State and territory data quality
In 2021–22, restrictions related to the COVID-19 pandemic continued and impacted delivery of services including AOD treatment for withdrawal management and residential rehabilitation. The latter included closure of services for a period of time in some states. Withdrawal and rehabilitation bed-based occupancy decreased compared to pre-COVID-19 occupancy in most states. Counselling and face-to-face outreach services also moved to providing telehealth services to ensure social distancing and public health guidelines were met. The number of AOD referrals decreased and the number of admission cancellations increased for residential withdrawal and rehabilitation services. The majority of providers moved to a telehealth model and discontinued face-to-face contact with clients unless the client received withdrawal or rehabilitation services.
Summary information provided by states and territories, regarding the AODTS NMDS data collection:
New South Wales
- services utilise telehealth, primarily telephone (metropolitan or rural and remote)
- services report an increased workload when staff on leave and also additional tasks (for example, ongoing cleaning)
- some services closed, which increased other workloads to services that still remained open with increase in referrals
- staff turnover and staff sickness impacting ability to deliver services
- some local health districts reported workforce and service delivery issues which may have impacted the number of closed episodes.
- bed based units were operating at reduced bed capacity during lockdowns, ensuring social distancing requirements are met. Occupancy across all residential services has fallen compared to pre-COVID as a result of social distancing requirements. Wait times between referrals and admissions have also increased due to reduced capacity. Leave and visitors have been prohibited during residential stays to decrease risk. This impacted withdrawal and rehabilitation main treatment types
- majority of providers have moved to a telehealth model, discontinuing face to face contact with clients unless they are receiving residential withdrawal and rehabilitation services
- reduced the number of referrals and increased the number of admission cancelations to residential withdrawal and rehabilitation services impacting withdrawal and rehabilitation main treatment types.
In January 2022, there was a lockdown in Queensland and services continued to provide treatment episodes via different modes of delivery. There was a drop in appointments for the Police Drug Diversion Program, Illicit Drugs Court Diversion Program and Drug and Alcohol Assessment Referral Program (DAAR). The diversion treatment episodes (and hence AODTS interventions) also decreased between financial years, however this may be for a number of reasons (including COVID lockdown).
As a result of COVID–19, services offered more telehealth appointments and organisations continue to report COVID impacted service delivery. Examples include inability to recruit staff due to border restrictions, staff sickness and/or isolation periods for close contacts meant no coverage to operate at times, and staff not being vaccinated in line with government requirements. Residential services were required to close beds at times due to restrictions put in place by government which may result in less episodes at some agencies.
During COVID-19 restrictions, a proportion of counselling services shifted from face-to-face appointments to telehealth and telephone clinical support to clients in treatment. There was also decreased bed capacity across residential services and withdrawal services reducing the amount of people accessing these services.
COVID-19 escalation management plan enacted to Tier 3 in quarters 3 and 4 of the 2021–22 financial year. This resulted in reduced face to face appointments on site with preference to be conducted through telehealth and phone. A slight reduction in new referrals was experienced. This reduction in consumers accessing services was common across many areas of the health system (for example, emergency departments). Inpatient withdrawal units were operating at reduced capacity for the entire 2021–22 period due to COVID-19 restrictions.
Australian Capital Territory
The ACT was in COVID-19 lockdown from August to October 2021. This lockdown slowed intake into residential withdrawal programs, which slowed admission to rehabilitation programs. Services shifted to non-contact programs (for example, face-to-face programs, including group programs, were suspended, or reconvened online or delivered by telephone or text). Staff illness and absence affected programs during both the lockdown period and other parts of the year, requiring staff to isolate at home if unwell and to take time off work. In mid-August 2022 the ACT went into lock-down and further restrictions included restrictions impacting services.
During 2021–22, COVID-safe procedures in residential rehabilitation resulted in a decrease in the number of people that could be accommodated in each facility (for example, one person per room). While different service types were impacted in different ways no service ‘shut-shop’ during this time. There was short-term reduction in capacity, but this eased quickly to business-as-usual once services learnt how to operate under the new COVID environments.
Policy, legislation and environmental changes
New South Wales
In 2019–20, a number of natural disasters impacted the 2019–20 NSW reporting period, including large areas of NSW experiencing unprecedented bushfires between October 2019 and March 2020, and in February 2020 some areas of NSW experienced flooding.
South Australia reported a high proportion of episodes of treatment where amphetamines are the principal drug of concern and assessment only is the main treatment type. This is related to assessments provided under the Police Drug Diversion Initiative. This program is legislated in South Australia, unlike other jurisdictions, and therefore results in a higher percentage of assessment only services with high rates of engagement with methamphetamine users. In addition, due to the Cannabis Expiation Notice legislation in South Australia, adult simple cannabis offences are not diverted to treatment and so are excluded from the data.
The South Australian Police Drug Diversion initiative also saw a change in legislation from April 2019 [Statues Amendment (Drug Offences) Bill 2018, where youth are no longer diverted immediately for an Assessment. Adults who have been apprehended twice in four years are no longer eligible for an Assessment.
As of 2018 all agencies; regardless of setting, are instructed to complete a separate assessment only episode prior to the commencement of treatment. This policy relates to monitoring the volume of assessment work performed by agencies, particularly in relation to certain alcohol-related legislatively-based programs.