Page 1

Service Mapping Rapid Phone Survey of Community Organisations Delivering Alcohol and Other Drug Services in the Central Queensland, Wide Bay, Sunshine Coast PHN catchment


CONTENTS Executive Summary ....................................................................................................................... 3 Background and Objectives of Service Mapping ........................................................................... 4 Rapid Phone Survey—Methods .................................................................................................... 4 Survey Sample ............................................................................................................................... 6 AoD Specialist Services .................................................................................................................. 6 AoD Service Providers ................................................................................................................... 7 AoD Services Delivered................................................................................................................ 11 Staff Delivering AoD Treatment Services .................................................................................... 16 Funding for AoD Services ............................................................................................................ 18

2


EXECUTIVE SUMMARY A rapid phone survey of community organisations delivering mental health and suicide prevention (MH) and alcohol and other drug treatment (AoD) services was undertaken during August-September 2016. It collected basic information about community providers and the services they deliver in the PHN catchment. Out of 65 MH and AoD organisations that responded to the survey, 14 deliver AoD services. Central Queensland and Wide Bay are each served by three providers, while five organisations operate in the Sunshine Coast. The most common source of funding for AoD services was the Commonwealth government (reported by 10 out of 14 providers), followed by State government (8). Only one provider received private funding and none reported funding from local government or philanthropic sources. Community organisations in the PHN engage 156 AoD treatment staff, 55 of which are independent contractors, 59 full-time, 25 parttime and 17 as casual workers. Most providers (9 out of 14) reported less than 10 AoD treatment staff. Most organisations (8 out of 13) – excluding residential, on-line and phone services – operate during business hours. AoD was the primary focus for nine organisations and the majority of organisations (10) have been operating for more than 11 years. Out of 14 providers, 11 have been possessing dual diagnosis capability external assessors and the same reported holding at least one accreditation.

six organisations, with two of them offering it as a stand-alone service. On average every month 439 clients in the PHN receive counselling services, 400 receive screening/brief interventions, 25 receive withdrawal management – as a stand alone service – and 17 are served by day-stay rehabilitation programmes. Residential rehabilitation is provided by three organisations (2 in Central Queensland and 1 in the Sunshine Coast), while two providers deliver day-stay rehabilitation programmes. Across the PHN catchment there are 46 beds available, with nine treatment staff required for the day shift and five for the night shift. Most providers (12 out of 14) offer AoD services at the practitioner’s office and through a phone line, while only one organisation offers on-line services. The most common source of referral for AoD clients was self-referral (reported by 5 out of 14 providers), followed by correctional services (4 out of 14 providers).

rated as through number external

All but one provider (13) deliver case management and coordination, 12 offer counselling, 11 screening and brief interventions and seven offer after care services. Withdrawal management is offered by

3


BACKGROUND AND OBJECTIVES OF SERVICE In the context of mental health and suicide prevention (MH) and alcohol and other drug treatment services (AoD), the PHN plays a pivotal role in the development of the corresponding regional plans and commissioning of primary care services for the population. To inform these activities and the work undertaken by the Regional Mental Health and Alcohol and Drug Strategic Collaboratives in Central Queensland, Sunshine Coast and Wide Bay, the PHN surveyed community organisations delivering mental health and AoD services in the PHN catchment.

The objective of the survey was to collect basic information about these providers and the services they deliver. Specifically, the survey sought information regarding:

   

The scope of services provided, including the type of services, opening hours, and geographic catchment Main target populations and sources of referral The qualifications of the staff delivering services Main sources of funding

RAPID PHONE SURVEY - METHODS Time and budget considerations led to a survey design that could be undertaken at low cost, over the phone and in a short time frame. A draft survey instrument was developed in early July 2016 and reviewed by local experts. They were requested to provide feedback on the overall content of the survey. After securing expert feedback, the survey instrument was adjusted and tested over the phone with a few service providers before making final changes. As part of the initial Mental Health and Alcohol and other Drugs Needs Assessments conducted in early 2016, a list of organisations delivering these services in the PHN catchment was compiled through sources such as the Queensland Health QFinder directory and lists compiled by Partners in Recovery Consortiums and the National Health Service Directory. The initial listing included 98 community organisations that could potentially be delivering MH and AoD services in the region.

