING ALCOHOL HARM
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Young people: managing and reducing risk taking behaviour
6.10 Programs directed at young people designed to decrease alcohol related harms need to acknowledge that risk taking, novelty-seeking and a preference for peer-group social relationships are normal, adaptive, biologically grounded responses in adolescents during their transition from the dependence of childhood to their independence as adults.
6.11 Promoting and supporting positive relationships and connections between young people, their friends, their schools and their communities reduces harmful risk taking behaviour including a reduction in harm caused by alcohol and other drugs. Develop increased support and coverage of programs that support positive youth development (such as Better Futures).
6.14 Explore innovative ways to address high risk alcohol drinking such as binge drinking by young people including consideration of establishing safe, supervised venues where responsible use of alcohol can occur. |
Government Response
Promoting and strengthening the connectedness of young people at risk
The Government has in place a range of prevention and early intervention programs and initiatives to target at-risk young people, to promote their connectedness to their family and the community, and to reduce their overall risk of harm through risk taking behaviour such as binge drinking or drinking at harmful levels. Key initiatives include:
§ The Better Futures strategy aims to improve health, education and safety outcomes for vulnerable young people aged 9-18 years. In 2003, six evidence based demonstration services started in Wollongong, Broken Hill, Cessnock, Gosford, South East Sydney (Menai) and Western Sydney (Penrith) which target young people at risk of disconnecting from their families and/or communities and getting involved in risk taking behaviours like alcohol abuse. Consideration will be given to further future expansion of the program.
§ The Primary Connect program targets vulnerable primary school children (and their families) who are potentially at risk of disconnecting from school early, at risk of misusing drugs or in a family situation where there is alcohol or drug misuse, at risk of offending or self-harming behaviour, or suffering from mental or physical health problems. Primary Connect is being trialled in seven locations in New South Wales - Bidwill, Fairfield, Guise, Miller, Warrawong, Lake Heights and Alexandria Park Public Schools. Consideration will also be given to further future expansion of the program.
§ The Getting It Together scheme offers funding to organisations to develop specialised services for vulnerable young people who are unwilling or unable to access conventional youth services. These services assist them to break the cycle of homelessness and allow them to achieve a stable living environment.
§ The Community Services Grants Program funds organisations supporting young people and their families. In 2003/2004, $20 million was provided for 332 youth support projects which included individual and family counselling, case work, group work, outreach support, recreational activities, and advocacy and referral options.
Tackling high risk binge drinking by young people
The Government has rejected the recommendation to establish a designated area for supervised underage drinking.
The Government is, however, strongly committed to reducing alcohol harm for young people in New South Wales. Alternative strategies to tackle risky drinking behaviour include:
§ continuing to provide targeted education and information campaigns that address the needs of young people in relation to alcohol abuse (Recs. 1.11 and 5.2)
§ continuing to provide a wide range of treatment and care services for young people who abuse alcohol or are alcohol dependent (Recs. 3.9, 3.21 and 3.22)
§ introducing new measures to prevent injury and harm for young people, including reducing child drowning associated with alcohol use and imposing a zero alcohol limit on Learner and Provisional licence drivers (Recs. 5.4 and 5.9)
§ providing programs and services that will divert underage drinkers from the criminal justice system, such as making greater use of the Young Offenders Act 1997 to deal with minors who breach the liquor laws and trialling a Circle Sentencing model for youth or juvenile offenders (Recs. 8.16 and 9.25)
§ continuing to prevent young people’s access to alcohol (Recs. 8.8, 8.9, 8.10, 8.11, 8.12, 8.15 and 8.23).
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Alcohol free entertainment and recreation opportunities for young people
6.12 As an alternative to high risk alcohol consumption, enhance low cost, accessible, safe entertainment and recreation opportunities for young people. |
Government Response
The Government is committed to providing a range of programs that provide entertainment and recreation opportunities for young people. These include:
§ Music NSW, with funding from the Office of Children and Young People, has been successfully running the Indent program since 2000. This program provides grants to young people to produce safe drug and alcohol free entertainment for their peers. Indent promotes youth development and fun without drugs and alcohol. Since October 2000, Indent has funded over 300 safe, alcohol and drug free, all ages events across New South Wales.
