Mission Australia’s response to National Drug Strategy (NDS)
December 2010

To obtain further information or discuss this submission pleased contact:
Anne Hampshire

National Manager, Research and Social Policy

Mission Australia

E:

T: 02 9217 1059

Executive summary

This response reiterates our earlier submission in February 2010to Australia’s National Drug Strategy – Beyond 2009 Consultation Paper. Mission Australia’s visionis of a fairer Australia and works with people in need to find pathways to a better life. We believe that the top priorities for action in the next five years in the drug and alcohol sector are well identified in the strategy and particularly note the value of:

  • The development of a strategy which integrates with the social inclusion agenda and related initiatives.
  • The need for ongoing and continued support for evidence informed practice service models for alcohol and substance misuse treatment which are integrated and holistic.
  • Realistic funding for sustainable outcomes.
  • Emphasis on strategies which support the development of the drug and alcohol workforce ensuring a well qualified competitively employedindustry that meets projected and future needs; and
  • Youth drug education strategies which support young people to development the capacity and skills to address their concerns about alcohol and drugs.

Background on Mission Australia

Mission Australia is a national, not for profit organisation that works within the community and employment sector. Each year its services support over 300,000 Australians in need. Our vision is to see a fairer Australia by enabling people in need to find pathways to a better life. Mission Australia delivers a range of services that help Australians in need to achieve pathways:

  • To strong families and healthy, happy children
  • Though a successful youth
  • Away from homelessness
  • To skills and qualification; and
  • To sustainable employment

Mission Australia has over 350 community services across the nation. Of these, nearly 20 services are specially focused on assisting individuals and families to deal with drug and alcohol issues. This year, one of our services, Triple Care Farm – was awarded the Nation Drug and Alcohol Award for service excellence in Services for excellence in Services for Young People. Triple Care Farm is an innovation, intensive residential rehabilitation program for young people with a dual diagnosis of substance use and mental health issues. In addition, Mission Australia runs the Drug and Alcohol Youth Service (DAYS) in Western Australia, the only residential youth drug and alcohol detoxification and rehabilitation centre in Western Australia. A significant number of our other services across all areas of our work are assisting clients with drug and alcohol issues.

Mission Australia’s programs and advocacy are informed but our Research and Social Policy Unit (RSPU) which identifies existing and emerging social needs and assists in developing innovation and effective responses to these needs, based on best practice and national and international research. These activities inform Mission Australia’s approach to service delivery, the prioritisation of its work, investment decisions, and the design of particular programs. They also enable Mission Australia to prepare submissions that are informed by the synthesis of practice wisdom with primary and secondary research.

RSPU is currently heavily involved with two research projects in collaboration with two of the three National Drug Research Centres of Excellence. Both research projects are seeking to develop the evidence around what works with specific population groups (youth in residential settings; homeless men) with regards to substance misuse issues.

  • The first projects in an ARC supported Linkage Grant collaboration with the National Drug Research Institute, academics from the University of Western Australia, University of Sydney, University of Western Sydney and two industry partners, Ted Noffs Foundation and Mission Australia. It is designed to produce a psychometrically robust outcome measure of young people’s process in treatment for substance misuse which is accessible to the workforce and which produces outcome data that is meaningful and useful. The national research project builds on previous work of the collaborators and responds to significant gaps in our understanding of ways of measuring the progress of young people in residential rehabilitation settings.
  • The second project is a three year philanthropically funded, ARC like, collaboration with the National Drug and Alcohol Research Centre, academics from the University of New South Wales, Murdoch University, and Mission Australia and seeks to asses the effectiveness and cost-effectiveness of a new model of intervention for homeless men. This new model, the Michael Project, in an initiative in Sydney which aims to improve the social inclusion of homeless men though enhanced, timely integrated homeless service delivery. A significant number of these men have substance misuse issues.

In addition, for the last nine years Mission Australia has been running an annual survey of young Australians, the largest of its kind, and in 2010 over 50,000 young people aged between 11 and 24 participated. The survey identifies the concerns of young people – both personal and national and in 2010 alcohol and drugs was the second top national issue identified by young people. The survey highlights some important gender and age differences regarding young people’s level of concern re alcohol and drugs with young males more likely than young females to be concerned about both, but particularly alcohol and younger respondents more likely than older respondents to be concerned about drugs. The survey also indicated that young people identified drugs as a ‘young people’s issue’ whereas ‘alcohol’ was seen as much more of a ‘whole of society’ issue. Given the data on usage patterns and age of initiation to drugs and alcohol the National Survey of Young Australians provides important information that should help inform the development and implementation of the National Drugs Strategy, particularly with regards to effective drug education strategies relating that target young people. The survey can be accessed at and Mission Australia would be happy to provide a fuller briefing on its findings.

Comments on the National Drugs Strategy

Mission Australia acknowledges the core principles that have underpinned the NDS for the last 25 years. It also sees the potential of targeted and broad based education strategies as part of a preventative agenda drawing on material such as the National Survey of Young Australians. Education strategies to date appear in many cases to have increased awareness of these issues but not necessarily increased capacity of young people to deal with them.

A stronger and more utilised evidence base, particularly in terms of what works with different population groups, is needed in terms of the identification of what works, the cost benefits of service provision, the gaps in knowledge and also supporting research to address these gaps in an ongoing concern for Mission Australia. Research should be jointly developed and implemented by policy, research and practitioner partnerships and collaborations.