Further information secured through the web, and when possible confirmed over the phone, verified that out of the original listing of 98 community providers 17 did not identify as a MH and/ or AoD service, two had closed down, one was no longer funded to provide MH and/or AoD services and one did not deliver services in the PHN catchment. This led to a survey sample of 77 currently active MH and/or AoD services. A letter requesting participation in the survey was sent to service providers and interviewers contacted them to request an appointment with the service manager or whoever else was identified as the best respondent for the survey. The vast majority of interviews took place in the first three weeks of August, but some providers were only available for interview in September.

4


Interviews were undertaken over the phone by a supervisor and two interviewers, and lasted on average 15 to 20 minutes. Survey data was cleaned and validated during September. The survey instrument included 96 questions with 40 relating to MH and 56 to AoD services. They covered operating years of the organisation delivering services, scope and volume of services offered, geographical catchment, treatment staff and funding. Survey questions sought information that respondents had at their fingertips and were able to provide over the phone. Only ball-park estimates of service volume and staff numbers were thus requested.

5


SURVEY SAMPLE In total 77 active MH and/or AoD community service providers were identified in the PHN region. Of these, 12 (16%) could not be MH & AoD SURVEY SAMPLE (1) contacted or were not available for Services Central Delivered PHN(2) Queensland interview. The non-response rate was highest in Central Queensland (22%), followed by Wide Bay (18%). All but one of the Sunshine Coast service providers were available for interview. Most providers deliver services across various LGAs in the same regional area. However, a few MH providers operate in several regions. One delivers services in both Central Queensland and Wide Bay. Three operate in Wide Bay and the Sunshine Coast.

Mental Health Only AoD Only Both MH & AoD

Wide Bay

Sunshine Coast

51

14

23

27

3

1

0

2

11(3)

3

3

5

No Response

12

5

6

1

TOTAL

77

23

32

35

Notes: (1) Interviewed providers might deliver services other than MH or AoD. (2) Some providers deliver across several regions, so totals do not add up to the PHN (3) Two providers answered the AoD section of the survey but did not complete the MH section

Out of the 65 service providers surveyed in the PHN, 62 deliver MH with 51 delivering MH and not AoD services. These results are discussed in the accompanying report. The survey identified 14 AoD service providers, 11 of which deliver both MH and AoD services.

AoD SPECIALIST SERVICES This survey focuses on non-government organisations delivering specialist Alcohol and other Drug services. How are these services defined?

 These services focus specifically on individuals whose level of substance use exposes them to significant risk.

 They include treatments to address substance dependence, problematic substance use, maintenance and stabilisation services.

 Though these services can respond to a range of issues, their primary focus and concern is addressing the client’s substance use. Source: Queensland Alcohol and other Drug Treatment Service Delivery Framework March 2015

6


AoD SERVICE PROVIDERS The survey collected information on community AoD services supplied by nongovernment organisations (NGOs). It does not include AoD services offered by hospitals, public organisations, and private providers. Out of 65 organisations that reported that they currently deliver MH and/or AoD services, 14 delivered AoD services across the PHN. The majority (11) delivered both MH and AoD services, with the remaining three exclusively delivering AoD services. The Sunshine Coast region with a population of 384,338, is served by seven providers (i.e. 1 per 54,905 people). Central Queensland, the PHN region with the highest rates of alcohol life time risk, has four AoD providers delivering services to 233,747 people (i.e. 1 per 58,437 people). The Wide Bay population (205,900) is served by four AoD providers (1 per 68,633 people).

