Tom Ogwang
In February QNADA submitted a response to the Mental Health Select Committee Inquiry into the opportunities to improve mental health outcomes for Queenslanders (the Inquiry). The submission addressed the Terms of Reference for the Inquiry in three distinct, but inter-related parts: Services (part A), Policy (part B) and Systems (part C). We’ve provided a very brief overview of highlights from our submission below. If you’d like to read it in full, you can download it here – https://documents.parliament.qld.gov.au/com/MHSC-1B43/IQ-5DEF/submissions/00000048.pdf.
Part A: Services
Developing a shared understanding of when and how the services system should respond to AOD related issues is key to improving AOD responses on the whole. Our shared understanding should recognise that only a small proportion of people who use AOD require treatment, however there are still insufficient specialist services available to meet demand. These challenges are compounded by critical specialist AOD workforce shortages.
Part A highlights that in order for the services system to become better coordinated or ‘integrated’, all systems of care should be informed by both AOD scientific evidence and lived experience in all aspects of program and policy development. In short, policy should be responsive to need and informed by the people it most directly affects. However, people who use drugs have traditionally been marginalised from policy debate and from receiving appropriate care.
Two case studies (Daisy’s Story and Jane’s Story) exemplify how QNADA member services and clients navigate system complexity, and how external system responses impact on client outcomes and opportunities.
Part B: Policy
The absence of a clear whole of government endorsed public AOD plan since 2017 has stifled leadership and prioritisation for AOD system reform outside the health system. It impacts agency understandings of their roles and responsibilities to deliver or support agreed state and national priorities and commitments. This absence means that there is no overarching mechanism drive action across systems such as criminal justice, domestic and family violence, youth justice, child protection, education, and communities.
Part B explores the reforms required to reduce costs and harms associated with criminalising illicit drug use. We note that the approach of criminalisation has proven largely ineffective at significantly reducing the consumption of illicit drugs and has not achieved a sustained reduction in supply. For example, the Queensland Productivity Commission’s makes a compelling economic argument for decriminalisation for low harm drugs within its 2020 Inquiry into Imprisonment and Recidivism and found that:
- Illicit drugs policy has failed to reduce supply or harm and was found to be a key contributor to rising imprisonment rates, with drug offences contributing to 32% of the increase since 2012
- Current illicit drugs policy results in significant unintended harms, through supporting a large criminal market and incentivising the introduction of more harmful drugs
- Evidence suggests legalising lower harm drugs and decriminalising others is unlikely to increase drug use and is likely to provide net benefits to Queensland of at least $2.8 billion by 2025
- Targeted community-level interventions and greater use of diversionary approaches are feasible alternatives to the criminal justice system which are significantly less expensive.
Part C: Systems
For the significant majority of people who use AOD, the risk of harm to both themselves and the community is increased primarily as a result of the social, policy and legislative responses to their use, rather than the substance itself.
Part C discusses opportunities for whole of system collaboration and partnerships across the criminal justice, child protection and youth justice systems. Queensland’s Mental Health, Alcohol and Other Drugs Strategic Plan 2018-23 (Shifting Minds) highlights the importance of collective leadership and responsibility across all policy, funding, program development and service delivery to achieve common outcomes and benefits. There is currently no entity in Queensland who has primary responsibility for, and a dedicated focus on, effectively influencing, driving and coordinating this change within the context of AOD policy and planning.
In early 2021 QNADA launched the self-funded Responsive Systems project to improve cross-agency collaboration and partnerships and support more effective system responses outside the health sector.