Opening of drug and alcohol treatment centre in Hout Bay

Over the past five years, the Provincial Government of the Western Cape and the City of Cape Town have identified a sharp increase in social, public health and safety challenges in the Hangberg and greater Hout Bay area that are directly associated with harmful drug and alcohol use.

In fact, the number of drug-related crimes recorded by SAPS is higher than ever locally, provincially and nationally:

• The Western Cape as a whole has seen an increase in reported cases of drug-related crime from 19 940 in 2004 to 60 409 in 2010.
• The Hout Bay Police Station recorded only 14 cases of drug-related crimes in 2004. This has increased to 203 in 2010.

The specific need for drug treatment services in the Sentinel region has also been emphasised by the Hangberg Peace and Mediation Forum in its interactions with the Provincial Government. The Forum has noted an increasing presence of harmful drug and alcohol use in the area.

Up until now there have been no state services available in the region to address this situation.

The Office of the Premier, the Provincial Department of Social Development and the Provincial Department of Health have therefore established the multi-service Alcohol, Drug and Crime Reduction project that we launch today, in partnership with NGO Favor-SA.

This centre will serve Hangberg and Hout Bay with drug harm reduction services, based on international best practices in the field.

The project has been initiated in line with the Western Cape Provincial Government's policy blueprint for the reduction of harmful drug and alcohol use in the Western Cape, and our strategic objectives of promoting social inclusion and wellbeing.

Our new policy platform has seen the Province increase its services for reducing drug- and alcohol-related harms in the province by over 50%, from R42 million in 2009 to R67 million in 2011. Among other services, this has enabled us to our overall treatment capacity from 3 300 spaces in 2009 to nearly 5 000 spaces in 2011.

The treatment and outreach programme we open today will operate from a previously unused wing of the Community Health Clinic building. It is funded at R1.6 million per annum by the Department of Social Development, and will offer up to treatment 200 spaces per year.

We have called it the Hout Bay Community Awareness, Rehabilitation and Education Services Centre, or Hout Bay "CARES" Centre, in line with a similar centre that we opened last year in the Helderberg.

The CARES Centre is an innovative project that incorporates a Matrix out-patient treatment model, but also contains a range of additional services. It is a multi-service centre, incorporating patient screening, assessment, brief interventions, education, outreach, liaison and follow-up services to the community.

Its outreach workers will go out and find people who need assistance, and bring them into the treatment or other programmes run at the centre. They will also help keep people in the programme by following up and, if necessary, going and collecting them. This is what is known as "affirmative outreach work".

It is also a community partnership. Its staff will work in close collaboration with local NGOs, community-based organisations, the police, health services, magistrates, prosecutors and other stakeholders.

Why This Approach?
 

Research done across the world shows that many people who go to rehabilitation, whether it is in-patient or out-patient treatment, are at risk of relapse.

This is often because the people involved in harmful drug or alcohol use have difficult and unstable life circumstances and relationships, and often struggle in the beginning of treatment services to maintain consistent involvement and attendance.

In cases of full-blown alcohol or drug dependence, we are dealing with an actual recurring health disorder, much like diabetes. Up to 50% of people suffering dependence will relapse after treatment unless they receive further support services after their initial recovery. The highest risk of relapse is at around six months after being discharged. So this centre is designed to ensure people get follow-up support after they finish their initial treatment. This is intrinsic to the Matrix method of treatment, along with monitoring of treatment progress through regular testing, and monitoring of overall programme performance through review of annual treatment success rates. However, the outreach component of this project will further strengthen its capacity to keep track of discharged patients, and bring them back in where necessary.

In addition, this programme's outreach component will help get people into the programme. In spite of the great need for treatment throughout our province, and in spite of long waiting lists at some rehabilitation programmes, others remain underutilised.

The programme's outreach workers will also work closely with clinics, hospitals, night shelters and schools in the area to help identify cases that need to be referred to the centre. It is about casting the net as widely as possible across the Hout Bay region.

The multi-service approach of this centre is also designed to avoid people "falling through the cracks" between services. Instead of being screened at one place and referred for treatment at another and then getting follow-up support somewhere else, this centre is a one-stop option. Maximising the time and consistency with which a recovering person is engaged with appropriate services is a key success factor for effective rehabilitation.

Finally, this centre's multiple levels of service are designed to ensure that people get appropriate services to address their condition. It does not make sense, for example, to put someone into intensive rehabilitation if they are only engaged in relatively moderate drug or alcohol abuse.

Such individuals can still be a major hazard to themselves and society, even if they are not severely addicted. Under these circumstances, brief interventions and follow-ups may suffice, and cost the state far less. There is no "one size fits all" for drug interventions.

I would like to thank everyone who made this project possible. In particular:

• The Department of Social Development officials, Dick Smith, Charles Jordan and their team.
• Dr Rob Martell and his team in the Community Health Clinic, who fall under the Provincial Department of Health.
• Jurgens Smit and his team from Favor-SA.
• Brian Williams and all of the members of the Hangberg Peace and Mediation Forum for their ongoing support for this project.
• Sarah Fisher and her team from SMART, who have advised Favor-SA and helped them to establish this project in line with best practice.
• Ferial Soeker and her colleagues from the Department of the Premier for bringing all of the roleplayers together and driving the project forward.
• Derrick Schroeder, the Human Rights Unit from DotP, Jikaleza Dance and all other community members involved for their efforts in setting up today's event.

I hope that the community of Hangberg will work closely with the Province, Favor-SA and their staff to ensure that we make a success of this project, and help to reduce the harms associated with harmful drug and alcohol use in this province.

I thank you.

For more information, contact 0800 220 250 Tollfree.