7


GEOGRAPHICAL CATCHMENT OF AoD SERVICES All Local Government Areas in the PHN, except Noosa – whose population might potentially be served by Sunshine Coast providers – have at least one organisation delivering AoD services in the PHN catchment. More providers deliver services population centres such as the Coast (282,822 population and providers) and Rockhampton population and 4 AoD providers).

in large Sunshine 6 AoD (83,439

Two of the Sunshine Coast AoD providers also deliver services in Gympie. Another provider also operates in Gympie, one of the most economically deprived LGAs in the PHN. LGAs with smaller populations in Central Queensland are served by at least one of the providers delivering services in Rockhampton. In Wide Bay, one AoD service provider operates across the three LGAs. Additionally, Fraser Coast and Bundaberg are each served by one provider that did not report delivering services across other LGAs. Out of the 14 providers surveyed, nine noted that some of their clients come from areas outside their geographic catchment. However for most (i.e. 7 out of 9), the proportion of these outside clients was relatively small (i.e. less than 10%).

Local Government Areas – Number of providers delivering AoD services Central Queensland Banana

1

Central Highlands

2

Gladstone

2

Livingstone

1

Rockhampton

4

Woorabinda

1

Sunshine Coast Gympie

3

Noosa

0

Sunshine Coast LGA

6

Wide Bay Bundaberg

2

Fraser Coast

2

North Burnett 1 Note: Providers operate across more than one LGA, so totals do not add up to region or PHN

8


SERVICE FOCUS AND OPERATING YEARS Although it is difficult to capture how consolidated the sector is, the survey suggests a relatively consolidated supply of AoD services. Out of the 14 organisations surveyed, AoD was the primary focus for nine and the secondary focus for five. The vast majority of surveyed providers have been operating in the community for more than 11 years.

DUAL DIAGNOSIS CAPABILITY Best practice suggests that dual diagnosis (i.e. the co-ocurrence of mental illness and AoD use) is most effectively addressed through integrated treatment. The majority of AoD providers in the PHN (11) have been rated as possessing dual diagnosis capability through an external assessor. This includes all the providers in the Sunshine Coast area (7) and two each in Central Queensland and Wide Bay. The two organisations without dual diagnosis capability rating in the sample were located in Central Queensland. The remaining provider – in Wide Bay – was rated through self-assessment.

9


EXTERNAL ACCREDITATION In the PHN, three providers – all in the Sunshine Coast – reported holding no external accreditation; five organisations had one and the remaining six had two or more. The most common accreditation was ISO (held by 7 out of 11), followed by ACHS (held by 3 out of 11).

AoD Providers - Number of Accreditations None

One

Two

Three

Four

Total

Wide Bay Central Queensland Sunshine Coast

0

2

0

1

0

3

0

2

1

0

1

4

3

1

2

1

0

7

Total PHN

3

5

3

2

1

14

Additionally, two organisations (in Central Queensland and Sunshine Coast) have received external recognition from the Australasian Therapeutic Communities Association (ATCA) - not included in the external accreditations in graph.

Key:

QIC Quality Improvement Council

ISO International Organisation for Standardisations

ACHS The Australian Council on Health Care Standards

SAI Global (Business Excellence Framework)

Other includes National MH Standards, Human Services Quality Framework, NGO quality and performance framework and AGPAL

10


AoD SERVICES DELIVERED Taxonomy of AoD services Screening and Brief Interventions: Commonly consist of a single time-limited session of information, assessment and advice that aims to motivate individuals to change their behaviour.

Withdrawal Management : Supports people to stop or reduce AoD use, often after a period of long or frequent use. Can be offered either as a stand-alone service or integrated with other services provided such as rehabilitation.

Counselling outside of Rehabilitation Programmes: Involves a trained professional providing advice or counsel to an individual about their drug and/or alcohol use. Aims to provide the client with the necessary psychological and physical resources to change drug/alcohol use behaviours.

to assist the development of coping and life skills through addressing the behaviours of addiction.

Aftercare/follow-up Services: Provide vocational, financial and/or social support to individuals once they have completed a recovery or rehabilitation programme.

Case Management, Care Planning and Coordination: Involves a range of treatment interventions ranging from short-term engagement to longer-term counselling and support. Individuals collaborate with case managers through a comprehensive assessment of individual care planning, service facilitation, outcome monitoring, and advocacy.

