Presentation to the National Conference of the Health and Disability Advocacy Service

1. Presentation to the National Conference of the Health and Disability Advocacy Service Peter Kennerley Ministry of Health 13 August 2013

2. Addiction Treatment Services in the Ministry of Health • Sits within Sector Capability and Implementation Business Unit • Part of the Mental Health Services Improvement Group • Responsible for implementing services as part of Methamphetamine Action Plan, Drivers of Crime, and other Government wide programmes • Responsible for Opioid Substitution Treatment Services with the Director of Mental Health • Responsible for improving approaches to Co-Existing Mental Health and Addiction • Responsible for implementing a Substance Addiction (Compulsory Assessment and Treatment) Bill

3. Why People Don’t Seek Treatment • Te Rau Hinengaro The Mental Health Survey 2006 identified the following reasons why people delay seeking help for mental health and addiction problems : • I wanted to handle the problem on my own (79.3%) • I thought the problem would get better by itself (63.2%) • The problem didn’t bother me very much at first (48.9%)

4. How long do people wait to contact services? • For alcohol and drug abuse, the percentages making contact at the age of onset were low (ref. TRH): • 8.9% for alcohol abuse • 13% for other drug abuse • 92.1 % eventually made treatment contact • The median delay for alcohol abuse was 16 years • The median delay for alcohol dependence was 7 years • The median delay for other drug abuse was 8 years • The median delay for other drug dependence was 3 years

5. What do these figures mean for treatment services? • When someone seeks treatment, we can’t leave them waiting • What do we tell them about treatment? • Working to improve motivation • What is important to the consumer? • How do we provide cultural interventions within an overall culture of recognising and valuing difference? • Do they need someone else to provide advice/support?

6. How many people are treated in our services • Through Vote: Health, we treat: • 43,000 people • Some 500,000 presentations • 16,000 access AlcoholDrug Helpline, • Websites available, eg Drughelp.org.nz, Methhelp.org.nz • 70-80 are treated under the Alcoholism and Drug Addiction Act 1966

7. Issues for New Treatment Legislation • Human Rights addressed – appeals, reviews possible • Stronger process of application and assessment • Legal criteria to determining someone’s “capacity” to understand treatment • Shorter period of compulsion • More opportunity for engagement and treatment • Significant guidance notes for staff • Identifying people with acquired brain injury

8. Timeline for new legislation • Draft Substance Addiction (Compulsory Assessment and Treatment) Bill to be finalised by Parliamentary Counsel • Bill to be introduced into Parliament this year if possible • Referred to Select Committee – your opportunity to comment • Bill passed • Commencement

9. Challenges for the Sector • Coming to grips with nationally accessible assessment and treatment – currently limited availability • Provision for those with appearance of brain injury • Broad implications across government agencies • Unsuccessful applications – need to ensure they are not turned away without help • Workforce development • Consumer advocacy