Residential Detoxification and Rehabilitation Liz Nardone Residential Rehabilitation Assessor/Co-ordinator Scottish Drugs Forum Conference

WHEN Fife Council gave a commitment to invest £250,000 for Residential Rehabilitation commencing April 2014, for one year (with the possibility of a second year depending on results). This decision was taken as a result of feedback from both service users and family members in terms of a gap in service provision. RESIDENTIAL DETOXIFICATION AND REHABILITATION

WHERE Following a robust tendering process, the following were selected: Phoenix Futures, Glasgow Jericho House, Greenock Abbeycare, Ayrshire Alexander Clinic, Aberdeenshire Spot purchasing can also take place if required. RESIDENTIAL DETOXIFICATION AND REHABILITATION

LAUNCH The Service officially launched on 30 th May 2014 with FIRST highlighted as the Fife link for people seeking residential treatment. RESIDENTIAL DETOXIFICATION AND REHABILITATION

FUNDING FIRST were given the finance for: staff costs (which would include visits to support clients whilst in residential rehabilitation); supporting families to visit the units. Fife Council would hold the remainder of the budget to purchase beds. RESIDENTIAL DETOXIFICATION AND REHABILITATION

Fife Wide Service Male and Female Drugs and Alcohol RESIDENTIAL DETOXIFICATION AND REHABILITATION

CRITERIA Clients being referred, must meet the following criteria: has had a drug and/or alcohol issue for a considerable period of time (years rather than months); previously tried and exhausted drug and alcohol services in the community; has not benefitted from previous formal community based detoxification; RESIDENTIAL DETOXIFICATION AND REHABILITATION

CRITERIA (continued) evidence of a willingness to change and to see change as a personal responsibility; committed to engaging in a structured and intense programme of preparatory work prior to detoxification followed by residential rehabilitation; willingness and understanding the need to continue to engage with services after returning to the community; assessed as capable of achieving absence and prepared to do so. RESIDENTIAL DETOXIFICATION AND REHABILITATION

REFERRAL PROCESS Single Shared Assessment Triage Drop In Clinics (for self referrals) Drug and Alcohol Services NHS Fife Addiction Services Social Work GP’s

ASSESSMENT STAGE Motivation for change Current and historic drug and alcohol use Criminal activity Housing issues Social circumstances Family network and supports Involvement with other services RESIDENTIAL DETOXIFICATION AND REHABILITATION

PREPARATORY STAGE Assess ongoing motivation Look at option for Rehab (four options) and suitability Issues around benefits Changes to drug or alcohol use Family issues Criminal activity Funding applications Involvement with other services Letter to Council re: Housing Benefit Assessment by Rehab Planning for admission Contact with family (if appropriate) Review Action Plan and Rickter

RESIDENTIAL DETOXIFICATION AND REHABILITATION WHILST RESIDENT Ongoing contact Family support (if appropriate) Six weekly reviews Contact with Rehab for updates Planning for discharge and aftercare

RESIDENTIAL DETOXIFICATION AND REHABILITATION EVALUATION Continuous Process Referral Preparatory Stage Residential Stay (Post Discharge) Aftercare

RESIDENTIAL DETOXIFICATION AND REHABILITATION AFTERCARE The expectation is that following discharge from Residential Rehabilitation clients will: engage immediately with FIRST’s Community Rehabilitation Service and/or attend SMART Meetings/Peer Support Groups/AA/NA.

RESIDENTIAL DETOXIFICATION AND REHABILITATION REFERRALS To date we have received 32 referrals from: DAPL - 3 NHS Fife Addiction Services - 11 FIRST - 5 Fife Community Drug Service – 2 ADAPT – 3 Addaction – 1 GP – 1 Criminal Justice Service – 1 Social Work Service - 1 Self – 4

RESIDENTIAL DETOXIFICATION AND REHABILITATION The story so far … To date, a total of 9 clients have been admitted to Residential Rehabilitation. Phoenix Futures – 8 Alexander Clinic – 1 3 clients have self discharged (2 from Phoenix Futures, 1 from Alexander Clinic). All 3 were drug/alcohol free when they left. 2 still report to be drug/alcohol free, 1 relapsed. 6 REMAIN IN REHAB They are at varying stages of their programme but all continue to do well!