For the first time South Africa is heading for international quality assessment and accreditation of alcohol- and substance-abuse treatment programmes, following a watershed symposium in Cape Town this week.
Indications are that in future, traditional in-patient care programmes requiring that abusers remain in rehabilitation centres for a period of time, are likely to be overtaken by more cost-effective out-patient treatment options.
At the two-day symposium last week, several front-line and community-based service providers in the alcohol- and substance-abuse sector, opted for the introduction of an accreditation system run by the US Commission for the Accreditation for Rehabilitation Facilities (CARF), based in Tucson, Arizona.
CARF is a non-profit organisation established in 1966 which monitors and accredits various facilities, including alcohol- and substance-abuse facilities, in countries such as the US, Canada, Europe and Kenya.
Separating the wheat from the chaff
While smaller service providers were concerned about the cost of introducing the system, there was consensus among delegates – mostly from Cape Town – that the alcohol- and substance-abuse sector in South Africa was in need of a system for measuring results and outcomes in treatment care that would “separate the wheat from the chaff".
CARF consultant Dr Stephen Kimani told delegates that unlike registration which is a legal requirement, CARF accreditation was voluntary and aimed at improving existing treatment programmes and ensuring positive outcomes.
“The key drivers of CARF accreditation are accountability, measurable effectiveness, efficiency and accessibility of existing treatment programmes as well as customer satisfaction,” said Kimani. “We will help you make the necessary adjustments to qualify for accreditation based on ongoing self-monitoring. It is reviewed every three years.”
Impact on the entire country
Cape Town executive deputy mayor Counsellor Grant Haskin said he hoped the impact of the symposium would be felt "throughout South Africa, as there is a dire need for ongoing deliberations between national, provincial and local governments to fight substance abuse in the country".
He said Cape Town was the worst hit SA city as far as teenage binge drinking was concerned, with over 30 percent of teenagers indulging in this type of behaviour.
“In 2007, drug abuse in the city shot up by 219 percent compared to 2006 – twice the national average. And incidents of drinking and driving in Cape Town are also twice the national average,” he told delegates.
This sentiment was echoed by Substance Abuse Advocacy Research and Training (SMART) chairperson Cheryl Frank, who said SA was facing a culture of a lack of any sense of accountability in many spheres. “It’s time we get back to the basics and consider how we treat people in our care, and show respect for the dignity of others,” she said.
Greater focus on out-patient programmes
Industry experts agreed that traditional treatment models based on the removal of alcohol and substance abusers from their homes and places of work in order to enter rehabilitation centres for prescribed periods were likely to make way for more affordable out-patient care programmes as funding from medical aids and government becomes less available.
Business mentor and consultant Neels Blaauw pointed out that the expected trend would require focused marketing to ensure that medical doctors and practitioners are aware of the alternative treatment options.
Delegates have now entered a consultation phase under the auspices of the SA Medical Research Council to prepare an application for CARF accreditation of their treatment programmes. This is expected to come into effect about a year from now.
- (Louise Cook, for Health24, April 2008)
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