<p>The total social and economic costs and harms of alcohol consumption in the Northern Territory (NT) equates to $1.38 billion per year (Smith, Whetton, & d’Abbs, 2019). A comprehensive strategy is required, that includes alcohol treatment services to curb these costs. Typically, alcohol treatment services are defined as clinical interventions such as withdrawal, counselling, residential rehabilitation and pharmacotherapy. However, a broader definition would include a broader range of interventions, such as brief interventions in primary care, and social and emotional wellbeing services provided in the context of reducing alcohol consumption.
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This report reflects a Demand Study of Alcohol Treatment Services in the NT. It is a mixed-methods research project examining the current NT alcohol treatment services system. It provides an assessment of how much treatment is currently provided; how much should be provided to meet current demand; and the challenges, barriers and opportunities associated with the planning and delivery of alcohol treatment services in the NT. It responds to multiple recommendations outlined in the NT Alcohol Policies and Legislation Review (Riley, 2017); and a subsequent Northern Territory Government (NTG) commitment to undertake the study in the NT Alcohol Harm Minimisation Action Plan 2018-2019 (NTG 2018). The project is modelled on two recent national demand studies. The first was completed by DPMP and involved a review of treatment service systems across Australia (Ritter et al., 2014). The second was completed by the National Drug Research Institute (NDRI) and involved a qualitative analysis of treatment services involving Aboriginal and Torres Strait Islander people (Gray et al., 2014). The research design has been adapted to meet the unique population distribution, geography and service delivery context of the NT.
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This study has been led jointly by Menzies School of Health Research and the Drug Policy Modelling Program (DPMP) at the University of New South Wales, and in partnership with the Aboriginal Medical Services Alliance of the NT (AMSANT).
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There were 42,871 episodes/encounters for alcohol treatment in NT in 2016/17, equating to 117 encounters every day across the NT. Aboriginal and Community Controlled Health Organisation (ACCHO) episodes represent the highest number of encounters (41%). The next highest is GP encounters (18%). Self-help also comprises a substantial amount of alcohol treatment in the NT (16%). Brief interventions provided as part of Sobering Up Shelters (SUS) represent the fourth highest number of episodes/encounters (13%). This is a signal that these settings are vital for picking up and referring people into more intensive alcohol treatment pathways.
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The subsequent analysis of unmet demand shows that there is currently a relatively small gap between met and unmet demand for alcohol treatment in the NT. It also highlights some areas of additional focus. Key findings reveal:
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• There is a large unmet demand for screening and brief intervention, in the order of 18,500 to 19,000 people
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• The provision of alcohol treatment (as described in the DASPM care packages), estimates 6,735 people need to be treated in any one year, representing an unmet demand gap of around 2,000 people aged between 18 and 64 years.
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• There are currently 158 residential rehabilitation beds provided in the NT for people with alcohol disorders. This is 15% below the modelled estimate of 187 residential rehabilitation beds.
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• The level of clinical FTE predicted to meet the care as specified in DASPM is well above the current clinical FTE in the NT. This suggests that while the numbers of people being treated may be about right, the intensity and the level of care is not configured in a way that might best meet needs.
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• More treatment is required to respond to mild and moderate needs.
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The qualitative component provides a descriptive account of key stakeholder viewpoints from across the alcohol treatment services system. This includes a discussion about alcohol treatment types, including preventative health interventions, brief interventions, counselling, withdrawal services, day programs, residential rehabilitation services and continuing care. The perceived strengths and gaps of each are discussed. A descriptive account of the factors impacting demand; pathways into treatment; intersections with treatment referrals from the criminal justice system; a discussion about the implications of remoteness on treatment accessibility in the NT; and the need for targeted workforce development, are also included.</p>