Complementing AOD treatment: Continuing coordinated care
By Michelle Ridley NADA People accessing AOD treatment will often present with co-occurring issues like homelessness, isolation, mental health problems, family and domestic violence, criminal justice and child protection involvement.¹ So it’s unsurprising that the National Drug Strategy reports that their multiple needs must be considered, including their physical and mental health, social, economic, legal and/or housing circumstances.²
When I asked consumers how they would like to be supported to help them achieve their goals in AOD treatment, they echoed the strategy:
‘Keeping connections is hard, people need help to link with other services.’ Sarah
‘Help with housing and Centrelink—the practical things are important.’ Barry
‘Help working with FACS, for me and my kids.’ Debbie
Unfortunately, the complexity of these co-occurring problems means that helping people with their AOD use and other psychosocial needs is not always straightforward. Social determinants like discrimination, unemployment and poverty can contribute to AOD use issues.³ And the chronic shortage of affordable and available housing is one of the main factors driving homelessness.⁴ Challenges like these cannot be addressed by individuals and AOD services alone. Nor can they be resolved overnight.
People experiencing AOD use issues who have other psychosocial needs, most often require continuing and integrated support for a longer period. It can often be the co-occurring issues that get in the way of people accessing or staying engaged in AOD treatment. However, it can be difficult for AOD services to provide support around all the needs of a client due to limited resources and gaps in service provision. While workers have made admirable attempts to leverage off goodwill partnerships with other services and sectors, and to provide holistic care with stretched resources, systemic barriers still exist.
Recognising the need for people with AOD issues to have more continuing and integrated support, the Continuing Coordinated Care (CCC) program was implemented with funding from the Ministry of Health. The program provides intensive wraparound support for people with AOD issues and other co-occurring needs. CCC helps with care coordination, intensive outreach support and access to other services (e.g. health, housing, and education), information and advocacy.
The program does not provide AOD treatment but compliments the work of AOD services, helping clients to access or maintain engagement with treatment. For example, if your client is on a waiting list for residential rehab they could be linked to CCC during this time, or when they leave, they could be referred to the program for ongoing support. If you provide AOD counselling in the community, you could refer your client to CCC for outreach support to help them navigate other health and human services.
James’ story James was experiencing issues with methamphetamine use and moving from crisis to crisis accommodation before being referred to CCC. Alongside a long history of substance use, he experienced long term unemployment and homelessness. Socially isolated, he also experienced mental health issues, intense self-stigma and shame. Working with James for nine months, CCC helped him to engage with an AOD counsellor and a community based AOD treatment program. They referred him to housing support where he secured permanent social housing and helped him to participate in volunteer work.
He is now taking a computer course, reducing his debt through a ‘work and development order’ and will soon start casual work. James has reconnected with family, made new friends and was referred to a good GP. He is regularly active, attends the gym and enjoys cooking healthy meals—now that he has a kitchen. He has achieved his goal of abstinence for several months and, while he still feels urges to use drugs at times, he reports that he now has the skills to work through these feelings.
Sarah’s story A mother of two toddlers, Sarah had a diagnosed mental illness, and was experiencing homelessness. While she was addressing her AOD use issues with the Local Health District’s AOD service, CCC helped her to secure stable rental accommodation with the assistance of Community Housing, access a good GP who developed a mental health care plan, enrol her children in day care twice weekly, and to successfully appeal a Centrelink debt. With the help of a lawyer, Sarah is now working to regain shared custody of her eldest son. Her confidence has grown over the past seven months and she is now advocating for herself and her children and has the supports in place to move on with her life independently.
Community Sector Consulting. (2011). NGO practice enhancement program: Working with complex needs initiative literature review and member consultation. NADA.
Commonwealth Department of Health. (2017). The national drug strategy 2017–2026.
Homelessness Australia. (2016). Homelessness in Australia. https://www.homelessnessaustralia.org.au/media/46