Qualified addiction counsellors not wanted in NZ prisons

addictionIn April last year, Radio New Zealand reported that the Corrections Department was paying for non-existent alcohol and drug counsellors. The story omitted the fact that most of the AOD counsellors who do work in the prisons are not actually qualified – at least not in addiction treatment.

The qualifications required to work as an AOD counsellor in prison are described in tender documents issued by Corrections recently. The documents relate to Drug Treatment Units (DTUs), the prison programme that inmates with addictions are required to attend. The tender states:

“DTU programme clinical staff and the DTU clinical manager will have a relevant qualification in psychology, counselling, psychotherapy or similar.

no-experienceRemarkably, the document does not specify that the ‘relevant qualification’ has to be a graduate degree. Nor does it state that clinicians require a qualification in the assessment and treatment of addictive disorders.

Currently an AOD agency called CareNZ has contracts with Corrections to run eight of the nine DTUs. CareNZ also has contracts with a number of DHBs up and down the country to provide addiction treatment to the public in community clinics. The DHB contracts are a great more specific. For example, CareNZ’s contract with the Waikato DHB says:

“Clinicians employed to deliver these services must have a level VII (graduate) AOD specific qualification.”

Clearly, the DHB’s want value for money; they want professional clinicians to treat addicts – ones who are specifically qualified in the treatment of addictive disorders. But Corrections doesn’t seem to care. Perhaps that’s because their clients are only prisoners – so any old counsellor with any old qualification will do. If that’s their attitude, no wonder drug treatment in prison doesn’t work.

Review of DTU’s under CareNZ

And it doesn’t work. Hundreds of inmates are put through these DTU programmes each year and they reduce reoffending by less than 5%. Mind you, 11 of the 12 rehabilitation programmes in prison don’t work. Corrections management are concerned about this because in 2011, Government set the Department a goal to reduce reoffending by 25% by June this year.

carenzThe Department seems to think the poor performance of the DTUs is CareNZ’s fault. They even initiated an evaluation of CareNZ’s performance by an independent consulting company, Julian King & Associates.   Amazingly, the independent review reported that CareNZ was doing fine. See Corrections pays consultant to whitewash failure of rehabilitation programme.

So when RNZ reported that Corrections was paying for non-existent counsellors, Corrections’ Southern Regional Commissioner, Ben Clark, spun the story like this. He said:

“If we had cause for concern that Care NZ weren’t delivering an effective service to our offenders, and weren’t giving the taxpayer good value for money, then absolutely we would look to put that money elsewhere, but so far we have no evidence of that being the case.”

Less than 12 months later, Corrections has decided to put the taxpayers’ money elsewhere. They’ve put the DTU contracts up for tender.  The tender process is nearly complete and my sources tell me that six of CareNZ’s eight contracts have now been offered to other AOD treatment agencies. But as described above, neither CareNZ nor any of the new treatment agencies will not be required to use qualified or experienced clinicians.

Prison inmates have extra needs

comorbidThis makes no sense whatsoever. There are now over 10,000 people in prison in New Zealand and up to 90% of them have problems with substance abuse. At least 45% of inmates also have underlying personality disorders, mental health problems, and learning disabilities. They often use alcohol and drugs to alleviate the symptoms associated with these disorders.

Not forgetting that addictions are hard to treat at the best of times; treating inmates with coexisting disorders is even tougher. The counsellors who work in prison therefore need to be as qualified, if not more qualified and more experienced, than AOD clinicians in the community. At the very least, they need to have a graduate degree in the assessment and treatment of addictive disorders; and they need at least five years’ experience working with addicts in the community before starting work in a prison.

So what’s happened is that Corrections has used CareNZ as a scapegoat. That particular agency’s role in the prison system has been cut, but nothing will change if the clinicians doing the counselling can’t cut the mustard.  To use another analogy, changing agencies is akin to re-arranging the deck chairs on the Titanic; unless the right people are sitting in the right chairs, the ship is still going to sink.

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