§ The new Indent program will encourage local projects to work with police youth liaison officers, Community Drug Action Teams, Police and Community Youth Clubs (PCYCs) and crime prevention officers to ensure that local events are supported and monitored by local authorities. Around 75 Indent partnership funded events will occur in 2004.
§ Over the next three years, the Indent program will focus on rural and remote areas, which will impact on the concerns of Aboriginal young people. It will also be independently evaluated.
§ Some venues in New South Wales are able to host alcohol free entertainment for young people under 18 years of age. These venues must hold a minors functions authority from the Licensing Court of NSW. The Department of Gaming and Racing has produced a guide to help hotel and nightclub licensees, and club secretaries to run safe and viable alcohol free functions on their premises for young people under 18 years of age. The Department of Gaming and Racing will review the operation of alcohol free entertainment provisions in the liquor laws to ensure they do not unreasonably prevent conduct of this entertainment by licensed venues.
§ Local Aboriginal groups, as well as Community Drug Action Teams (Rec. 1.5) in New South Wales have taken part in a national annual event, the Croc Eisteddfod Festival which started in 1997. The Croc Eisteddfod is a two to three day event, jointly funded by a number of agencies including the Alcohol and Education Rehabilitation Foundation. It builds partnerships in regional and remote communities by celebrating youth culture and involves young people in visual and performing arts, sports clinics, careers markets in a 100 percent drug and alcohol free environment. The festivals promote health, education and employment in a spirit of reconciliation.
§ The NSW Department of Tourism, Sport and Recreation will continue to implement the Youth in Sport (YIS) program, which aims to give young people at risk of coming into contact with the criminal justice system a chance to develop self esteem and skills that will assist them keep out of the criminal justice system. The program is conducted in partnership with PCYCs throughout New South Wales.
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Local responses to minimise risks to children and young people
6.13 Explore whether further use of the Parental Responsibility Act and liquor licensing accords could assist with minimising risk to children and young people. |
Government Response
The Children (Protection and Parental Responsibility) Act 1997 consists of three key parts dealing with parental responsibility (Part 2), the welfare of children in public places (Part 3), and local crime prevention (Part 4) which provides for the preparation of local crime prevention plans and safer community compacts by local councils. All parts of the Act have scope for reducing the risk of harm to children and young people.
The link between the Act and liquor licensing accords essentially lies in the scope for Local Crime Prevention Plans and Safer Community Compacts to include proposals for or concerning liquor licensing accords.
The Safer Community Development Fund (SCDF) established to provide financial assistance for initiatives of approved Safer Community Compacts, could also provide opportunity for grants associated with the implementation of alcohol harm reduction initiatives connected with liquor accord plans incorporated and endorsed by such Compacts.
There is opportunity for improved links between Part 4 of the Act, liquor accords, and other community based approaches of Community Drug Action Teams and other community groups in order to promote initiatives to minimise alcohol related risks to children and young people.
Accordingly, the proposed best practice liquor accord model (Rec. 8.26) will address and promote connections between local crime prevention plans and Community Drug Action Teams. In addition, the Attorney General’s Department will provide guidance to local councils and other community groups about the importance of linking local crime prevention plans to liquor accords with clear objectives around minimising alcohol related community harm and reducing the risk of alcohol related harm to children and young people.
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C. TREATMENT AND SUPPORT SERVICES
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Access to alcohol treatment services
6.15 Treatment for people with established alcohol problems needs to be available and accessible (in rural, regional as well as metropolitan areas).
6.17 Improvement to existing treatment services should be explored by:
6.17.1 making treatment more attractive, and accessible
6.17.2 strengthening and increasing funding for family based approaches
6.17.3 introducing a ‘visitors program’ allowing families a role in developing responsive services
6.17.4 supporting telephone and other linking services that can provide information, peer-support, advice and referral to parents and family members. |
Government Response
This recommendation will be addressed in a new state-wide Drug and Alcohol Treatment Services Development Plan 2006-2015 that will incorporate alcohol related services (Recs. 3.6, 3.7 and 4.4).
