`
Dunlewey Addiction Services Ltd Annual Review 01 April 2022 – 31 March 2023.
Objects of the Company
Dunlewey Addiction Services provides counselling, training, support and advice services in the field of addictions. We offer free and confidential counselling, training and mentoring for those experiencing difficulties with their own, or other people's substance misuse or gambling issues. Our services are delivered across a number of Health & Social Care Trusts areas in Northern Ireland. The Problem Gambling service is provided Ireland wide.
The Centre’s objects are for the relief of persons suffering from alcohol, solvents or drug dependency, the advancement of education and the protection of health and, in particular, to provide counselling for people who are concerned about chemical dependency and to provide education and training on substance misuse.”
Public Benefits
The direct benefits flowing from Dunlewey Addiction Service organisation purpose include
Supporting people to be in a better position to deal with issues across all aspects of their lives that have resulted from their addiction.
Improve mental health and well-being of people with addictions.
Provide individualised support to enhance the recovery journey for service users. Support service users to build positive routines, structure, and goals into their daily lives.
Empower people with addictions in the recovery process to deal with issues in their everyday lives.
Promote a self-care approach to recovery.
For families we develop a greater understanding of addiction issues being faced by their family member. Improve relationships between people with addictions and their families.
These benefits will be evidenced through feedback from service users and regular internal and external monitoring and evaluation of all our services. An annual report is produced each year which collates the benefits identified.
There is no harm arising from the organisation purposes.
The beneficiaries are all individuals who are affected directly or indirectly by substance misuse and problem gambling issues.
1
There is no private benefit flowing from the organisation’s purposes.
Adult Services in Belfast HSCT area
In the year 1[st] April 2022 – 31[st] March 2023, 272 service users availed of Dunlewey Counselling Services. In the year 1[st] April 2021 – 31[st] March 2022, 1878, sessions were offered.
Service users have engaged at a steady and consistent level, from SMD’s, LDQ and alcohol audit scores, service user feedback, family input and referral agents’ comments indicate that clients are taking onboard areas discussed and for the most part making positive changes.
Substance use figures identified that alcohol dependency is still one the main drugs of choice among our service users in Belfast, however cocaine use has trebled among our service users.
. Evaluations of the service were overall very positive.
-
87%- very positive.
-
4% - very helpful.
-
9% - stating more time would be beneficial.
Over 55% of clients requested an extension on top of 6 sessions initially offered.
The highest referral source was ‘Self’, followed by GP’s. Other referring agencies include Welcome organisation, mental health and community and voluntary organisations and, concerned relatives
Funding from Homelessness Prevention allowed us to work with individuals and support workers in relation to providing pre-crisis intervention through advice, proactive interventions and targeting individuals at known risk.
316 service users have availed of this service. The age of the service users ranges from 19-73 with a higher percentage being male (62% male, 38% female).
Service users have stated they feel understood and supported, sometimes to have someone listen without an agenda makes them feel human. Weekly service user return to talk which is reducing their isolation. Some service users have enrolled in other community groups, churches, and education schemes.
2
STEP 2 Services South Eastern HSCT
During 2022 - 2023 the Step 2 Early Intervention Service supported 476 clients , providing a total of 4532 sessions to individuals affected directly or indirectly by substance misuse.
REFERRALS, STATISTICS AND TRENDS
During the 2022-2023 period the service received a total of 675 referrals.
Family members affected by substance misuse accounted for 14% of referrals. This is a 55% increase from last year and a significant increase compared to previous years. This can be attributed to promotional work and networking, particularly with Carers support services.
Males continue to be the primary cohort representing 60% of adult treatment referrals however there has been a slight increase of 7% in the number of females referring to the service .
In comparison to last year, there have been slight shifts in age profile. Of note, we recorded a 7 % increase in referrals for 60 years old and over , and alcohol was registered as the substance of choice for 90% of these cohorts.31-40-year-olds accounted for 30% of referrals, an increase of 5% since last year. Like last year, 20– 40-year-olds , represented 53% of all referrals, and 45% of these referrers cited alcohol as their primary substance, cannabis was the 2[nd] drug of choice at 20%
Alcohol consistently continues to be the preferred drug of choice , accounting for 58% of adult treatment referrals, 53% of this cohort reported using alcohol with no other substance.
The number of clients reporting cocaine use stands at 14%, with 64% of these reporting using cocaine only, and 36% reported using cocaine in addition to another substance. 44% of these referrals were for males aged 18–30yrs old.
Self-referrals continue to be the primary source of referrals, representing 45% of referrals. Almost 8% of referrals were re-referrals from clients who had previously used the service. Referrals from CAT remained static at approximately 35%. While consistent with the previous year, it is still significantly lower than previous years. Discussions with CAT report this is due to clients presenting with complex needs who are not suitable for the Step 2 service. 42% of referrals came from our partner agencies.
