Executive summary

The Clients at Residential Agencies (CARA) database of the New South Wales Drug and Alcohol Directorate was analysed for trends in admissions of clients with alcohol problems over the years 1988-1992. CARA forms are completed by all 23 non-government residential treatment agencies funded by the Directorate for each admission and discharge.

There were no trends in the age or sex of admissions. Over all years, admissions for alcohol problems to residential agencies were overwhelmingly males in their mid-thirties. There was no change in the number of admissions by people of aboriginal descent although this group was over-represented, relative to the proportion of people of aboriginal descent in the general population, in all years.

There was a marked decrease, from 25% in 1988 to 16% in 1992, in the proportion of admissions who reported full time employment in the preceding six months. Over the same period the proportion of admissions that had been recently imprisoned and/or had previous criminal convictions increased. By 1992, over half of admissions had criminal convictions. Increasingly agencies are seeing admissions for alcohol problems who are unemployed and have criminal histories.

The proportion of clients who were admitted with no previous treatment history fell markedly over the study period. By 1992, over 80% of admissions had been treated previously. The proportion of admissions that had previously been treated at a residential agency fell over that period. It would appear that the non-government residential agencies who contribute to CARA are increasingly dealing with people with alcohol problems who have tried other treatments, prior to seeking residential admission. The duration of the alcohol problems prior to admission further illustrates the chronic nature of alcohol problems among this client population. In each year, more than 70% of admissions had problems of more than five years standing.

In all years, there was a high rate of attrition in the early stages of treatment. Approximately a fifth of admissions left treatment within the first week. While there were minor variations, length of stay did not significantly alter during the study period.

The current study indicates the value of collecting data on age, gender, type and duration of drug problem and prior treatment in documenting changes in client populations. It recommended that data similar to CARA be collected. In particular, it is recommended that i) the form be simplified and standardised and ii) a single form, completed at discharge, be used.

In conclusion, non-government residential agencies in NSW are now seeing a group of clients with increasingly chronic problems. Program planners need to take these findings into account in reviewing their programs.