Family based program prevention programs have been substantially expanded over the past five years (Recs. 6.1 and 6.7).
The Alcohol and Drug Information Service (ADIS) also provides a confidential 24 hour telephone service with qualified counsellors and the Kids Help Line provides a 24 hour counselling and support line. Both help lines are supported by the Government.
Some services involve family members in the treatment process by having a visitor component to the rehabilitation program. NSW Health is currently undertaking a number of evaluations of programs that will inform the development of the NSW Drug and Alcohol Treatment Services Development Plan 2006-2015. This will include an evaluation of the non-government organisation residential rehabilitation beds program (Rec. 3.6).
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Alcohol detoxification as an entry point to treatment
6.16 Detoxification should be recognised as a necessary and preliminary step in treatment. This needs to be linked in a smooth and seamless manner to on-going treatment services where clients are willing to proceed. |
Government Response
The current NSW Drug Treatment Services Plan 2000-2005 outlines a new approach to the management of detoxification services and the principles of service delivery for detoxification treatment. The principles note that detoxification should be viewed as an entry point into the treatment continuum. The plan and principles are backed up by the Detoxification Clinical Practice Guidelines 1999.
Accessible detoxification treatment for illicit drug abusers has been encouraged through an expansion of home detoxification and ambulatory detoxification programs across the State since 1999. Three new residential detoxification programs have been opened at Lismore, and Wyong and Nepean Hospitals. A youth-specific residential treatment service run by the Ted Noffs Foundation opened in Sydney’s Cumberland Hospital in 2000. The applicability of this type of treatment delivery for people with an alcohol dependency will be considered in development of the ten year NSW Drug and Alcohol Treatment Services Development Plan 2006-2015.
Crossing Area Health Service boundaries will also be examined so that individuals who are able to travel will be allowed to access detoxification units in other Area Health Services. The concept of nurse practitioners will be further examined as a means of tackling the need for greater access to detoxification in rural areas (Recs. 4.2 and 4.4).
All future detoxification needs and services for people with an alcohol dependency will be considered in the development of the new NSW Drug and Alcohol Treatment Services Development Plan 2006-2015 (Rec. 4.10).
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Improving access to housing
6.18 As housing is critical in treatment outcomes:
6.18.1. Development of culturally appropriate halfway houses should be explored (eg. Oxford Housing and Alcohol and Drug Treatment supported accommodation services)
6.18.2. Examine ways of assisting SAAP services to support high needs clients, clients with drug and alcohol and/or mental health problems, including the feasibility of establishing health treatment teams
6.18.3. Opportunities be examined to enhance residential treatment services that can include extended family members including mothers and their children. |
Government Response
About ten percent of people in drug and alcohol treatment services are homeless. Tackling their homelessness can assist in getting better treatment outcomes. There are many initiatives underway to address this problem.
Key initiatives underway include:
§ Provision of more affordable housing for people in need who also have alcohol abuse problems. In 2003/2004, approximately 83 dwellings will become available as crisis accommodation or supported housing. One example includes a transitional housing initiative for young people with a drug and/or alcohol dependency to be run by the Western Suburbs Housing Co-operative in partnership with the Blacktown After-Care service.
§ The Inner City Homelessness Action Team Support and Outreach Service which assists homeless people with an alcohol or drug dependency.
§ Funding by the Centre for Mental Health, NSW Health, of a position on the Homelessness Action Team Support and Outreach Service to focus on dual diagnosis issues.
§ A Western Sydney Strategic Action Plan Against Homelessness.
§ Establishment by Department of Housing of the Bennelong Housing Company to assist low income people with housing and support needs through partnerships with support providers. The aim of this project is to expand opportunities for sustainable tenancies, build specialist management expertise, and trial new ways of meeting the needs of clients such as people with mental health and/or coexisting drug and alcohol dependency. The company will commence operations in 2004/2005.
