QUEENSLAND INDIGENOUS SUBSTANCE MISUSE COUNCIL (QISMC)
The Queensland Indigenous Substance Misuse Council (QISMC) is an association of Aboriginal and Torres Strait Islander Community Controlled Alcohol and other Drugs agencies which are located in various sites across the state of Queensland. Community Controlled alcohol and other drug services are initiated by local Aboriginal and Torres Strait Islander people to deliver holistic and culturally appropriate care to people within their communities.
The Aboriginal and Torres Strait Islander community controlled alcohol and other drugs sector in Queensland is diverse. There are currently 14 QISMC member agencies. They provide a range of services to Aboriginal and Torres Strait Islander men, women and young people including:
• Education, prevention and early intervention;
• Treatment, care and support;
• Rehabilitation;
• Staged re-integration; and
• Post-treatment care and support.
The agencies are located across Queensland, delivering services in remote, rural and urban settings. They range from small to medium to large service delivery capacity.
Member services are located in Cairns, Townsville, Palm Island, Mt Isa, Yarrabah, Cleveland, Rockhampton (2), New Farm, Coolangatta, Cherbourg, Hervey Bay, Bundaberg and Fortitude Valley. A list of these services can be located at the end of this document.
The continuum of care
Traditionally, the Aboriginal and Torres Strait Islander alcohol and other drugs sector in Queensland has focused largely on treatment and rehabilitation. The task has been large and ongoing. The community controlled alcohol and other drugs sector is overwhelmed with the demand for treatment and rehabilitation services and the sector has consequently focused strongly on end-stage activities.
The principle of harm minimisation has formed the basis of the National Drug Strategy since 1985. Continuing to shift the focus towards education, prevention and early intervention, driven in partnership with the community controlled primary health care sector has been identified as a priority by QISMC and the Queensland Aboriginal and Islander Health Council (QAIHC), which is the state peak body for community controlled primary health care services. To this end, QISMC and QAIHC have an ongoing partnership arrangement through a Memorandum of Understanding.
The move towards prevention and early intervention activity in the sector requires significant additional effort and resources. The Aboriginal and Torres Strait Islander Health Workers in the primary health care services, provide education, prevention and early intervention programs, although it is not clear to what extent this occurs in relation to the use of alcohol and other drugs. The work of residential care agencies is predominantly in the area of treatment and rehabilitation. While they acknowledge the need for prevention and early intervention activity, for many the burden of demand for their core activity (ie. treatment and rehabilitiation) is such that their capacity to broaden the scope of their operations to include other earlier stage approaches is somewhat limited.
Challenges for the community controlled alcohol and other drugs sector in Qld
The challenges for the sector are many and varied. Priority should be given to developing the community controlled sector to a level where it can provide alcohol and other drug services across the state to a level of quality at least equal to if not better than that of most mainstream services.
A number of key areas have been identified for maintenance and ongoing future development. These include:
• Financial resources
• Governance
• Policy and procedures
• Workforce training and development
• Infrastructure
• information technology and data management
• Intra/intersectoral collaboration and cooperation
• Cultural security
It must also be recognised that there are some organisations in the community controlled primary health sector which provide varying levels of alcohol and other drugs services. The challenge for both sectors is to find the means to complement each others work recognising that alcohol, tobacco and other drugs contribute significantly to poor health and well being in our communities. Conversely, the alcohol and other drugs service agencies in Queensland make a significant contribution to the effort to address the level of poor health and well being of Aboriginal and Torres Strait Islander people.
At the State level, there is a working agreement between the community controlled primary health sector and the community controlled alcohol and other drugs sector. This agreement is formalised by a Memorandum of Understanding between the Queensland Aboriginal and Islander Health Council (QAIHC) acting as the state peak body for community controlled Aboriginal and Torres Strait Islander primary health care organisations and QISMC. Originally signed in July 2004 for an initial 2 year period, the MoU was recently renewed for an indefinite period from July 2006. The ongoing challenge here is to ensure that the intention of this agreement is translated out into the field of operations, requiring the development of locally and regionally based arrangements for collaboration and cooperation.