TED NOFFS FOUNDATION

Submission in Response to the Consultation Paper

“Australia’s National Drug Strategy – Beyond 2009”

Ted Noffs Foundation, based in Sydney, has been treating young people experiencing drug/alcohol and mental health issues, for over twenty years. We provide full-time residential rehabilitation in Sydney, Coffs Harbour, Dubbo and Canberra; out-clients and outreach services at Mt Druitt in Sydney and in Canberra; school-counselling services in schools in and around Mt Druitt; and legal assistance for young people with drug/alcohol and mental health problems.

Given Ted Noffs background,this submission is particularly applicable to the problems faced by the young people.

Comprehensive and Holistic Approach

Critical Components in the Treatment of Young People Experiencing Drug/Alcohol and Mental Health Issues

Based on our work with the young people we believe that the drug and alcohol issues faced by the young people require a comprehensive and holistic approach. As part of this approach we suggest using professional services and community capital to create optimum health for the young people in both the short and long terms. In the following discussion we address a number of components, including the issue of “community involvement”, in the treatment of young people experiencing drug/alcohol issues”.

  • Prevention and early intervention: This involves identification of at-risk young persons and protective and harm-creating factors. Prevention and early intervention should include parental training, parent support groups, counselling for parents and young people and support groups for the young people. Ted Noffs’ Street University, based in Liverpool, engages marginalised and disadvantaged young people in creative exercises and educational endeavours. It also assists young people in job-related training and, related, apprenticeships.
  • Continuing Care and Aftercare: As mentioned above, prevention and early intervention are essential elements of a comprehensive strategy. However, despite best efforts, many young people will engage in drug/alcohol intake and, as a result, drop out from school, suffer from poor physical and mental health, and engage in violent activities and criminal behaviours. These young people may be assisted through community outreach activities, counselling and long-term residential rehabilitation.

A crucial component, following the treatment, is the continuing care for these young people. Continuing care will involve working out a plan for life-after-rehabilitation (or treatment); educational/training/apprenticeship/job opportunities; skills training for dealing with people and for finding training and employment opportunities;

assistance in going back to school and/or training and assistance in finding apprenticeship/employment; assisting the young people with their drugs-related problem through follow-up counselling; and the involvement of family in the rehabilitation of young people.

  • Evidence-based Treatment and Procedures: The national Drug Strategy’s emphasis on evidence-based treatment is well-placed.

Evidence captures high quality and timely information from a range of sources, including feedback from relevant populations, for example, service users, carers, families, clinicians, service providers and strategic partnerships.

It is important that professionals at treatment facilities work with experienced researchers. However, there also is a strong need for researchers to be based at the NGO facilities and training of staff at NGOs in research skills. These will require extra funds for the NGOs. However, this will be money well spent since it will lead to research being conducted by those who are directly working with the clients and, thus, will lead to a stronger evidence-base.

Before the staff at NGOs can use the evidence-base, it is crucial that the evidence is clear to the professionals at the treatment facilities and steps are taken to translate the research findings into a language that is understood by the drug/alcohol professionals.

  • Trained Workforce: It is time for all stakeholders to work together to agree on professional and continuing training for professionals working with clients experiencing drug/alcohol and mental health issues.
  • Engaging the Community: Both the family involvement and community involvement are important in assisting those who are experiencing the drug/alcohol and, related, mental health issues. Community involvement requires a partnership between the treatment sector and the community. Service providers need to engage with service users in partnerships with their families, carers and the public to shape service and improve drug treatment reintegration and life management programmes.

Community involvement will use the community as the change agent and will include community training and community education. Here we use the word “Community” in the wider context, for example, members of the local community, sporting organisations, clubs, entertainment industry, etc. Community involvement poses a challenge to the professionals in that they need to ensure that the community involvement does not deter from the evidence-base and that community members work with the professionals.Clinical leadership is critical to the strategic process. Clinicians are best placed to advise and lead on issues relating to clinical quality and effectiveness.

  • Tackling/targeting Multiple Issues: The treatment program should not target only the drug-related and psychological issues. The program should aim at “life management”. Life management is defined as achievement of the client’s goals for making positive change in their lives to be free of drug dependency and make positive life choices which includes employment/education options, housing and functional relationships either within the family or with the client’s community.

Drug/Alcohol and, Related, Mental Health Issues Faced by Indigenous Youth

All the points made above, or issues raised above, apply equally strongly to the drug/alcohol issues faced by Indigenous young persons. We believe that the treatment programs for indigenous youth should not be markedly different to the programs for non-indigenous young people.However, resources in line with the issues experienced by the indigenous youth and other indigenous persons should be allocated to this sector.

