The COVID-19 pandemic has raised new challenges for the reach, accessibility and sustainability of alcohol and other drugs support services, yet the adoption of virtual care has increased access for clients located in regional, rural and remote areas, a new report has found.
The research – the first into the specific impacts of COVID-19 on the NGO sector – was commissioned by the Network of Alcohol and Other Drugs Agencies (NADA) with Australian Government funding, to inform future planning and ensure the ongoing viability of service delivery into communities across NSW, ACT and TAS.
Undertaking surveys (NSW, ACT and TAS), and using focus groups (NSW) and reviewing administrative data from NSW AOD service providers in the non-government sector, lead researcher, UNE criminologist Dr Katinka van de Ven (pictured), says the research uncovered a number of themes and challenges, particularly impacts related to funding, business practices, workforce, service delivery and treatment demand.
“Around two-fifths of alcohol and other drugs (AOD) service providers in the non-government sector reported increased costs, particularly due to the need to expend resources in ICT infrastructure and workforce training, personal protective equipment, and cleaning products and services,” Dr van de Ven says.
“While the majority also reported receiving government funding to cover additional costs and income loss, nearly a quarter of service providers reported needing to draw on financial reserves during the COVID-19 period. This meant that while they saw themselves as financially viable in the short term – at least another 12 months – it would present a challenge in the future if funding didn’t increase,” she says.
The research looked at a number of impacts on the workforce, including staff recruitment and turnover, adapting to flexible and work from home arrangements, workload and staff mental health and wellbeing.
“We found that while almost all participants – 97% – perceived an increase in their stress levels over the COVID-19 period, leading to a concern about burnout in the sector, this issue also led to a greater recognition among work teams of the need to take sick leave in order to stay healthy.”
While longer wait times for services were reported particularly among metropolitan and regional services, a surprise finding of the research was the increase in innovation and resilience of service delivery, particularly in rural and remote areas.
“While there is no doubt that the pandemic has exacted a toll on AOD services, their staff and the clients who attend for treatment, this project has highlighted a number of unintended positive consequences of the pandemic,” Dr van de Ven said.
“Almost every service in NSW, ACT and TAS that participated in this project adapted their service delivery and a number embarked on innovative new programs, both technology-based and in real-life.”
The research found technology-based services enabled continuity of care during the COVID-19 pandemic, even expanding the reach for some services, particularly in rural areas, while protecting service providers from the risk of infection. It also increased communication between staff, and between staff and clients, and allowed for more flexible work arrangements.
“Providing flexibility and hybrid services – that is, both face-to-face and virtual care (including telehealth) – to better meet client needs is all part of the ‘new normal’. This has particularly positive consequences for people in regional, rural and remote areas, where physical access to treatment has been a long-standing barrier to receiving care, which is some positive news out of this research,” she said.
But virtual care does not come without its limitations, for example, clients not having access to internet and phone, and it is not suitable for all client groups and treatment types; face-to-face services are a key core component of service delivery. And it requires technological infrastructure investment and the outcomes are not yet known – research into the costs, benefits, and limitations is vital.
The research report offers 31 actions across treatment funders and service providers in the non-government sector including short, medium, and long-term actions that can be implemented to help improve communication, collaboration, staff recruitment and management, policies and practices, funding opportunities and more.
It seems clear that some of the COVID-19 impacts have been worsened due to two systemic issues for the sector that pre-date COVID-19:
* The chronic underfunding of treatment; and
* The challenges in recruiting and retaining a specialist workforce.
Both of these long-standing systemic issues require resolution. At the same time, the innovations with ICT, and engagement with virtual care models has provided the basis upon which to build new ways of providing treatment and responding to client needs with a greater diversity of practices. It is vital that greater investments are made into virtual care models, and their evaluation.
“We hope the services will use this list as a way to develop priority actions plans, to recognise what they have already achieved, and what remains to be done both immediately and in the medium term,” said Dr van d Ven.
“Likewise, this list of actions can inform government about priorities and how to ensure that AOD treatment continues to meet the needs of those seeking help.”
The research was conducted with Prof Alison Ritter from the University of NSW, Drug Policy Modelling Program, and Robert Stirling, from the Network of Alcohol and other Drugs Agencies (NADA), Sydney.
To view the findings and action points from the research, view the full report