Day stay rehabilitation and other intensive non-residential programmes: These programmes require individuals to participate in daily counselling, psychological, legal, financial and physical support programmes while continuing to live in their own homes.

Residential Rehabilitation: Intensive treatment programmes that aim to provide a therapeutic environment in which behaviour change and major lifestyle adjustments can occur. A large focus of these programmes is to develop a range of strategies

11


TYPES OF AoD SERVICES DELIVERED One of the main objectives of the survey was to capture the number of providers delivering different types of community AoD services across the PHN catchment. All but one provider in the Sunshine Coast (13), provide case management and coordination. The majority of AoD providers in the PHN also offer counselling (12 out of 14) and screening/brief interventions (11 out of 14). After care services are provided by seven organisations, including four (out of 7) in the Sunshine Coast, two (out of 3) in Wide Bay and one (out of 4) in Central Queensland. Withdrawal management integrated and/or as a stand-alone service is delivered by six organisations in the PHN. They include all three providers in Wide Bay, half of the providers in Central Queensland (i.e. 2 out of 4) and just one provider in the Sunshine Coast. As a stand-alone service, withdrawal management is delivered by two providers, one each in Wide Bay and Central Queensland. Out of 14 AoD providers, three offer residential rehabilitation with two in Central Queensland and one in the Sunshine Coast. Wide Bay does not have any residential rehabilitation facility. Day-stay rehabilitation programmes are offered by two providers, one each in Wide Bay and Central Queensland.

12


VOLUME OF SERVICES The survey aimed to capture ball-park estimates of volume of AoD services delivered in the PHN catchment. Approximate estimates of the average number of clients receiving AoD services every month was available for counselling, screening/briefing intervention, day-stay rehabilitation and withdrawal management. They broadly reflect the number of providers delivering those services in each region. For counselling, it was estimated that over 439 clients receive services across the PHN each month. A similar estimate, i.e. 400 clients every month receive screening/brief intervention. The vast majority of counselling (75%) and screening/brief interventions (70%) clients were in the Sunshine Coast. Counselling services were delivered to similar number of clients in Central Queensland (52) and Wide Bay (56). A slightly higher number of clients in Central Queensland (64) received screening services when compared to Wide Bay (55). On average 25 clients receive withdrawal management – as stand alone services – and 17 receive day-stay rehabilitation every month across the PHN. These services are mostly delivered in Central Queensland, that is, 20 out of 25 clients for withdrawal management (i.e. 80%) and 7 out of 12 (i.e. 71%) for day-stay rehabilitation. The remaining clients receive services in Wide Bay.

AoD Services - Approximate Number of Clients per Month Withdrawal Screening % Stand-Alone Wide Bay 55 14% 20 Central Queensland 64 16% 5 Sunshine Coast 281 70% 0 Total PHN 400 25

% 80% 20% 0%

Counselling 56 52 331 439

% 13% 12% 75%

Day-Stay Rehab 12 5 0 17

% 71% 29% 0%

13


RESIDENTIAL REHABILITATION Number of beds and staff numbers for day AoD Residential Rehabilitation - Service Capacity Staff Staff Night and night shifts are used to capture the Beds Day shift Shift capacity of residential rehabilitation services Wide Bay 0 0 0 in the PHN. Central Queensland

In total 46 beds are available in the PHN Sunshine Coast catchment, with nine treatment staff Total PHN required for the day shift and five for the night shift.

19

6

4

27 46

3 9

1 5

The majority of beds (27 out of 46, i.e. 59%) are in the Sunshine Coast area. The remaining beds (19, i.e. 41%) are in Central Queensland, with no residential rehabilitation services provided in Wide Bay.