What must be acknowledged in Clinical Practice and community integration are the culture based needs of indigenous people.What is critically important is that cultural identification and relationship to the living history of the culture is encouraged and supported as a basis of treatment.

It is important that indigenous persons be trained to work in the D & A (Drug and Alcohol) area and provide treatment to indigenous and non-indigenous young people. In assisting indigenous young people, we need to work with the education/training authorities and the employers and employer organisations. There is a significant need for indigenous young people to receive more education, further training and to be placed in apprenticeships/jobs. As funding and job providers, all arms of the government (local, state and federal) can play a significant role in satisfying this need. Indigenous young persons should receive more job opportunities in all areas but particularly in public service, education, health and community services.

As mentioned above, it is also extremely important and crucial that young indigenous persons feel part of, and proud of, the indigenous culture and tradition, while, at the same time, becoming part of the mainstream Australian society.

Arguments and points similar to the treatment of indigenous youth experiencing drug/alcohol issues may also be made in respect of problems faced by young people from culturally and linguistically different backgrounds.

Emerging Issues and New Developments

The above addresses many issues raised in the section titled “emerging issues and new developments”. We provide below our response to the issues raised in the Consultation paper.

  • Cross-Sectoral Approaches: As mentioned above Ted Noffs is of the view that in treating the drug/alcohol issues faced by the young people, it is important to work with the sporting bodies, entertainment industry, employers, training organisations, hotel and club industry and the community at large. Their involvement will go a long way towards solving many issues faced by the young people. It is important that the

various abovementioned sectors be seen as part of the solution and contributing to the solutions.

  • Indigenous Australians: In the discussions above, we have already included a section on drug/alcohol and other related issues faced b y the indigenous youth. Ted Noffs is of the view that there should be no segregation, or separate policy, in treating young indigenous youth. However, there is a strong need to consult indigenous community and professionals, and to provide funding and resources commensurate with the problems faced by the community. Also, indigenous youth should be encouraged to feel part of and proud of, their heritage, culture and tradition.
  • Capacity Building: Traditionally the sector has been a training ground for the people working in this field. However, it is now increasingly important that the Drug and Alcohol workforce be professional and well-trained. It will, however, be difficult to attract and retain the professionals if they are (particularly those employed by the NGOs) paid significantly less than other similar professionals. This comes down to funding. However, any cost benefit analysis will show that the money on capacity building in the workforce is extremely well-spent. Similarly, there also needs to be investment in employing and training researchers in the D & A sector. They will contribute to the evidence-base for treatments and procedures and, thus, to improved productivity in the field.
  • New Technologies and On-Line Services: Though the technologies are, at least partly, contributing to some of the drug/alcohol problems, they also provide opportunities for innovative practices in the areas of prevention, early intervention, treatment, continuing care, community involvement, etc.

The web and the internet provide significant opportunities for training and treatment in various forms. On-line education, training, information, counselling and treatment are a few examples of the role of the new technology in solving drug/alcohol issues. The challenge is to ensure that those who are in greater need of services are not left out of the technological revolution. Many of these young people may not have easy access to the latest technology.

  • Increased Vulnerability: As mentioned above, Ted Noffs believes in a comprehensive and holistic approach. This approach tackles not just the drug/alcohol issues but also all issues related to disadvantage and marginalisation, for example, education, training, social inclusion, employment and housing.
  • Performance Measures: In the above we have already commented on the importance of a comprehensive evidence-base. Equally important is improved data collection and streamlined reporting. The latter is important since slightly different questions being posed by different funding bodies, in their reporting requirements, take up so much of the NGOs’ time and money.

Not all the agencies and funding bodies should necessarily use the same performance questionnaires or scales but it will be good if information relating to agreed-upon measures is provided by all agencies. It will be good to include some measures of drug intake, health, criminal behaviours in the agencies’ annual reports; additionally, reports should also include information on quality of life, employment, housing, relationships and other related variables. Thelatter measures may require data collection over a relatively long period of time. However, the information collected through these measures will be a more important indicator of the effectiveness of treatment than the information collected through the “micro” level measures.

Ted Noffs Foundation thanks the Ministerial Council for the opportunity to contribute to Australia’s National Drug Strategy; we are happy to talk further about, and expand on, the issues discussed in this submission.

Ted Noffs Foundation24 February 2010

P O Box 120

Randwick, NSW 2031