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THE DRUG COURT PROGRAMS

RESIDENTIAL PROGRAMS

How assessments and recommendations for residential treatment are made

An assessment or recommendation for residential treatment may be made at any stage in the process, including initial assessment or if the participant does not do as well as expected in an out-patient program.

The table below lists the factors relevant to officers deciding whether to recommend to the court that a defendant should undertake either residential or non-residential treatment programs. It was compiled by the pilot program magistrate and Drug Court co-ordinators on 24 August 2000. At the time of compilation supported accommodation was not available. It was from this that seeds were planted and bore fruit as the supported accommodation program.

Now, if a defendant is assessed with a score of 6 or more, excluding the accommodation items, he or she will be assessed as requiring a residential rehabilitation program. If a score of 6 is inclusive of accommodation items the defendant would require supported accommodation. The defendant can argue otherwise and the final decision rests with the court.

Primary criteria Score

Long term chronic drug abuse with few breaks Lack of family/social supports

Lack of stable accommodation Lack of appropriate accommodation

2 2 2 2

Secondary criteria Score Poly drug dependence

History of sexual/other abuse History of institutionalization History of incarceration

History of recent failure/breaches of other community based orders Lack of literacy skills

Lack of life skills

Minimal previous drug intervention Primary care of children

Requiring detoxification

Dual diagnosis (drug dependence & mental illness) Prior failure on outpatient rehabilitation programs Not suitable for pharmacological intervention Age

The Department of Corrective Services (DCS) will also consider whether the offender can be kept safely in the community while addressing his or her drug related problems. If so, the assessor then does a home assessment at the proposed accommodation. If the home is not considered appropriate the supported accommodation program will be recommended for that person.

If a defendant cannot be left safely in the community because of a likelihood of relapse and consequent re-offending, and appear sufficiently capable of dealing with the demands of a residential rehabilitation program and sufficiently motivated, or likely to become motivated, then the DCS assessor will request Queensland Health (QH) to refer the person for assessment for residential rehabilitation.

Each residential rehabilitation centre has a different program. Therefore the assessors strive to match defendant’s needs with the program most suited to addressing those needs. They are staffed or serviced by professionals with graduate and post-graduate qualifications, including nurses, psychologists, social workers, psychotherapists, counsellors, doctors and psychiatrists.

The centres offer various holistic programs focused on biological, psychological and social factors which may underlie a person’s use of drugs. A range of treatment components are offered including: group psychotherapy, 12-step programs and self-help groups, didactic (psycho-educational) groups focusing on life-skills (such as anger management, assertion training), and relapse-prevention groups).

An important aspect for some centres is the operation of the program by a therapeutic community (TC). In a TC the members of the residential community themselves are vehicles for change. They give mutual feedback to each other on their behaviours, and confront behaviours which may be damaging to a resident’s recovery and/or the community itself. This assists the offender to re-integrate into the wider community.

Beenleigh, Ipswich and Southport

The South-east Queensland Drug Courts now have funding for 46 positions (a ratio of 1:3 on a cap of 141 maximum concurrent intensive drug rehabilitation orders) at 5 residential drug rehabilitation centres as outlined in the following table.

Name and location Type of program Duration of program

In North Queensland, Drug Courts have funding for 20 positions (a ratio of only 1:4 on a cap of 40 maximum intensive drug rehabilitation order’s in each city) at 3 residential drug rehabilitation centres. They are—

• 10 places at St Vincent’s Community Services, Cairns.

• 8 places at St Vincent’s Community Services, Townsville.

• 2 places at Stagpole Street Drug and Alcohol Rehabilitation Service, Townsville specifically for indigenous offenders.

Mothers with children

There is a total absence of residential rehabilitation facilities suitable for drug dependant women with infants or young children. There have been several cases where women have been unable to gain access to residential programs although they were assessed as requiring residential treatment.

The profile of an addicted mother who requires residential treatment is similar to any other resident. However, she will usually exhibit more social disadvantage and poor socialisation or immaturity. Usually her partner will have also left her with the burden of child rearing. Additional services may need to be provided in a therapeutic community for disadvantaged women with children. These can include family unit housing, child care, parenting programs and special medical/psychological care to cater for a mother’s special clinical issues.

Indigenous needs

Residential rehabilitation programs

A primary principle in establishing residential placements for the Drug Court has always been that additional beds (i.e. placements) be State funded so that the Drug Court program does not take beds away from the general community (i.e., so that community members do not feel compelled to say they have to commit offences to get into rehabilitation). There are no Drug Court pilot residential placements funded in South-east Queensland for those indigenous participants who have specific indigenous and cultural issues needing to be addressed to assist their recovery.