TREATMENT SETTINGS FOR AoD SERVICES Most providers across the PHN (12 out of 14) offer AoD services at the practitioner’s office and through a phone-line. Other common treatment settings are the client’s residence, outreach and nonresidential facilities (8 out 14). Only one provider in the Sunshine Coast, offers online services. AoD Services - Treatment Settings Practitioner's office 3

Central Queensland

Outreach 2

Nonresidential Facility 3

Residential Facility 1

On-line 0

2

3

3

2

0

7

4

3

2

2

1

12

8

8

8

5

1

Phone-line 2

Client's residence 2

4

3

Sunshine Coast

5

Total

12

Wide Bay

14


OPERATING HOURS FOR AoD SERVICES To examine the availability of AoD services during and out of business hours, the survey requested information on the operating hours of AoD services, excluding those that are residential or delivered over the phone and on-line. Out of 13 providers who answered this question, eight operate during business hours (4 in the Sunshine Coast and 2 each in Wide Bay and Central Queensland).

Operating hours of AoD services.

Wide Bay Central Queensland

Limited Business Hours

Business Hours

Extended Business Hours

24/7

Total

0

2

0

1

3

4

0

2

1

1

Sunshine Coast

1

4

1

0

6

Total

1

8

2

2

13

Two organisations regularly deliver services during extended business hours while one has more limited operating hours during weekdays. The remaining two organisations (1 each in Wide Bay and Central Queensland) deliver AoD services 24/7.

MAIN SOURCES OF REFERRAL FOR CLIENTS OF AoD SERVICES To understand the main sources of referral for clients of AoD services in the PHN catchment, the survey requested respondents to identify the top three sources of referral for their clients. Out of 14 AoD providers, five noted that the most common source of referral was self-referral. For the three providers in Wide Bay, the most common source of referral was either self-referral (2) or family (1). For two providers, both in the Sunshine Coast, the most common source of referral was health services. Correctional services was the most common source of referral for four providers (2 in the Sunshine Coast and 2 in Central Queensland). Police diversion was the most common source of referral for one provider in Central Queensland while Court diversion was the most common for one provider in the Sunshine Coast.

15


STAFF DELIVERING AoD TREATMENT SERVICES With a view to capturing the capacity of the AoD sector in the PHN catchment, the survey estimates numbers of staff currently engaged to deliver AoD treatment services to clients, excluding corporate support staff, such as managers or accountants. Although data on full-time equivalent staff were not available, the survey estimates numbers of full-time, part-time, casual and independent contractors delivering AoD treatment services. A total of 156 staff deliver services in the region. Independent contractors – all in the Sunshine Coast – represent a third of the workforce (55 staff, 35%).

Full-time staff (59 out of 156) represent 38% of the workforce in the region. The majority of the full-time staff delivering AoD services (34 out of 59) are engaged in Central Queensland, followed by Wide Bay (14) and the Sunshine Coast (11). Approximately 16% of the workforce are part-time workers (25 out of 156) , with the vast majority (22) working in the Sunshine Coast. Casual staff represents 11% of the AoD workforce (17 out of 156) with the vast majority (10) engaged in Central Queensland.

AoD Staff Numbers – Total Across Providers Wide Bay Central Queensland Sunshine Coast Total PHN

Full-Time

Part-time

Casual

Contractors

Sub-total Region

14

2

2

0

18

34 11 59

1 22 25

10 5 17

0 55 55

45 93 156

Most providers in the PHN (9 out of 14) have less than 10 AoD treatment staff. Out of 14 providers, one (in the Sunshine Coast) has over 25 AoD treatment staff and four (3 of which in Central Queensland and 1 in the Sunshine Coast) have between 10 to 25.

AoD Providers - Classification as per staff levels 1 or 2

3 to 9

10 to 25

Over 25

Wide Bay Central Queensland Sunshine Coast

1

2

0

0

0

1

3

0

3

2

1

1

Total PHN

4

5

4

1

16


DISTRIBUTION OF AoD TREATMENT STAFF Most AoD staff are engaged as full-time workers in Wide Bay (78%) and Central Queensland (76%). In the Sunshine Coast, 59% of staff are independent contractors.

