Changing the Culture of Alcohol Use in New South Wales (Section 6)
Outcomes of the NSW Summit on Alcohol Abuse 2003 |
|
Section 6: Family and Wellbeing
|
A. PREVENTION AND EDUCATION: SUPPORTING FAMILIES AND YOUNG PEOPLE
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) 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.
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.
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 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.
Government Response
Peer support mechanisms are being implemented and expanded including state-wide, community and school based programs (Rec. 1.11).
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).
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. 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.
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 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. 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.
B. PROTECTING YOUNG PEOPLE: REDUCING ALCOHOL HARM
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 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 § 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)
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
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.
C. TREATMENT AND SUPPORT SERVICES
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).
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).
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. 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.
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.
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.
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).
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. See Recommendation 8.42.
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 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.
Government Response
See Recommendation 4.13.
D. RESEARCH
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 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. Research concerning other cultures and jurisdictions and the issue of alcohol: The sharing of data is being promoted at a national level by the Government which raised the matter with the Ministerial Council on Drug Strategy. It is anticipated that further examination of this will lead to identification of an organisation or institution that can provide national reports on alcohol related harm and perform a clearing house function.
Government Response
Reporting and evaluation of programs and their impact in reducing alcohol related harms measured against agreed criteria and appropriate performance indicators is addressed at Recommendations 2.2, 2.4 and 4.8.
|