§ Planning by Department of Housing for a trial of strategies targeted at homeless people with comorbid mental health and substance use disorders. (see Recommendation 3.13)
§ Development of a new State Rail policy, with community service groups such as Missionbeat, to encourage homeless people to move to safer places rather than congregating at railway stations.
§ General Accommodation Support programs for juvenile offenders who may come back into contact with the juvenile justice system because they are homeless.
§ Bail Accommodation Support programs provide for young people who would otherwise be refused bail because they do not have appropriate accommodation.
§ A range of housing projects which address the particular needs of Aboriginal people, including acquisition of properties for use by members of Aboriginal communities and managed by Aboriginal community housing units.
More generally, the Office of Community Housing under the Community Housing Assistance Program allocates at least twenty percent of resources for new projects to supported housing projects. This provides opportunities for people with complex needs to be provided with housing linked to support. The Office also accepts applications from groups for self managed housing projects.
The Office will investigate the Oxford Housing and Alcohol Treatment supported accommodation services model and other transitional housing models for possible future inclusion as part of the Community Housing Assistance Program. In particular, the Office will look at projects that respond to the housing needs of people recovering from the affects of prolonged alcohol abuse. Funding of new projects will be considered if the examination indicates good results from these models.
In addition, the Supported Accommodation Assistance Program (SAAP), a Commonwealth funded/State administered program provides support and supported accommodation for people who are homeless and women and children affected by domestic violence. SAAP is administered by the Department of Community Services and currently provides over $100 million and funds more than 400 community based projects across New South Wales.
SAAP priorities include developing better ways of working with Aboriginal communities and developing improved responses to clients with complex needs including those with significant alcohol abuse problems.
SAAP recognises that clients with complex needs, including those with alcohol related problems, require a range of health, accommodation and ongoing support services. Coordinating these services is critical to achieving the best results for these clients. Developing or improving linkages with NSW Health and the Department of Housing is a key priority for SAAP during this current five year Agreement (SAAP IV). An example of a new approach to improving service coordination is the new Joint Guarantee of Service for persons with a mental illness. This protocol aims to improve linkages between mental health services, public and community housing services and SAAP services.
The Government will also fund a new homelessness peak body, Homelessness NSW/ACT, launched in March 2004, through its Supported Accommodation Assistance Program. Through this body, the Government will work together with non-government organisations to develop new ideas and new approaches to the way it addresses homelessness. Homelessness NSW/ACT will primarily focus on single men and women but will also provide support to families including women and children who access the women’s housing services network. It will also be responsible for the coordination and development of new training for workers in homeless services.
See also 3.13 and Section 8 Part J – Managing intoxicated persons in public places.
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Alcohol treatment services for Aboriginal communities
6.19 There is a need to establish locally relevant Aboriginal treatment services across the State. This could commence with five-year demonstration programs developed, implemented and delivered by Aboriginal people. An important aspect is to facilitate culturally appropriate, competency based education and training for workers.
6.20 That the NSW Government provide funding and support for effective implementation of the Aboriginal and Torres Strait Islander Substance Abuse Plan. |
Government Response
The Government’s policy on these two recommendations is outlined in Recommendations 3.8, 3.18-3.20 and 4.14 concerning the development of alcohol treatment services in Aboriginal communities.
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Pregnancy and alcohol use
6.21 As pregnancy is the first critical developmental phase of life, guidelines be developed for progressing healthy pregnancy with regard to alcohol, tobacco and other drug use. |
Government Response
The NSW Government referred the issue of Foetal Alcohol Syndrome (FAS) to the Ministerial Council on Drug Strategy in order to place this issue on the national agenda. All Australian Governments are giving increased attention to this issue.
See also Recommendation 3.19 which outlines services for Aboriginal women and 4.17 which outlines initiatives to promote safer pregnancies.
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Improved collaboration between agencies to provide services for people with multiple needs
6.22 As alcohol-induced harm is frequently associated with other adverse outcomes (eg. mental health disorders, homelessness, unemployment) means of enhancing collaboration across different services and levels of government need to be explored and implemented. |
Government Response
Tackling the complex requirements of people with multiple needs will be pursued through improved case management (Recs. 3.10, 4.6 and 4.11), improved cooperative agency approaches (Recs. 3.12 and 4.5), and new strategies to tackle dual diagnosis (Recs. 4.15 and 4.16).
