Community services worker Katrina Bester recently travelled to California as part of Anglicare’s Jerrim Fellowship, a program that allows staff to pursue a project or training courses they may be interested in.

The focus of the five-week trip was a continuum of care comparison between Tasmania and California, for which she attended the annual Addiction Conference, and visited three alcohol and drug centres that had high success rates.  

Ms Bester said her findings highlighted gaps in Tasmanian drug and alcohol rehabilitation services.

“In Tasmania, detox is kept separate from residential care, and there is often long waiting periods,” she said.

“Here, we are almost setting people up to fail, because we know if they complete detox, it’s going to take more than 10 to 14 days for them to be able to make behavioural changes.”

While Tasmanian has residential care services like Missiondale or the Salvation Army, Ms Bester said the outpatient support people needed after such care was lacking.

“They are thrown back out into the community and it becomes pretty hard for them to sustain the changes they have made.”

In the US, patients are put through a detox of 10 to 14 days, before being released into residential care, where they can remain for up to 90 days.

From there, they move into a sober living arrangement, which includes a live-in support person.

When they progress to living on their own, the support continues through a case worker who comes during the day and can help with arrangement they have made. 

Ms Bester said the outpatient program continued when they eventually returned home.

“From the time they come into detox, there is an individualised care plan, which is frequently reviewed throughout the process,” she said.

“When they get out of residential care and living on their own with support, they have a plan that might include counselling, group therapy, or other things they would be doing each day.

“This allows their brain to create new neural pathways, and a new default way of being.”

The US system is based on behavioural wellbeing, and has a more holistic approach, she said.

Ms Bester noted the support of mental health services in drug and alcohol rehabilitation as one of the key differences between Tasmania and California.

“There is no wrong door approach in US,” she said.

“Mental health and addiction falls in with the drug and alcohol rehabilitation.”

She said the current state of Tasmania’s mental health system meant it was ill-equipped to provide the same assistance.

“It’s almost impossible for clients to get the same sort of specialised knowledge and support here,” Ms Bester said.

“I had a client whose trauma and mental health acted as triggers for her alcoholism. For most of them, it is about self medicating to get rid of feelings that hurt too much to think about.

“It’s hard to get mental health services to work collaboratively on the issue.”

Earlier this year, the state government responded to a report highlighting gaps in Tasmania’s alcohol and drug services,  with $9.5 million allocated for beds and community-based support.

Siggins Miller consultancy was commissioned to produce the report, entitled A single Tasmanian alcohol and other drugs service system.

Health Minister Michael Ferguson said government was now in the process of consulting with service providers across the state.

“Following on from the work of Siggins Miller, the government is continuing to work closely with the Tasmanian alcohol and other drugs sector on developing the new Tasmanian Alcohol and Other Drugs Service System Framework,” he said.

“Consultations have been held across the past month with key stakeholders, including the Alcohol, Tobacco and Other Drugs Council and local service providers, and it is intended that this work will be finalised in 2019.

“The Framework will guide better integration of alcohol and other drug services and drive future development of the sector.”

Ms Bester said more resources were needed on the ground if Tasmania was improve its continuum of care.

“We need more skilled professionals with the knowledge and expertise to work well in this space,” she said.

“Instead of one detox centre, they should have them across the state, with residential spaces linked to them. The outpatient care is important, as is the counselling.

“The way the resources are now, we cant provide intensive support for outpatients.”