This chapter reports on substance-use services funded by PM&C (see Box 6.1). The National Aboriginal and Torres Strait Islander Health Plan 2013–2023 suggests that promoting links across alcohol and other drug (AOD) and mental health services is an important strategy for improving Aboriginal and Torres Strait Islander health and wellbeing. Continuing to increase community awareness and education about the range of options for dealing with the use of drugs, alcohol and tobacco is also vital (DoH 2013). Many projects funded by the Australian Government are designed to reduce substance abuse through the provision of culturally appropriate AOD prevention, education, counselling, treatment, rehabilitation and after-care services for Aboriginal and Torres Strait Islander people.
In 2015-16, over 80 organisations were funded by PM&C to provide substance-use services under the IAS and 80 organisations contributed to the OSR. This was 13 more than the 67 organisations reporting in 2014–15.
In 2015–16, there were 25 new organisations in scope for substance-use reporting that were not required to report in 2014–15, while 12 organisations from 2014–15 were not required to report in 2015–16. This chapter includes a profile of these organisations and information on the types of services they provide, client numbers and episodes of care, and service gaps and challenges.
Box 6.1: Overview of substance-use services
There were 80 organisations providing substance-use services, and of these 38 (47%) were also funded by the DoH to provide primary health-care services. It should be noted that in 2015–16, the number of organisations providing non-residential substance-use services in scope for the OSR was higher (77 compared with 61 in 2014–15). In these 80 organisations:
• Around 32,700 clients received at least one type of substance-use service. Most clients (around 26,500) received non-residential services, while 8,100 (25%) received sobering-up, residential respite or short-term care and 2,800 (9%) residential care services.
• Around 170,400 episodes of care were provided, with 87% of these for non-residential services, 11% for sobering-up, residential respite or short-term care, and 2% for residential care services.
• Clients of non-residential services had on average 5.6 episodes of care, while those receiving sobering-up, residential respite or short-term care had on average 2.3 episodes of care.
• Non-residential episodes of care were evenly split between males and females, as were sobering-up, residential respite or short-term care episodes of care. More males than females received residential episodes of care.
65
Aboriginal and Torres Strait Islander health organisations: Online Services Report—key results 2015–16
65
6.1 Organisation profile
Location
The 80 organisations reporting on substance-use services were spread across all states and territories,
except the Australian Capital Territory (see Figure 6.1 and Table S6.1). There were 24 (30%) in New South Wales, 15 (19%) in Queensland, 14 (18%) in the Northern Territory and 11 (14%) in Western Australia. Smaller numbers were in South Australia (8), Victoria (5) and Tasmania (3).
Note: Multiple organisations may be located within a small geographical area, so not all organisations will be visible on the map.
Figure 6.1: Australian Government-funded organisations providing substance-use services to Aboriginal and Torres Strait Islander people, by remoteness area, 2015–16
Organisations were spread across all remoteness areas, with 19 (24%) in Outer regional areas, 16 (20%) in both Major cities and in Remote areas, 15 (19%) in Very remote areas and 14 (18%) in Inner regional areas (see Figure 6.2 and Table S6.2).
Key characteristics
Of the 80 organisations:
• 38 (47%) were also funded by the DoH to provide Indigenous primary health-care services and 42 (53%) were not funded by the DoH for primary health-care services.
• 59 (74%) were ACCHOs and 21 (26%) were other non-government-run organisations.
• 78 (98%) had a governing committee or board and of these, 48 (62%) had all Indigenous board members.
• Most organisations (84%) were accredited with the RACGP and/or against organisational standards. This was higher in organisations also funded for Indigenous primary health care (97%) than in other organisations (71%). Just over two-thirds (69%) of other organisations providing substance-use services were accredited against organisational standards only.
• 58 (73%) had 500 or fewer clients.
• 51 (64%) provided services from 1 site and 36% had more than 1 site (see Table S6.3).
6.2 Services provided
At a glance
In 2015–16, the number of organisations providing non-residential substance-use services in scope for the OSR was higher (77 compared with 61 in 2014–15). In 2015–16 therefore, a higher proportion of all
substance-use organisations provided non-residential services (96% compared with 91% in 2014–15) and more provided substance-use services in a primary health-care setting (48% compared with 30%). Most organisations (96%) provided non-residential services, 40% provided residential care services and 15%
sobering-up, residential respite or short-term care services (see Table 6.1).
Services were delivered from 159 sites. Around two-thirds of these sites provided non-residential counselling services (69%) and around one-third (35%) residential counselling and residential group work. Around 32,700 clients were seen through 170,400 episodes of care. Compared with 2014–15, the number of organisations in the OSR increased by 19%, while total client numbers increased by 30%, and episodes of care by 13%.
16
Figure 6.2: Number of substance-use
organisations, by remoteness area, 2015–2016
67
Aboriginal and Torres Strait Islander health organisations: Online Services Report—key results 2015–16
67
Table 6.1: Indigenous substance-use services, 2014–15 and 2015–16
2014–15 2015–16
Number % Number %
Total organisations providing substance-use services 67 100.0 80 100.0
Organisation also funded for primary health care 20 29.9 38 47.5
Other organisation 47 70.1 42 52.5
Type of service(a)
Residential 27 40.3 32 40.0
Sobering-up/respite care 12 17.9 12 15.0
Non-residential 61 91.0 77 96.3
Sites providing services during usual opening hours
Receive referrals 109 97.3 152 95.6
Residential counselling 41 36.6 56 35.2
Non-residential counselling 74 66.1 109 68.6
Residential group work 43 38.4 56 35.2
Mobile assistance patrol/night patrol 8 7.1 10 6.3
Group work with clients not in residential care 76 67.9 97 61.0
Total sites(b) 112 100.0 159 100.0
Clients(c)
Residential 2,663 10.6 2,844 8.7
Non-residential 19,938 79.1 26,467 80.8
Sobering-up/respite care 5,769 22.9 8,080 24.7
Total clients 25,196 100.0 32,740 100.0
Episodes of care
Residential 2,932 1.9 3,173 1.9
Non-residential 133,731 88.5 148,842 87.4
Sobering-up/respite care 14,384 9.5 18,355 10.8
Total episodes of care 151,047 100.0 170,370 100.0
(a) Organisations may provide more than one type of service, so categories will not add to the total number of organisations.
(b) Includes all sites whether services were provided during normal hours or not.
(c) Clients may receive more than one type of service, so categories will not add to the total number of clients.
Note: In 2014–15, the reporting period was 1 June 2014 to 31 May 2015. In 2015–16, it was the financial year from 1 July to 30 June.
Source: AIHW analyses of OSR data collection, 2015–16.