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Treatment and prevention services in Western New South Wales
6.23 An integrated service delivery model for Indigenous and non-Indigenous communities in Western New South Wales be developed to assist people affected by alcohol misuse and domestic violence. |
Government Response
The diverse and often isolated communities of Western New South Wales continue to be a priority for the NSW Government.
The NSW Government has implemented a series of initiatives to drive the provision of integrated services including the establishment of the Regional Coordination Management Group, representing all Government agencies in the region.
Government agencies in the Far West will work together to develop a shared Agenda for the Delivery of Integrated Alcohol Abuse Service. The aim of the agenda will be to increase the integration of drug and alcohol services with other human services in the Far West.
Anticipated outcomes include ‘one stop’ service centres, shared assessment protocols, joint case management and an increase in funding to the Far West through successful grant applications.
Agencies involved in the department of the agenda will include, but not be limited to, NSW Health, the Department of Community Services, the Premier’s Department, NSW Police, the Attorney General’s Department, the Department of Aboriginal Affairs and the Ministry of Transport.
The agenda will be informed by principles and themes contained in the NSW Drug and Alcohol Treatment Services Development Plan 2006-2015, the Far West Area Health Service Drug and Alcohol Treatment Services Plan and the complementary Aboriginal Drug and Alcohol Treatment Services Plan being developed by NSW Health.
A reference group will be established to guide the development of the agenda and this will be chaired by the Director of Drug and Alcohol Services, Far West Area Health Service.
The agenda will be developed with input from the Regional Coordination Management Group to ensure support in securing agency cooperation and commitment.
The agenda will build on and complement initiatives proposed or underway in Far West New South Wales including:
§ An alcohol treatment project, the Grog Project funded under the National Mental Health Reform Incentive Project and the NSW Drug Summit, operating in Menindee and Brewarrina and helping service providers and communities to respond more effectively to alcohol related problems.
§ A new Intensive Family Preservation Service (Aboriginal) to be established by the Department of Community Services to help Aboriginal families in crisis and where child protection concerns exist. Two new services will be established in Bourke and Wollongong, with other services being introduced in later years (Rec. 4.17).
§ The Murdi Paaki trial in the Murdi Paaki Aboriginal and Torres Strait Islander Commission (ATSIC) region in Far West New South Wales also aims to improve outcomes for Aboriginal children and young people (Rec. 8.50).
§ A proposal for a Remote Alcohol Resource Unit sponsored by the Broken Hill Department of Rural Health, University of Sydney, in the Far West and servicing the ATSIC Murdi Paaki region, is being considered by the Alcohol Education and Rehabilitation Foundation. Under the proposal, the unit would develop collaborative community approaches to alcohol problems and a Regional Reference Group, including Government agencies (Rec. 2.16)
§ A new MERIT Alcohol Program for Western New South Wales (Rec.9.14).
See Recommendation 8.42.
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Treatment within the justice system
6.24 In recognising that people including young people, in custody often have high problematic alcohol use, treatment must be provided both within custodial facilities, on transition out of custodial facilities and as part of post release services. There must be parallel programs and information to facilitate family engagement in treatment programs, and support services to maximise the likelihood of long-term effectiveness. |
Government Response
Community Based Programs (Probation & Parole), Department of Corrective Services, provides community based supervision to approximately 17,500 offenders across 64 District Offices in New South Wales.
Other services such as the Psychological Service and the Welfare Service provide counselling and support indirectly to inmates with alcohol related problems.
See Recommendations 9.7, 9.8, 9.9 and 9.15.
Treatment in custodial settings – young people
The Department of Juvenile Justice provides a community based intensive program and counselling service. There are 38 community based Juvenile Justice Counsellors throughout the State, of which 26 are Alcohol and Other Drug Counsellors. The Alcohol and Other Drug Program aims to reduce the harm associated with alcohol and drug use to the benefit of both the individual and the community.
