The NT Government policy of forcing so-called problem drunks into rehabilitation is potentially discriminatory, lacking in evidence and expensive, a new report has found.
The Medical Journal of Australia article co-authored by three experts found the Alcohol Mandatory Treatment (AMT) scheme disproportionally affects Aboriginal people, “severely limits the freedom of movement of affected individuals”, and may breach the Racial Discrimination Act.
The report’s release came on the same day the Northern Territory coroner delivered his opening remarks criticising mandatory alcohol rehab at the coronial inquest in Alice Springs into the death of Kumantjayai Brown.
Brown was found dead where she slept at the Central Australian Aboriginal Alcohol Treatment Unit in October last year.
Under the AMT legislation introduced by the incoming Country Liberals Government in 2012, people picked up for being drunk three times in two months could be forced into three months of alcohol rehabilitation, after being assessed by a tribunal.
Figures tabled in NT Parliament in 2014 revealed 99 per cent of people in AMT are Aboriginal, with homeless or itinerant people much more likely to fall foul of the scheme.
The report, called The Alcohol Mandatory Treatment Act: evidence, ethics, and the law, said there was little evidence that the scheme was effective.
It said the NT Government could adopt more cost-effective alternatives “that would not involve the dubious application of a medical intervention to reduce public intoxication, with its concomitant legal and ethical issues”.
About $27 million was being spent on the program annually, amounting to $64,000 per person, the report said.
The report also found there was little evidence of long-term mandatory treatment working anywhere in the world, and use of it contradicted international guidelines and human rights law:
To date, no formal evaluation of the clinical effectiveness of the program has occurred.
The Government has provided short vignettes containing patients’ success stories and has released reports containing numbers treated, but with no indication of post-discharge relapse rates.
Given the aforementioned paucity of evidence for civil commitment, this lack of evaluation is concerning … the AMT Act may infringe s 9 of the Racial Discrimination Act 1975 (Cwlth) by prohibiting enjoyment of a human right based on race, colour, descent, or national or ethnic origin.
Although the scheme could constitute a “special measure” taken for the benefit of Aboriginal people, this would be difficult to justify given that the legislation was not written to apply specifically to Aboriginal people.
The authors of the report — Dr Fiona Lander from Harvard T.H. Chan School of Public Health in Boston, and Professor Dennis Gray and Associate Professor Edward Wilkes from Perth’s Curtin University — also questioned the integrity of the tribunal and concern over a lack of interpreter and support services.
The Northern Territory Government has been contacted for comment on the report’s findings.
BDR out, AMT in
The AMT scheme replaced the outgoing Labor government’s Banned Drinker Register (BDR) which required people purchasing alcohol to present their identification to be scanned at liquor outlets.
Under the short-lived Labor regime, so-called banned drinkers – people taken into police custody three times in three months, or those who committed alcohol-related offences – were flagged at point of sale and the transaction was refused.
There were 2,500 people on the BDR by the time it was abandoned after 14 months of operation.
Last month a federal committee recommended Labor’s BDR be reinstated.
The recommendation, one of 23 in the Alcohol, Hurting People and Harming Communities report handed down by the House Standing Committee on Indigenous Affairs, said it noted “with concern the lack of cooperation from the Northern Territory Government to this inquiry”.
The committee was prevented from obtaining any direct evidence from hospital staff and police in the Northern Territory on their experience of alcohol-related harm.
Although the Northern Territory Government provided an aggregated submission, this did not address many of the concerns of those dealing with alcohol-related harm on a daily basis in the Territory.
NT Attorney-General John Elferink said he had not read the report, but he criticised it for not addressing what he identified as the underlying cause of alcohol-related harm — “passive welfare”.
Concerns raised internally
In 2014, the ABC reported on internal emails by a member of the AMT raising concerns over assessments and patient wellbeing.
The Health Department responded by saying staff handling the rehabilitation program were all highly trained to deal with the task.
Aboriginal justice advocacy group NAAJA flagged legal action in light of the allegations made by the former tribunal member.
Late in 2014, the NT Government launched a six-month trial of Temporary Beat Locations (TBL) which saw police officers stationed out the front of bottle shops in Alice Springs, Tennant Creek, Katherine and some locations in Darwin.
The move came under fire from the outgoing president of the Police Association, Vince Kelly, who said it took police away from other duties and said it showed the influence of the liquor industry.
“I think everyone acknowledges that you simply can’t have highly paid, professional police standing outside bottle shops providing a service that, in my view, the licensee should pay for,” Mr Kelly said in February this year.
“They’re the ones making the money, they’re the ones who should take responsibility for the problems that come when they sell their product.”