Responding to Drug Use - Manager, Adult Mental Health Services - Transcript - 16 July 2004

MR. I. DYER, MANAGER, ADULT MENTAL HEALTH SERVICES

1. Rangeoftreatmentoptions:HarmReduction to Residential Rehabilitation

1. Statutory services offer a wide range ofoptions.In the majority ofcasesharm reduction or minimisation is the focus but residential rehabilitation programmes are also required in a balanced service.
2. There is a lotofgoodworkalso being doneby voluntary agencieswhichprovideresidential programmes.
3. There is a need to improve co-ordination between the various agencies. This is being addressedthroughthedevelopmentofanintegrated care pathwaysstrategy.
4. Client needshave to beassessedso that appropriate treatment canbe offered.
5. Clients wants are notnecessarilythesameasclientneeds. It isimportanttoremember that responsibility remainswith the substanceuser. Statutory andvoluntary services are there to support the user toregaincontroloftheir lives and to moveback into society.
6. Methadoneis a triedandtestedprogramme helping to reduce the problems caused to society by problemdrugusers.
7. Detox is sometimesrequiredas a drug holiday'. It is not necessarily the first step for all substance misuserson the road to abstinence.It is common for users to relapseand to go through a number of detoxes.It is important that appropriate after care is in place.
8. It is important that, nomatterhowmany relapses occur,societydoesn't shut the dooron addicts. A response from services attheright time can lead to change in anindividual's lifestyle.

2. Jersey Addiction Group

1. This voluntary,charitable organisation, wasestablishedfiveor six years agoandSilkworth Lodge was open three years ago. JAG is now recognised as one of the main players in abstinence based treatment.
2. Co-ordination between JAGandstatutoryservices,althoughslowtogetestablished,hasnow improved. A sourceoffundingfor referrals hasnowbeen identified throughdrugconfiscation funds but there isnocurrently identified establishedbudget within HealthandSocialServices for this purpose.
3. The cost per resident at Silkworth is £600 perweek.HealthandSocialServices have beenable to negotiate a reduced contribution of £400, with some form of self funding from clients were appropriate.
4. The useofSilkworthfor the treatment ofopiateaddictionas well as alcohol, is nowexpanding.
5. Health andSocialServiceswould ideally like toestablish a ServiceLevelAgreement for the provision of rehabilitation and a form of half wayhouse in return for a regularStatesannual contribution of, say,£200,000.

3. Prison

1. The Woolreport called for the developmentof a comprehensivesubstancemisuse strategy and the needfor this hasbeenrecognisedby both Home Affairs andHealthandSocialServices Committeeswho have called for a progress report in sixmonths time.
2. Specific issuesat the Prison,suchasneedleexchange,methadoneandsentenceplanning, need to becarefullythoughtthrough.

4. Identification ofaddictionandappropriatereferral

1. Drug users are not the same stereotype in Jersey as in United Kingdom where addicts commonly are unemployed, living insquats etc.
2. In Jerseyaddictsaremore likely tobe in employment. Addiction is hidden from public view and is notsoeasily identified.
3. There is a need to raise public awarenesssothatfriendsandfamilycanread the signs before addiction develops.
4. Health Promotionshouldbe a key investment for theIslandand would save money in thelong term byreducingaddictionand its associatedproblems.Jerseycouldsetup a pilotschemeand become a modelshowingtheimpactandcost effectiveness ofsuchinvestment.
5. Transforming the Education Curriculum should also be a priority. Studiesshow that problem drug users have commonlyexperiencededucational difficulties andhave low self esteemwhich has beenevidentthroughoutschool.Some children get bored with curriculumandneedmore proactive approach.

5. Integrated database

1. Health andSocialServices are considering a new information basedpackagecalledFACE,due to beintroduced into Adult mentalHealth Services by the endofthe year.
2. ADShavebeenasked to assesshowusefulitwouldbeandhow it would tie into other systems as recommendedbytheICSM report.

Corrected Notes 27.07.2004