The Department of Juvenile Justice also provides the No More program to clients on community based supervision. The program addresses the issue of alcohol related violence amongst Aboriginal young people.
The Targets for Effective Change Program aims to increase motivation to change and minimise negative consequences of alcohol and drug use. This program assists young offenders to accept responsibility for the consequences of their alcohol use for themselves and others.
The Department of Juvenile Justice funds community organisations to provide Post Release Support Programs (PRSP) for clients exiting custody in ten locations in New South Wales. The needs of clients with problematic alcohol use are addressed by the PRSP providers through direct support and/or referral to adolescent alcohol and drug services.
The Department of Juvenile Justice provides the Community Funding Program (CFP) to reduce the likelihood of re-offending by young people who have come into contact with the Department. It is linked to a broad crime prevention approach to juvenile justice where detention is a last resort and diversion from the criminal justice system and community reintegration are central to breaking the crime cycle.
In partnership with the University of Sydney and Corrections Health Service, the Department of Juvenile Justice has completed The Young People in Custody Health Survey and is beginning work on the complementary Young People on Community Orders Health Survey.
Treatment in custodial settings – adult offenders
The Department of Corrective Services (DCS) provides the following Offender Services and Programs to reduce the level of harms associated with alcohol abuse:
§ The Relapse Prevention Group Work Program assists offenders in identifying triggers to possible relapse situations, develop coping strategies that facilitate behaviour changes using cognitive behavioural techniques and motivational interviewing.
§ The Alcohol and Violence Group Work Program develops strategies concerning alcohol use that facilitate behaviour change.
§ Anger management programs assist offenders develop strategies that facilitate behaviour changes around violence and aggression. The programs identify the link between substances, in particular alcohol, and aggressive behaviour.
§ The Grog and Driving (Aboriginal and Torres Strait Islander) program raises awareness in relation to drink and drive behaviours within the Indigenous community.
The DCS will review its Offender Services and Programs area. This review will enable the Department to better allocate resources and target offenders who are assessed as being at medium to high risk of re-offending.
Contained in this review is a trial of an assessment tool (the Level of Service Inventory – Revised) to measure the level of risk and be part of the basis of a sentence/treatment plan that will assist the offender whilst serving a sentence. In terms of those offenders whose offence is alcohol related, the tool will clearly identify the need for programs and services that address this use.
In addition, the DCS will review the way data is collected on offenders. As a result of this, a new information technology project has commenced that allows key service areas within the Department to share information on offenders.
Family engagement in treatment programs
The Department of Corrective Services works with a number of family support agencies, including Family Drug Support and Children of Prisoners Support Group.
The Ted Noffs Foundation provides two adolescent rural rehabilitation programs located at Dubbo and Coffs Harbour. Both facilities provide six beds and run 12 week residential programs for juvenile justice clients. The Ted Noffs Foundation based at Randwick provides an adolescent family worker to work with substance using adolescents and their families.
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Integrated service delivery to assist gay, lesbian and transgender people
6.25 Develop an integrated service delivery model to assist gay, lesbian and transgender people affected by alcohol misuse and domestic violence. |
Government Response
See Recommendation 4.13.
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D. RESEARCH
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Research on the causes and impacts of alcohol abuse
6.26 Additional information is required to understand aspects of the causes and impacts of alcohol abuse and to develop sound alcohol related programs.
Five broad areas are recommended for consideration:
6.26.1 Improved collecting and reporting of input and outcome data (eg. liquor sales, linkages between alcohol abuse and child abuse and neglect and between alcohol abuse, sexual assault and domestic and family violence)
6.26.2 Examine the attitudes, experience and responses to alcohol use among culturally and linguistically diverse communities in Australia
6.26.3 Pathways to and away from alcohol abuse, including child development and the extent to which peer group accepted ‘smart risk taking’ minimises engagement in harmful risk taking and gender based biases
6.26.4 A fundamental exploration of the links between alcohol misuse and Australian culture with a view to identifying ways to decrease the impact of these links in key areas such as sport and leaving school
6.26.5 Research is needed to determine whether harm minimisation strategies that encourage responsible drinking in young people (aged 12 to 17 years and 18 to 24 years) (eg. supervised venues for underage drinking in moderation) are more effective or less effective than total abstinence in this age group
