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TRANSFORMATION JOURNEY OF TREATMENT AND REHABILITATION PROGRAMS IN MALAYSIA: COMPULSORY OPEN AC

TRANSFORMATION JOURNEY OF TREATMENT AND REHABILITATION PROGRAMS IN MALAYSIA: COMPULSORY OPEN ACCESS SERVICES. CURE & CARE. DR. SANGEETH KAUR NATIONAL ANTI DRUGS AGENCY MINISTRY OF HOME AFFAIRS MALAYSIA.

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TRANSFORMATION JOURNEY OF TREATMENT AND REHABILITATION PROGRAMS IN MALAYSIA: COMPULSORY OPEN AC

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  1. TRANSFORMATION JOURNEY OF TREATMENT AND REHABILITATION PROGRAMS IN MALAYSIA: COMPULSORY OPEN ACCESS SERVICES CURE & CARE DR. SANGEETH KAUR NATIONAL ANTI DRUGS AGENCY MINISTRY OF HOME AFFAIRS MALAYSIA
  2. Evolving government policies towards Treatment and Rehabilitation of Drug Dependency Drugs as a social problem - Department of Social Welfare - Facility – PusatInsafDiri 1975 1983 2004 2010 onwards
  3. COMPARISON STATISTICS OF DRUG DEPENDENTS 2011 AND 2012 Total no of registered drug dependents since 1988 till 2012 are 345,234 individuals
  4. PROFILE OF DRUG DEPENDENTS 2012 / 48.3% / 31.3% / 12% Adults, 29.85% 98 % drug dependents are male 77.4%between the ages of 18-44 91.6% use traditional drugs like heroin/ morphine/ marijuana Youth, 66.88% Teenagers, 3.29%
  5. Treatment Scenario in Malaysia Compulsory Treatment Provided for drug dependants since 1983 Drug Rehabilitation Centers (DRC) & Supervision in the Community 22 DRCs – capacity of 7,000 residents Supervision - 55,000 estimated in the communityHow can N.A.D.A take care of the massive numbers in the community?
  6. Why NADA needs to Transform? Stakeholders Success Rate 75% ? 50% ? 20% ? 10% ? Success Rate 75% ? 50% ? 20% ? 10% ? Compulsory Treatment Reluctant & Resistant Clients Problems in the DRCs Compulsory Treatment Reluctant & Resistant Clients Problems in the DRCs Treatment Services Programs in DRCs and those undergoing Supervision Treatment Services Programs in DRCs and those undergoing Supervision Parents, Families Stigmatized Residents – criminalized (records) Parents, Families Stigmatized Residents – criminalized (records) Changes Impact of New drugs on Clients Need for Clinical Approach Changes Impact of New drugs on Clients Need for Clinical Approach GTP & NKRA Concept of 1Malaysia
  7. OBJECTIVE In response to the growing drug problem and its complexity and realizing that the existing strategies are not achieving the intended effects / targets, NADA has shifted its approach from INSTITUTIONALISEDrehabilitation to an open approach, OPEN ACCESS SERVICES, by setting up THE CURE AND CARE 1 MALAYSIA CLINICor better known as C&C 1MALAYSIA CLINIC. This is a paradigm shift for NADA to transform its treatment and rehabilitation services to all its clients in the country. 2 NADA MALAYSIA
  8. Major Developments since 2010 in terms of the extension of voluntary community based treatment
  9. AKTA PENAGIH DADAH (RAWATAN DAN PEMULIHAN) 1983 COMMUNITY BASED INSTITUTION BASED AADK DAERAH
  10. Treatment and Rehabilitation Strategy Return of clients as socially funcionalindividuals Provide a holistic approach in treatment and rehabilitation Treat Drug Dependents as patients
  11. TRANSFORMASI Cure & Care 1 Malaysia Clinic Registration Office– Sg. Besi Psychiatrist/ Medical Officers Treatment Wards
  12. CONCEPTOPEN ACCESS SERVICES Voluntarism or Walk-in Support from parents or family Referral Outreach / Motivate No Legal Implications No Pre-conditions No stigma Private and Confidential Options for clients Community-based Program Clients as patients
  13. PROGRAMME PROVIDED CLINICAL SERVICES VOCATIONAL TRAINING AND JOB PLACEMENT PSYCHOSOCIAL 2 3 1 Medical Detoxification MAT with Methadone/Suboxone Psychiatric Management HIV/HEP/TB/STI Management Inhalan Management Alcohol and Nikotin Management Immunisation Infectious Disease Screening INH Prophylaxis Skill Training Business Job Placement Early Recovery Relapse Prevention Sosial Support Family Development Spiritual and Religious programmes Counseling Self Management Outing/Excursion Sports and Recreational Activities
