Evaluation of SWSLHD Aboriginal Outreach Drug & Alcohol Clinics in Airds and Bowral: Overarching Report

Aboriginal people experience a disproportionate amount of the harms associated with use of substances such as alcohol, illicit drugs and pharmaceuticals. Treatment is one component of a multifaceted approach to reducing the impact of drug-related harm on Aboriginal people and communities. In 2013, South Western Sydney Local Health District (SWSLHD) Drug Health Services (DHS) introduced specialist Outreach Drug and Alcohol (D&A) Clinics in Airds and Bowral for members of the Aboriginal community that do not access or engage well with mainstream health services. The Outreach Clinic in Airds is a partnership with Tharawal Aboriginal Corporation and is delivered in collaboration with Tharawal’s Medical Service and Social & Emotional Well Being (SEWB) Unit. Aunties Clinic at Bowral Community Health Centre (CHC) is a collaboration with SWSLHD Mental Health Services (MHS). In 2017, DHS in partnership with SWSLHD Aboriginal Health embarked on an evaluation of the two Outreach D&A Clinics. The project had three objectives: (1) Complete an evaluation of the Outreach D&A Clinics in Airds and Bowral; (2) Make recommendations to support the continuing development of DHS outreach service models; and (3) Develop an ongoing evaluation framework for the Outreach D&A Clinics in Airds and Bowral. This external evaluation adopted a collaborative, participatory approach together with a strengths-based/appreciative inquiry approach, and drew on the Ngaa-bi-nya Aboriginal and Torres Strait Islander program evaluation framework. Data collection methods included key informant interviews, document review and participant observation. As it was not possible to extract reliable data from the new CHOC Electronic Medical Record, service activity data for 2017 were manually collated and analysed. Detailed findings for the Outreach Clinics Outreach D&A Clinics in Airds and Bowral are presented in separate reports, attached. Reflecting the different local community and service contexts, the two Clinics have different service models. Common features include delivery of services in an outreach setting, partnerships with other service providers, and holistic and culturally-appropriate and sensitive ways of working. Overall, they align well with current policy frameworks and best practice service models. Given the complex, multiple needs and often chaotic lives of Aboriginal people with D&A issues, no single organisation can be expected to provide all the services required. Care must be coordinated, with clear referral pathways (in and out) and continuing support and/or case management as needed. The participation of an Aboriginal team member is critical to successful client and community engagement and ensuring the delivery of culturally-appropriate care.