Mission Australia welcomes the NDS approach to a whole of community approach which is cognisant of the social inclusion agenda which resonates well with Mission Australia’s experience. This experience has highlighted for example the complexity of issues around homelessness and housing provision: a home does not necessarily solve homelessness as there can be deep seated and complex issues for those who experience homelessness, including drug and alcohol issues. Recent work published by Mission Australia on homeless men (Increasing our understanding of homeless men: The Michael Project, 2010) indicated that half of the over 250 homeless men surveyed had a substance use disorder that had been diagnosed by a health professional and that dependence was high amongst those reporting current usage.An approach that recognises that there are many areas of work which need to be dealt with simultaneously resonates well with the social inclusion agenda. This will have training implications for the workforce and as well as a renewed emphasis on partnership.

Mission Australia welcomes the continued statements around the core principles of evidence informed practice and an emphasis on prevention. Addressing vulnerability, cross sectoral approaches, Aboriginal and Torres Strait Islander peoples and capacity building in the context of fostering the goals of the social inclusion agenda is the key to harm reduction and prevention.

Recommendations

Harm minimisation

Periods of transition such as from school to the workplace and particular ages and stages of life are seen as times when individuals are more at risk of harm from drugs than at other times. At Mission Australia we recognise that there are many ways to approach this, and of particular importance is though strengthening family relationships.Mission Australia recommends programs that focus on integrated approaches as well as community based initiatives. Consequently we recommend:

  • A recognition that the most important factor influencing substance abuse are early life experiences, family relationships and parental attitudes and behaviour is needed, if harm minimisation is going to be achieved. Good parenting and a stable family life can reduce the risks of hazardous substance abuse. Investing in people who are socially excluded, living in poverty and are disadvantaged and vulnerable is therefore essential in both hard reduction and demand reduction. Evidence based family centred cervices that support families in terms of building resilience and cohesion are a critical part of this.
  • A stronger focus in adolescence on young people’s peer/friend networks is important in addressing drug and alcohol usage given the importance of what is seen as ‘the norm’ during this time of development. This is particularly the case for more vulnerable young people such as those in juvenile justice and those who are homeless. These groups tend to have higher rates of alcohol and drug usage and they tend to identify a greater level of concern regarding alcohol than other young people (see 2010 Mission Australia’s National Survey of Young Australians).
  • Recent statistics show that the consumption of alcohol at levels of associated risk for young women has increased. However Mission Australia’s National Survey of Young Australians shows young females are much less concerned about alcohol than their male counterparts. Strategies which take account of gender perspectives are required.
  • Research shows that the portrayal of health and social problems associated with drugs usage have a greater impact on young people than those associated with the ‘illegal’ dimension (eg the legal consequences of being arrested etc) of drug usage. However current media reporting on drugs tends to focus on the latter rather than the former with health and social problem messages accounting for only a small proportion of the news media reporting on drugs. The media could potentially play a stronger preventative role in the demand for illicit drugs simply through redressing the dominant message in the way it reports on this issue. Efforts should be made to engage with media on these issues.
  • Strategies aimed at reducing the risk factors associated with drug and alcohol use and maximising health promotion strategies need to be advanced. These should include a mixture of parent-child services and strategies, health education in schools as well as broader society wide interventions such as the sale of alcohol to minors.
  • Intergenerational issues need to be addressed to break the cycle of rates of harmful alcohol consumption for young people. This may include the wider family network of grandparents and other significant relatives as primary carers.
  • The development of synergies between the new NDS and the Social Inclusion agenda continue.
  • Multi-component programs which address local issues, co-ordinate projects with clear aims, objectives and indicators are essential in harm minimisation.Engagement and involvement of the local community should be an essential part of all initiatives.
  • There should be a focus on the social determinants of health and substance related harm.

Demand reduction

Mission Australia approves of many of the initiatives in the NDS in terms of demand reduction especially in terms of delaying the first onset of drug taking, tackling issues at the school and family level and especially around disadvantaged communities and setting / place based approaches. It recommends:

  • The continued emphasis on cross sectoral collaboration between government and non government agencies, especially in terms of co-location, referrals and team building; networking;
  • That the non-governmental sector is recognised on the National Expert Advisory Panel.

Within both harm and demand reduction there needs to be a particular emphasis on Indigenous Australians. This is in part due to their disadvantage in society and also their lack of access to services. Services need to be embedded in their culture and practices as well as local polices. In regards to Indigenous Australians under the revised strategy Mission Australia recommends:

  • The revised strategy should be underpinned by the recognition that substance and alcohol related harm for Aboriginal and Torres Strait Islander people is linked to other areas of Aboriginal and Torres Strait Islander disadvantage and that the broad response should be aligned with a boarder framework of ameliorating Aboriginal and Torres Strait Islander disadvantage and poor health outcomes across a number of areas.
  • Integrated services should be developed for Aboriginal and Torres Strait Islander clients, particularly the co-location of social support with health services. Comprehensive, co-ordained and sustained responses are needed to support ATSI.
  • A workforce that is skilled and trained with particular attention to ATSI clients. In addition there is the need for a workforce able to respond to the particular needs of CALD clients.
  • Emphasis on developing the capacity to deal with clients who find services difficult to access due to their cultures or practices and their complex needs.
  • Identification, co-ordination and mobilisation of appropriate agencies, stakeholder and communitiesneeds to occur. A holistic approach, with drug issues being addressed alongside housing, mental and physical health, employment and education.

Mission Australia believes that the top priorities for action over the next five years are well identified in the core principles of the NDS including evidence informed practice and the emphasis on prevention, harm and demand reduction. Cross sectoral approaches are essential when working with vulnerable and socially excluded clients. Workforce capacity and development is fundamental in providing for these client groups.