  14. Distribution Karangan 01/05/12 Kota Bharu 15/10/10 Papar 01/11/10 Bachok 1/8/12 Bkt. Mertajam 15/10/10 Kuching 15/10/10 Dengkil 07/01/13 Jerantut 01/07/11 TOTAL NO OF CURE & CARE CLINICS - 11 CLINICS Sg. Besi 01/07/10 Tampoi 15/10/10 Tampin 04/04/11 Tampin 04/04/11 TOTAL NO OF MINI C&C : 4 CLINICS(BESUT, KINTA, MIRI & KENINGAU) : INPATIENT – 479 CLIENTS : OUTPATIENT – 525 CLIENTS : OPERATIONAL SINCE– 15 NOV 2011 (TILL April 2013)
  15. STATISTIC OF CLIENTS PERCENTAGE OF INCREASE OF CLIENTS FROM 2011 TO 2012 } INPATIENT :66%OUTPATIENT : 71 %
  16. DRC VS. C&C CLINIC
  17. FUN, EFFECTIVE & EASY TO IMPLEMENT APPROACH
  18. OUTCOME RESULTS OF CLIENTS DISCHARGED FROM CURE & CARE CLINICS (2010-2012)
  19. OUTCOME STUDY AT C&C CLINIC
  20. Drug use history OUTCOME STUDY AT C&C CLINIC
  21. OUTCOME STUDY AT C&C CLINIC Health status, needs and access In general, how satisfied are you with the medical attention you receive for your health problems (other than drug addiction) at the Cure and Care Clinic? Satisfied 69.3% Very satisfied 23.9% Not very satisfied 5.6%
  22. Qualitative analysis: Opinions and feedback on C&C program and services. OUTCOME STUDY AT C&C CLINIC Overall, happy with the C&C concept C&C encourages voluntary and ambulatory care and rehabilitation MMT is seen as a stabilizer giving 2nd chance Programs offered by C&C were well received Good support from C&C staff, Counselors and Medical Team
  23. OUTCOME STUDY AT C&C CLINIC METHADONE MAINTENANCE PROGRAMME 2010 2011 2012 936(67.8%) clients employed in 2012 compared to 543 (53%) clients in 2011. Example text
  24. OUTCOME STUDY AT C&C CLINIC
  25. KAJIAN KEBERKESANAN PROGRAM KLINIK C&C OLEH UNIVERSITI MALAYA OUTCOME STUDY AT C&C CLINIC
  26. CRIME HISTORY OUTCOME STUDY AT C&C CLINIC KAJIAN KEBERKESANAN PROGRAM KLINIK C&C KOTA BHARU Average number of times inpatients and outpatients have been sent to prison, lock up, or PUSPEN
  27. OUTCOME STUDY AT C&C CLINIC Mental Health KAJIAN KEBERKESANAN PROGRAM KLINIK C&C KOTA BHARU
  28. PENGIKTIRAFAN ANTARABANGSA UNODC (United Nation Office of Drug And Crime) UNAIDS WHO IDPC (International Drug Policy Consortium) Pengiktirafandaripada Negara Luar Drug Issues and Priorities for Southeast Asia 24th IFNGO Conference, Kuala Lumpur Gary Lewis Regional Representative, UNODC 8 November 2011 Positive example: Malaysia’s Cure and Care 1 Malaysia Clinics (Gary Lewis. Regional Representative, UNODC) Commendation by Mr. Andrew Marshall, Journalist from Al-Jazeera
  29. AFTERCARE Outpatient CCSC Options for Aftercare Services after discharge from C&C Clinic : as outpatient with the same C&C Clinic or other facility; or CCSC (Cure & Care Service Centres); or CCH (Community Caring House) CCVC (Cure & Care Vocational Centre) – vocational skills training TransCC – Transitional Cure&Care facility CCH CCVC AFTERCARE SERVICES TransCC NADA District Offices
  30. VISIONS AND TARGETS NADA Nation’s Targets Healthier people, drug-free country Strategy Targets Scaling up of Community-based services /programs Outcome Targets Better outcome and success rate in treatment & rehabilitation Process Targets Engaging Strategic Partners and Smart Partners People Targets Capacity Building – Training for officers, partners, volunteers
  31. STRATEGIC PLANNING FOR COMMUNITY-BASED SERVICES / PROGRAMS What are N.A.D.A’s Future Plans? By 2015 By 2015 CCH / MOBILE UNITS C&C 1MALAYSIA CLINIC CCSC
  32. STRATEGIC PLAN (2011 – 2015) C&C1Malaysia Clinic CCSC CCH 2015 2015 2015 No. of Compulsory Rehab. Centers (CCRC) (4) No. of CCSC – 98 No. of CCH – 96 No. of C&C 1Malaysia Clinics (18)
  33. THANK YOU TERIMA KASIH We Care, We Serve
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