NACCHO health report: NT debate mandatory rehabilitation for treatment for alcohol dependant persons

 alcoholbottles

In response to the NT Governments press release April 12

BOLD NEW PLAN FOR TREATING PROBLEM DRUNKS (full release below)

AMSANT the NACCHO affiliate in the NT has provided the following report and in COMMENTS below is their response press release

 A Report into the Effectiveness of Civil Commitment in the Treatment of Alcoholism, and its Suitability for Implementation the Northern Territory

Alcohol and Australian Communities

Download full report here

Alcohol plays a significant role in the way of life for many Australians, with people drinking for enjoyment, to socialise and celebrate.

Unfortunately, as a nation with a high per capita consumption of alcohol, it is perhaps also unsurprising that alcoholism has created major problems in Australia. Alcoholism is a multi-faceted issue. Not only does alcohol abuse have devastating effects on its consumer, it also poses serious threats to the individual’s community.

Alcoholism is a significant contributor towards a number of long and short term health problems, as well as socio-economic issues in society.

With the second highest per capita consumption rates in the world, alcoholism is especially detrimental in the Northern Territory. Shockingly enough, with an average of 14.6 litres per NT resident aged 15 years and above, the PCAC (Per Capita per Alcohol Consumption) rate of the Northern Territory is almost five litres higher than the national figure.

As a result, minimising alcohol related harm and anti-social behaviour is a high priority for the NT government.  Despite the achievements of many programs that have produced short term improvements, it is undeniable that alcoholism remains a large problem in the Northern Territory.

 The Proposal

 Recently, the Country Liberal Party has proposed a model of civil commitment for ‘problem drinkers’

Under the planned scheme, if a person is arrested for being drunk three times within a six month period, they will become subject to an order that will require compliance with a voluntary rehabilitation program.

If the individual fails to complete the program (thus breaching the order) they will be guilty of the offence of having breached the order. If found guilty of the breach, they will face a mandatory sentence of 3 months in a rehabilitation centre

 The centres, famously promoted as a ‘world first’, and ‘one of the best tools for combatting alcohol abuse in the Territory’, have been met with considerable opposition

Many have labelled the policy as ‘dangerous’, with the potential to kill dependant users through for example, the effects of further traumatisation on mental health, rather than rehabilitation

Current Australian civil commitment laws, upon which the proposal will likely be based, have been strongly criticised on a number of ethical, moral and legal grounds

 Many have argued that  is not an ethical process, and should not be implemented unless it has been proven to be highly beneficial for subjects of the treatment.

Civil commitment legislation from Victoria and New South Wales have faced condemnation as they potentially breach numerous human rights, including those of liberty, freedom from arbitrary detention, least restrictive treatment and access to an acceptable appeals and review process As a consequence, there is also the risk that the legislation may breach the Universal Declaration of Human Rights and the International Covenant on Civil and Political Rights

 This paper wishes to explore existing evidence from studies on both civil and forensic mandatory rehabilitation in order to evaluate if this is indeed an efficacious form of treatment for alcohol dependant persons, and if it would be appropriate to implement such a regime in the Northern Territory.

Given the lack of evidence for the effectiveness of civil commitment, the potentially significant impact that is will have upon the freedoms individuals, families and the community. it appears that it could be difficult to justify the proposal.

NT Government press release April 12

BOLD NEW PLAN FOR TREATING PROBLEM DRUNKS

Repeat problem drinkers will be required to undertake alcohol mandatory treatment under new legislation to be introduced at the next Parliamentary sittings by the Northern Territory Government.

 The landmark reform will require problem drunks to undergo a clinical assessment and referral to an Alcohol Mandatory Treatment Tribunal for recommendation to appropriate mandatory treatment.

 They will face up to 12 weeks of mandatory rehabilitation in centres located in Darwin, Alice Springs, Katherine and Nhulunbuy.

 Alcohol Rehabilitation Minister Robyn Lambley said the measures target problem drunks who are disrupting businesses, affecting local neighbourhoods and harming themselves.

 “Territorians are fed up with the levels of anti-social behaviour and violence on the streets and they want their Government to implement real measures that work,” Mrs Lambley said.

 “Every year, thousands of problem drinkers are picked up by police only to be placed in Police Protective Custody and then released back out on the street to continue drinking and anti-social behaviour.

 “Our Mandatory Rehabilitation measures will ensure serial habitual drunks are off the streets and receiving meaningful treatment.”