The Jessie Buddy Healing Centre, at Llewellyn Street, New Farm, is run by QAIAS (Queensland Aboriginal and Islander Alcohol Service). It is NOT State funded. It has Commonwealth funding under ATSIC. Drug Court participants may be accepted. However, participants would have to make their own arrangements for admission and travel to and from the facility for placement and court reporting.

The facility caters for up to 25 residents and has a half-way house next door for up to seven residents. Participants can be male or female but must be aged 17 or over. Non-residential clients may also undertake the structured group and counselling sessions.

The residential and non-residential programs focus on—

Recommendation No. 49

Resources should be allocated to establish residential programs specifically for women with children, to include family unit housing, child care, parenting

programs and special medical/psychological care to cater for special clinical issues.

• Education about harmful affects of drugs and alcohol

• Relapse prevention

• Stress and anger management

• Social skills

• Budgeting

• Personal growth

• Emotional problems

• Sexual abuse (individual and group; usually weekly but also on a needs basis)

• Family re-unification

• Family therapy and couples counselling.

Culturally appropriate programs

The Drug Court does not have ready access to culturally appropriate programs.

The recent employment of an indigenous health worker by QH (see below) may assist the Drug Court to find appropriate programs. However, unless government and non-government organisations connected to such programs are willing to volunteer their services, funding will be required. Also, to expect them to do so would run counter to the policy adopted thus far, i.e. that the Drug Court should have its programs specifically funded and should not take scarce places away from other members of the community who do not come via the courts.

Case illustration # 5

Several Aboriginal men and women would have benefited if the Drug Court had access to more culturally appropriate programs. It is cliché to say Aboriginals and Torres Strait Islanders have experienced many alcohol related problems. Now, there appears to be a disturbing trend toward use of illicit drugs among young Aboriginals and Torres Strait Islanders, especially amphetamines.

Typically, the criminal convictions commence when they are juveniles.

Convictions as an adult include property and drug offences. Many of them left school early and have limited literacy skills. Some have never been employed.

In at least one case, the pilot program magistrate refused a request by an Aboriginal participant that the program be terminated, and offered encouragement and support to continue with the conditions imposed by the IDRO. One such participant has since graduated. In the Drug Court’s experience, grants from community development funds and from other sparse sources have helped indigenous Drug Court participants to gain qualifications and work in projects which also teach them about their own cultural heritage.

As recently as May 2003 QH employed an indigenous health worker at the West Moreton Community Health Service District office of the Alcohol Tobacco and Other Drug Services (ATODS).

This position is not a dedicated Drug Court position. Queensland Health was funded to provide an extra resource in Health Service Districts where ATODS provides services not only to Drug Court clients but also QH clients from other courts who are given bail conditions requiring attendance at QH drug treatment and counselling services.

The QH Drug Court co-ordinator sees this role as not having a formal therapist component but rather that, if provided, any therapy would be opportunistic. It is intended the Drug Court related duties will be—

• to assist the ATODS counsellors to identify the culturally appropriate health case management needs of the identified indigenous Drug Court participants

• to assist the Drug Court Health Assessor to identify the health case management needs of the identified indigenous clients and assist the assessor to develop a culturally appropriate treatment plan to be recommended the court.

• to offer suggestions via the Drug Court Health assessor (or co-ordinator) for culturally appropriate sanctions and rewards for the Indigenous Drug Court participants.

• to assist other West Moreton HSD indigenous workers to effectively case manage community health indigenous clients who may have problems with alcohol and other drugs.

• to be available to the Gold Coast and Logan Beaudesert Health Service Districts’ Drug Court Health Assessors on a consultative basis as needed to assist with the development of treatment plan options for indigenous clients appearing in the Southport and Beenleigh Drug Courts.

• to periodically provide feedback to, and have discussion with the Drug Court health co-ordinator/health assessor, about the need for, and availability of, culturally appropriate services for indigenous participants.

Recommendation No. 50

Drug Court resources should be extended to include indigenous and culturally appropriate programs such as the Jesse Buddy residential program, the Youth Enterprise Trust Camp, and other employment and training programs. The Reference Group should be responsible for identifying appropriate and relevant programs and identifying the relevant State department to administer the funds and co-ordinate itself with the Drug Court.

It is hoped this position will vastly improve service delivery and the health outcomes for indigenous Drug Court participants.

SUPPORTED ACCOMMODATION PROGRAMS