QUALIFICATIONS OF STAFF DELIVERING AoD TREATMENT SERVICES The majority of AoD providers in the PHN engaged Social Workers (7 out of 14 providers) and AoD workers (8 out of 14) Out of 14 providers, nine reported other professions – i.e. not listed in other professional categories in graph – as one of the qualifications of their AoD staff. It is likely that they include student placements. Out of the 14 providers surveyed, four did not provide information on the most common qualification of their AoD treatment staff.

There is variability in terms of the most common staff qualification across providers. Social worker, AoD worker and other professionals were chosen as the most common staff qualification by two providers. The remaining four providers each reported General Practitioner, Nurse, Psychologist and staff with a Diploma or Certificate II/IV as the most common qualification amongst their staff.

Most Common Staff Qualifications reported by Providers

Most common staff qualification

N=

AoD worker

2

Social Worker

2

Other Professionals *

2

Diploma/Certificate

1

Psychologist

1

Nurses

1

GP Missing information

1 4

17


FUNDING FOR AoD SERVICES Out of 14 providers, 10 reported the Commonwealth and eight the State government as sources of funding for their AoD services. None of the surveyed providers received funding from Local government or philanthropies and only one received private funding.

AoD Providers - Funding Sources

Commonwealth

State Government

Local Government

Private

Philanthropic

2

1

0

0

0

3 5 10

2 5 8

0 0 0

1 0 1

0 0 0

Wide Bay Central Queensland Sunshine Coast Total PHN

TARGETED POPULATION FUNDING Targeted funding for delivering AoD services to vulnerable populations was common across providers in the PHN, though some groups were more commonly targeted than others. All surveyed providers in Wide Bay (3) and Central Queensland (4) received targeted funding for Aboriginal and Torres Strait Islander people as only two out of seven did in the Sunshine Coast. Out of 14 providers, five reported funding for delivering services to populations from economically disadvantaged backgrounds and youth. Only two providers (one in Wide Bay and one in Central Queensland) reported funding targeting forensic populations. Number of AoD Providers Receiving Targeted Funding for Vulnerable Populations Wide Bay

Central Queensland

Sunshine Coast

PHN

Aboriginal and Torres Strait Island People

3

4

2

9

Econ. Disadvantaged

2

2

1

5

Pregnant Women

1

2

1

4

Women

1

2

0

3

Men

1

2

0

3

Children

1

2

1

4

Youth

2

2

1

5

Ageing

1

2

1

4

LGBTI

1

2

1

4

CALD

1

2

1

4

Rural/Remote Forensic

1 1

2 1

1 0

4 2

18


TARGETED GEOGRAPHICAL FUNDING Out of 14 providers, six received funding for targeting their delivery of AoD services to specific geographical areas. This includes three (out of 4) providers in Central Queensland, two (out of 3) in Wide Bay and one (out of 7) in the Sunshine Coast. AoD Providers Receiving Targeted Funding for Geographical Areas

No

Yes

Total

Wide Bay

1

2

3

Central Queensland

1

3

4

Sunshine Coast Total PHN

6 8

1 6

7 14

19


The PHN sincerely thanks the organisations and individuals who participated in the survey for their generosity in providing information to enable the PHN to build a picture of current services across the region. The information presented in this report will be used by the PHN in relation to planning and commissioning services and to support the integrated delivery of mental health and suicide prevention services within the community.

While the Australian Government Department of Health has contributed to the funding of this material, the information contained in it does not necessarily reflect the views of the Australian Government and is not advice that is provided, or information that is endorsed, by the Australian Government. The Australian Government is not responsible in negligence or otherwise for any injury, loss or damage however arising from the use of or reliance on the information provided herein.

20

Alcohol and other drugs service mapping  

Service Mapping - Rapid Phone Survey of Community Organisations Delivering Alcohol and Other Drug Services in the Central Queensland, Wide B...

Alcohol and other drugs service mapping  

Service Mapping - Rapid Phone Survey of Community Organisations Delivering Alcohol and Other Drug Services in the Central Queensland, Wide B...

Advertisement