 The measures proposed by Government include:

 Enshrining into law three Police Protective Custodies in two months as a trigger for referral into alcohol mandatory treatment

Start-up of an Alcohol Mandatory Treatment Tribunal to assess the suitability of problem drinkers for alcohol mandatory treatment and/or income management orders.

 At start-up, establishment of treatment centres in Darwin, Alice Springs, Katherine and Nhulunbuy.

 Phase two roll-out of additional capacity in Tennant Creek and the Tiwi Islands.

 In the initial implementation phase there will be up to 140 alcohol mandatory treatment places, increasing to 200 in coming years.

 When it is fully operational, up to 800 habitual drunks will undertake alcohol mandatory treatment every year.

 Treatment may include participation in therapeutic alcohol and drug treatment, chronic disease and other health management, life skills programs and work readiness as well as after care programs to assist people when they are discharged.

 It is proposed the Alcohol Mandatory Treatment Tribunal will have income management referral powers.

 “I am speaking with rehabilitation service providers and am encouraged at their response to this innovative initiative,” Mrs Lambley said.

 “Last year police placed more than 19,000 people in Protective Custody and of those, almost 3000 were repeat offenders.

 “One drunk was placed in Protective Custody 117 times – this is clearly unacceptable and shows the deficiencies in supply side alcohol reduction measures like the ineffective Banned Drinker Register.

 “Our new rehabilitation model will provide repeat problem drinkers with a real chance to break the cycle of alcohol abuse and harm.

 “This is a significant commitment by the Northern Territory Government to work with health service providers to tackle the problems caused by alcohol within the community.

 “It also gives value to the work done by police who become understandably frustrated with putting the same drunks in Protective Custody night after night.

 “The Northern Territory has the highest per capita alcohol consumption in Australia, one-and-a-half times the national average.

 “Studies show alcohol costs the Territory $642 million a year through hospitalisation costs, policing costs, courts and correctional services costs and loss of productive.

 “Police statistics show 60 per cent of all assaults and 67 per cent of all domestic violence incidents involve alcohol.

 “Our alcohol mandatory treatment policy, alongside our commitment to deliver an additional 120 police on the beat, the fast tracking of outstanding Alcohol Management Plans and residential rehabilitation programs ensures the Country Liberals Government has a comprehensive plan to get drunks off the streets.”

One comment on “NACCHO health report: NT debate mandatory rehabilitation for treatment for alcohol dependant persons

  1. AMSANT PRESS RELEASE New alcohol regime: what happens after release?

    “Today’s announced plans for treating “problem drunks” at least gives us some certainty as to government plans—but leaves a major and worrying gap for the longer term Aboriginal Medical Services Alliance Northern Territory [AMSANT] CEO John Paterson said today.

    “We welcome the fact that the new Government has a ministry for Alcohol Rehabilitation—and that recognises the tragic effects alcohol consumption has on the Northern Territory,” said Mr Paterson
    .
    “However, we are not convinced that the proposals as outlined today will prove to be much more than a very expensive white elephant.”

    Yesterday, AMSANT released an independent desktop study that has a careful look at the evidence from around the world and the nation.

    The study looked at a whole range of these sorts of programs around the world, and found that:

    Evidential justification for the efficacy of civil commitment for alcohol rehabilitation is scarce, incomplete and largely anecdotal. There is little empirical evidence in support of such programs producing long-lasting positive behavioural changes, or ongoing rehabilitation.

    “And that’s what worries us most of all: what happens to people after their 12 weeks inside, when all the evidence tells us that 12 weeks is nowhere near enough to effect long term change, let alone a 12 week mandatory program?
    “This means having Alcohol programs in the community—whether it be in Darwin, Alice or remote areas—and we really need an answer to this as soon as possible.
    “The only thing we have heard on this issue so far is not encouraging—early this year the Department of Health suspended the roll out of 10 AOD workers for remote communities, and the majority of social service delivery organisations in the Territory are facing cuts in excess of 10% in real terms in the coming year.
    “Three of the existing facilities to be utilised by this program—in Alice Springs, Katherine and Nhulunbuy—are already over stretched and will be transformed into secure facilities.
    “Now the chances of voluntary clients attending these facilities will disappear.
    “We do acknowledge the government was elected on this platform. Let’s see if it works, and let’s see if it can provide good evidence of it working. And let’s hope that the government, as it evaluates what works and what doesn’t, is open to change.
    “Above all, they must address the issue—now—of post-release support to people damaged by alcohol.”
    Interviews/information contact: Chips Mackinolty 0419 844 774
    http://www.amsant.org.au

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