6.26.6 Reporting mechanisms be developed for government agencies in relation to outcomes from alcohol programs.
6.28 Research must encompass evaluating the experience and programs in other jurisdictions and cultures for its relevance to New South Wales, as well as primary research in New South Wales. |
Government Response
Priorities for research on alcohol issues are outlined in the National Alcohol Research Agenda endorsed by the Australian, State and Territory Governments in 2002. The matters outlined above are generally identified as part of this research agenda.
Three national research centres have been established to carry forward research on drugs and alcohol: the National Drug and Alcohol Research Centre at the University of New South Wales, the National Centre for Education and Training on Drug Addiction at Flinders University in South Australia, and the National Drug Research Institute at Curtin University of Technology, Western Australia. The NSW Government will ask the Directors of these research centres to give careful consideration to the important research priorities identified by the Summit when planning their forward research programs.
Current action on areas identified in this recommendation is outlined below:
Collection and reporting of input and outcome data: Health and treatment data is being addressed through the Alcohol and Other Drug Treatment Services National Minimum Data Set published each year by the Australian Institute of Health and Welfare. Police and alcohol crime related data collections are expected to be enhanced following the work of the proposed Alcohol Related Crime Intelligence Working Party. The Department of Community Services will also examine the current collection of data on drug and alcohol issues in DoCS cases and will consider developing the KIDS new client information system to collect separate information on alcohol cases.
The National Alcohol Indicators Project being undertaken by the National Drug Research Institute and Turning Point Alcohol and Drug Centre will also provide a new data set on which to base future policy considerations. The question of national collection of wholesale alcohol sales data is being addressed under the auspices of the Ministerial Council on Drug Strategy (Rec. 2.5).
Research on alcohol use in culturally and linguistically diverse communities: The Drug and Alcohol Multicultural Education Centre (DAMEC) is currently undertaking a study, funded by the Alcohol Education and Rehabilitation Foundation, on alcohol and drug use in six non-English speaking communities. This study, over three years, will determine the prevalence and patterns of alcohol and drug use in Chinese, Vietnamese, Arabic speaking, Spanish speaking, Italian and Pacific Islander communities in New South Wales.
The NSW Government also recently funded a study by the DAMEC to examine contextual issues around drink driving/walking in two diverse communities, the Pacific Islander and Italian communities. The Government will carefully consider the findings and proposals arising from both these studies.
Research concerning pathways to and away from alcohol abuse: The Centre for Parenting and Research has been established by the Department of Community Services to develop resource materials about parenting issues, promote community awareness of positive parenting practice, and conduct research.
The NSW Commission for Children and Young People, with the Queensland Commission for Children and Young People has commissioned the National Drug and Alcohol Research Centre to undertake research on investing in families and children to provide a possible policy framework that can contribute to a national approach to the early years.
Research on alcohol misuse and the Australian culture: Community attitudes to alcohol have changed and society’s permissive acceptance of irresponsible patterns of drinking has declined over the past 20 years. Key research such as the Study of Attitudes and Behaviours of Drinkers at Risk Research Report undertaken by the National Drug Strategy in 2002 has identified the importance of cultural change as a key to long term behavioural changes. The report sets out a number of recommendations and communication ideas that will be addressed through the work of the Alcohol Education and Information Taskforce and the NSW Alcohol Communication Plan (Rec. 1.3).
Research on the respective merits of alcohol harm minimisation strategies targeting young people versus abstinence strategies: The Government will work with the three national drug and alcohol research centres to examine the merits of harm minimisation strategies as opposed to abstinence strategies for managing youth alcohol abuse. This will be discussed in the new NSW Youth Alcohol Action Plan 2005-2009 (Rec.1.11).
Reporting by Government agencies: Recommendations 2.2 and 2.4.
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