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CHN, ACT’s PHN commissioned Directions Health Services (Directions) to provide outreach and in-reach service to people with an alcohol, drug or other addiction. Directions’ integrated AOD primary care and counselling/case management outreach and in-reach services provide wrap around, responsive care to vulnerable Canberra populations. The services utilise a drop-in arrangement, optimising practitioners’ time and the clinics’ accessibility to clients. Despite having complex needs, clients have often been without health care for many years prior to engaging with the service due to stigma, previous negative help-seeking experiences and challenges navigating the health care system.
Over the last year, Directions provided outreach at:
- Civic Needle Syringe Program: weekly nurse-led clinics
- Oaks Estate: weekly nurse and GP and fortnightly AOD Practitioner via PAT*
- Ainslie Village: weekly nurse, GP and weekly AOD Practitioner via PAT*
- Headspace Tuggeranong: fortnightly AOD Practitioner
- Canberra Alliance for Harm Reduction and Advocacy (CAHMA): weekly nurse and medical practitioner.
*PAT is Directions’ mobile clinic, Pathways to Assistance and Treatment. This custom-built clinic enables Directions’ staff to offer the full range of minor procedures and services usually on offer in a standard GP clinic, enhancing clients’ access to health care in the housing estates.
Primary health care services offered by Directions include:
- Diagnosis and treatment of acute health problems
- Immunisation
- Chronic disease management and care plans
- Wound management and dressings
- Vein care
- Psychological services
- Health promotion, coaching and support
- Adult health checks
- Quit smoking support
- Dental referral.
On average Directions receive 14 client presentations per clinic. Over the last year, Directions conducted 227 clinics with a total of over 4,000 client presentations. During the first half of the financial year Directions provided services to 474 individuals followed by 428 individuals during the last half of the financial year. Directions continue to see a growing number of clients presenting with complexities and risks who require a significant level of support.
The appointment of the psychiatrist in March 2022 added to the services provided by the ongoing psychologist which has increased the ability of clients to access mental health treatment. Clients accessing PAT are referred to the psychiatrist, who also attends PAT regularly to engage clients requiring specialist mental health support.
Directions trialled two new evening outreach clinics during the reporting period at Dickson and Veterans Park. Orange Sky Laundry and Vinnies Night Patrol partnered with Directions at both these locations. Both clinics received a warm welcome from community members and were well utilised by different clientele than usually present to PAT daytime clinics, including a high rate of people experiencing homelessness.
Directions has continued to work closely with its partners including CAHMA, Orange Sky and Vinnies to ensure the services are well integrated and connected at each site.
Client story
While living in public housing, Lucas (not his real name) was visited by Directions’ mobile clinic, Pathways to Assistance and Treatment (PAT). Lucas had a long history of trauma and complex psychosocial issues including heavy poly drug use, chronic health issues and mental health instability. He engaged with both medical and counselling services on PAT.
Lucas’ condition deteriorated during the pandemic, with increased substance use and escalations in unsocial behaviours. This led to Lucas being evicted from the housing estate in which he lived and becoming homeless during a period of significant instability. By collaborating with CAHMA and advocating to OneLink and Housing, interim accommodation was able to be sourced for him while awaiting a detox admission.
Directions provided intensive support in the interim to stabilise and maintain the clients’ engagement with services and motivation to address his use. Lucas completed detox and has engaged in ongoing AOD treatment and mental health support services with PAT and City Mental Health.
