Rebecca Wen
The rapid review undertaken as part of QNADA’s Responsive Systems project examined fifty Queensland inquiries, reports and strategies undertaken in the past ten years and identified 444 recommendations and actions that are relevant to addressing alcohol and other drug related (AOD) issues across a range of systems. The findings from this review brings a valuable perspective in how cross sectoral collaboration and coordination can provide better systemic responses to improve the health and social wellbeing of individuals, families and communities that are affected by problematic AOD use.
In this article, I’ll focus on the recommendations that are related to workforce and training. There are 73 of them and it is the second largest area of focus following pathways and programs. The majority of them focuses on service improvements (27%). This includes capacity building activities for the workforce in systems such as child safety, primary health care, correction and emergency services to increase their knowledge and improve their skills about AOD related issues. For instance, Queensland Health’s Insight service has developed an AOD Brief Intervention Toolkit to help GPs and other health professionals to screen, assess and conduct brief interventions with their clients if there are concerns with AOD use. In addition, there have also been capacity building activities for our own AOD specialist workforce. Family Drug Support (FDS), for example, has expanded their service delivery scope to Central Queensland to provide workshops and information sessions for AOD and other health professionals on how to support family members who are affected by problematic AOD use.
A portion of the recommendations under service improvements is also about developing frameworks and educational recourses to encourage the communication of cross sectoral practice and knowledge. For examples, ATODA’s Domestic and Family Violence (DFV) Tools for AOD Settings provide some very practical guidance to the AOD sector on how to prevent and respond to DFV, and the recently released DFV Common risk and safety framework also includes some considerations on assessing and responding to problematic AOD use in DFV settings. A small number of the recommendations is also related to increase human resources to promote cross sectoral collaboration, such as employing youth AOD liaison staff to assist with child safety officers in some situations.
However, there are a number of recommendations that considered AOD use as a risk factor (15%) that need to be mitigated. Almost all of them are concerned about individuals displaying violent behaviours under the influence of alcohol and/or other drug. Subsequently, some workforce building and training activities were implemented, including an increase of police officers in night time precincts and the roll-out of self-defence and aggressive behaviour management trainings for ambulance and hospital staff. While these recommendations can be considered as reasonable based on the findings from their corresponding inquiries, we are apprehensive about some of the language that is used to provoke fear and marginalisation to perpetuate stigma and discrimination on people who use AOD. For example, the 2010 Inquiry into Alcohol Related Violence which has a number of recommendations related to mitigating people’s AOD use as a risk factor states:
“The Committee agrees that the majority of law abiding citizens should not have to suffer for the actions of a few……The report calls for greater enforcement and increased penalties.”
Pleasingly though, the rapid review identified a number of recommendations that are also promoting stigma reduction work (8%) across workforces. Most of these recommendations come from QMHC’s Changing attitudes, changing lives report that was released in 2018, and one strategy that has already been endorsed by the Queensland Government is the incorporation of AIVL’s ‘Putting Together the Puzzle’ anti-stigma awareness training “into existing agency training programs and professional development strategies…, for all social service sector workforces, including, health, housing, child safety and justice”[1]. The report[2] also recommended that anti-stigma trainings should be delivered in partnership with people with lived experiences of problematic AOD use as it may help to promote social inclusion and address biases and stereotypes. Some recommendations also expressed support for similar anti-stigma awareness training to be delivered to frontline police officers.
After all, it is evident from the review’s findings that, there has been efforts from a number of systems and across different workforces in Queensland attempting to address AOD related issues, and improving the wellbeing of people and communities who are affected by problematic AOD use. Most of the recommendations that focus on workforce and training have acknowledged the importance of communicating cross sectoral knowledge and building workforce capacity to provide adequate health and social care for individuals, such as responding to DFV issues in AOD settings and vice versa. Besides, I think the involvement of the AOD sector (eg the peer workforce) to provide education and trainings to other agencies about stigma reduction is in itself an effective way to reduce prejudice that some may have towards people who use alcohol and other drugs.
QNADA’s position has always been seeing the ‘person’ first while their AOD use is just one element of their life. I think this is also a belief commonly held by our members, that when a client walks through the door, they may be experiencing other difficulties in life along with their AOD use. So if QNADA can lead this momentum in facilitating better collaboration and partnership between the AOD sector and the other systems such as the child protection, youth justice, and criminal justice systems, we hope to achieve effective systemic responses to support our members to provide high quality, person centred, and evidence informed care to their clients.
————————————————————————
1Queensland Mental Health Commission, 2018. Changing attitudes, changing lives. [online] Brisbane: Queensland Mental Health Commission. Available at: https://www.qmhc.qld.gov.au/documents/changingattitudeschanginglives
2 ibid