A health professional has raised serious concerns for patients forced into the Northern Territory Government’s mandatory alcohol rehabilitation program, internal emails obtained by the ABC reveal.
The concerns are aired in an email exchange from 2013–2014 between the then minister for health and alcohol rehabilitation, Robyn Lambley, and a health professional who was a member of the Alcohol Mandatory Treatment (AMT) tribunal.
The emails also questioned the decisions of some working for the program and said they were in danger of putting patients “at very serious risk”.
One email read:
There is a tendency at the moment for responsibility for the patient to be viewed as a ‘pass the parcel’ exercise.
Inside the ‘parcel’ is a very sick person often frightened and confused by their situation.
The emails, obtained under Freedom of Information legislation, also warned about the psychological effects of removing alcohol ‘cold turkey’:
Using alcohol as a way of managing distress is suddenly removed without advanced psychological preparation for this to occur … this can cause overwhelming feelings of panic as the consequences of symptoms returning (eg PTSD flashbacks and nightmares) can be terrifying.
The Northern Territory is the only place in the country where people considered to be problem drinkers can be forced into rehabilitation.
Under the policy introduced 18 months ago, anyone who is intoxicated and detained by Northern Territory Police three times in two months goes before the AMT tribunal.
The tribunal then assesses that person on whether they should spend the next three months in rehab.
One email sent in September last year to the then health minister by the concerned tribunal member raised concerns about a patient not understanding what was happening to them.
The member wrote:
I found last week’s tribunal hearing with a very sick man who appeared to have no idea what was happening deeply disturbing.
The member then went on to say they were “alarmed by the continuing inadequacies of some of the assessments”.
Court action a possibility: NAAJA
The tribunal member went on to write by email they had tried to raise concerns several times with their superiors “with no response”, forcing them to take their complaints higher:
As the Minister appointed me to this position, I feel I have an obligation to inform her when my capacity to carry out the role is being (if not legally?) compromised … and patients put at very serious risk.
The tribunal member warned there was no supervision of the centres:
I am very concerned that there appears to be no mechanism for overseeing what is happening in treatment at MTCs.
The tribunal member went on to warn tribunal decisions could be challenged in the courts, because patients were not told about the limitations of assessment beforehand.
Even if not legally challenged now, there may come a time when all tribunal decisions based on improper assessments could be legally challenged in a class action.
This alleged lack of oversight was cause for concern, according to North Australian Aboriginal Justice Agency (NAAJA) chief executive Priscilla Collins.
She said there were long-held concerns about a lack of interpreters for patients.
“If a client doesn’t speak English as their first language it is essential and a necessity that they do have an interpreter to represent them,” she said.
“If you are going to put someone before a tribunal they need to understand what the process is they are going through and what they are there for.”
She said challenging tribunal decisions in the courts was an option.
“That is something that we could consider,” she said.
“If someone is going before a tribunal and being assessed and they are not understanding the process and don’t have interpreters, that’s not fair access to justice.”
The NT Government recently reviewed the mandatory alcohol treatment legislation and made some changes but health advocates said that was not enough.
Dr John Boffa, from the community group People’s Alcohol Action Coalition (PAAC), described the program as an “incredibly expensive social experiment”.
“It hasn’t been done anywhere else in the world like this,” Dr Boffa said.
“It’s beholden on the Government after a good 18 months of implementing mandatory alcohol treatment that we have an independent look at what is working and what is not working.”
He said without an independent review it remained unclear whether mandatory rehab was helping or harming alcoholics.
“PAAC does not trust the Government or internal people to actually properly assess the situation it really needs to be done independently and externally,” he said.
All staff highly trained, Health Department says
After being contacted by the ABC, the Health Department issued a statement saying staff handling the rehabilitation program were all highly trained to deal with the task.
“Alcohol mandatory treatment is designed to get help to some of the most chronic abusers of alcohol in our community,” the statement read.
“The Department of Health operates a number of centres across the Territory where clients are assisted and managed by qualified health professionals across a wide variety of disciplines including primary healthcare, allied healthcare and medical staff to ensure optimum opportunity for rehabilitation.
“There are individual treatment plans, and for the period of time a client participates in treatment and rehabilitation their plans are overseen by team leaders then general managers and the Alcohol and Other Drugs Clinical Governance Group.
“All professional staff are highly trained clinicians with a number recognised specialists in the treatment of cases involving alcohol and other drugs.
“We appreciate the vulnerability of this client group and are also sensitive to the serious co-morbidities often confronted by a number of these individuals.
“On presentation many are frail and very sick not only from alcoholism but many other ailments and chronic diseases which are treated as part of their treatment regime while at AMT.”