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People who experience drug dependence are likely to experience stigma, discrimination and ongoing impacts of criminalisation. This leads to a wide range of social and health inequities and requires an integrated approach in providing appropriate health care. Many people experiencing AOD dependence need multidisciplinary approaches to primary health care. However, they often face challenges navigating the primary health care system due to complex needs and a lack of tailored support services. Outreach services can reduce barriers and increase access to health services and treatment for people at-risk of poor health outcomes.
Directions Health’s integrated AOD primary care and counselling/case management outreach and in-reach services provide wrap around, responsive health care for people at-risk of poor health outcomes. The services utilise a drop-in arrangement, optimising practitioner time and the clinics’ accessibility to clients. PAT is Directions’ mobile clinic; Pathways to Assistance and Treatment. This custom-built “clinic on wheels” 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.
Directions Health continues to provide comprehensive, respectful, non-judgemental support to people who are impacted by alcohol and other drugs (AOD), and their families in the ACT and surrounding regions of NSW. In 2022, an evaluation of the PAT service was completed by ANU, commissioned by ACT Health in collaboration with CHN, and results were overwhelmingly positive. Feedback from PAT clients and service users surveyed and interviewed included: 72% reported that their health had improved since they started using PAT services; 67% said having access to PAT reduced the need for them to attend the Emergency Department; 83% for whom substance use was an issue said PAT had helped them manage their alcohol and other drug use.
Over the last year, across the combined outreach locations, Directions’ PAT service conducted a total of 313 clinics with 2,860 people. This equated to an average of 16 client presentations per clinic, demonstrating consistently high demand for the service.
Client story
Kate* (not her real name) has a history of childhood trauma and spent much of her childhood in foster care. She lives in public housing and has longstanding mental health issues. She is currently diagnosed with depression and anxiety, has difficulty regulating her emotions and has a history of self-harming when distressed. She has struggled with substance use since her late teens, which increases when her mental health deteriorates, creating a vicious cycle.
Kate has attended the clinic for treatment of wounds and other relatively minor ailments, as well as STI and BBV treatment. She is prescribed opioid maintenance therapy on daily pickups, and assistance was sought from the local pharmacy to also provide her Hepatitis C treatment and anti-depressants daily. The importance of using sterile equipment and not sharing equipment was emphasised and she now attends the Needle and Syringe Program weekly outreach service if she needs equipment.
Over the past 3 months, Kate reports that her mental health has been more stable, her mood has lifted, and she has reduced her substance use. Her self- harming behaviour, including her need for wound treatment, has also decreased. She was referred for priority dental work and this has contributed to reduced pain and discomfort and improved self-esteem. She was previously unreliable in attending dental appointments, and consequently was placed at the end of the waiting list. However, staff advocated on her behalf and helped with transport, resulting in a positive outcome.
PAT staff will continue to support Kate to improve her health and wellbeing and will seek to create opportunities for her to confide in them.