The trend for online support continues despite the availability of face-to-face sessions, with just over half of our clients still opting for telephone or zoom calls. Clients cite the ease of accessibility to online support as a benefit that has arisen from
3
the lockdown period by removing barriers such as physical and/or mental health issues, financial issues, and risks ie concerns about travelling to certain areas, or threats made against them.
FAMILIES There has been a significant increase (55%) in the number of referrals received for family members. 5% of these were for more than one family member, primarily parents, accessing the service in relation to an adult child. 84% of referrals for family support were for female. Like previous years, females are the primary cohort accounting for 87.5% of referrals, a slight increase from last year. The oldest person who referred for family support was a 79-year-old female. The majority of family members were self-referrals and referred in relation to an adult child. Overall, IMT outcomes report positive changes from beginning to end of treatment including increased coping skills , improved physical symptoms and an increased support network . While our family support has been on hold for most of the year, we have continued to support family members at point of crisis by providing ad hoc telephone support when needed. All family members ae provided with the “Taking the Lid Off” booklet via email or post when they are initially triaged.
STEP 2 Partnership Services Southern HSCT
This service is provided in partnership with Addiction NI, Ascert and Extern. Dunlewey Addiction Services are the lead partner.
Over the last year of the Step 2 Partnership, we received 534 referrals, of which 146 have been allocated to Dunlewey. This past year the Step 2 Partnership has worked very hard to establish the service within the southern trust area. Our service has increased, and over this past year has become a valuable addition to the services offered in the Southern trust area. Our Tri-age meetings held on Monday morning continue to be an excellent way for us to work together to offer the best service we can for our client’s while also being an invaluable support to each other. We have developed a way of working together in an open and transparent way, which enables us to discuss client’s clinical needs and which service is best suited to the individual. Over the last year we have continued to develop our way of working with the Community addiction team (CAT). We find having that direct contact and Judith from the CAT, sitting in on our tri-age meetings is invaluable. The Partnership have received 12% of their referrals from the CAT.
This has been a key outcome of our service that in building this relationship we are now able to step client’s up directly to CAT. We are also working directly with the GP federation in Newry/Mourne area to set up a meeting with the Practice managers with the aim of trying to establish a more fluid and direct referral pathway from GPs, this
4
could help to further reduce the referrals of step 2 client’s being referred to the CAT and help reduce their waiting list for both the client and service.
The Step 2 Service was also represented at SDACT meetings,and contributed to connections meetings and consultation events on the New Substance Use Strategy and Mental Health Strategy. Our team of counsellors continue to actively contribute to the Substance Misuse Database (SMD) and the Impact Measuring Tool (IMT).
After supporting our clients through the Covid 19 pandemic, and the changes and restrictions it brought with it, we have now been able to move forward. We have over the last year been able to gradually open up our face-to-face appointments. We make sure our clients are offered a number of options. Considering each client’s needs, while also considering the health and safety of both client and counsellor. Our referral rates have been consistent while increasing over time. We continue to proactively engage with service users to encourage feedback, to ensure we are meeting the changing needs of our clients. We send feedback forms online, so clients feel free to send an anonymous response, while also offering evening appointments to meet client needs. Based on the feedback from clients we know how much they value the flexibility of our service.
“I felt that the counselling I received helped support me in making better choices, I felt someone was actually listening.”
“It was very important to me that I could have my sessions outside of my working hours, and Dunlewey accommodated this, I felt well supported by my counsellor.”
In addition to supporting clients to reduce the harm and risks associated with their use, we have also supported clients in their work with social services which has resulted in them gaining more access to their children, as well as signposting to further education and volunteering opportunities. Signposting for the Recovery college, Arch Programme, and recovery groups.
REFERRALS AND TRENDS
2022/23 has been a year of continued growth in the southern trust area. Dunlewey have received 146 referrals through the partnership, with 13 of these being family members. We are working closely with referrers to help highlight the family support aspect of our service as this continues to have low referral numbers. It is still quite obvious from our numbers that our clients are feeling the benefit of having appointment options, but we are starting to see an increase in people wanting to return to face-toface appointments.
“I tried counselling during the lockdown over the phone, I wasn’t really able to connect to my counsellor, but am able to see my counsellor face to face now and am finding it extremely helpful.”
5
We have seen that 70.5% of referrals overall to our service are male and 29.5% female. Also noticeable is that Dunlewey have only 3.2% of referrals who have been born outside of Northern Ireland.
Families
Families make up 8.9% of our referrals in this past year. 15.4% of our family referrals have identified as male, and 84.6% identifying as female. We have supported our family members not just by one-one counselling but by also supplying information and resources for eg: ‘Taking the lid off’ and information on services available to support them, and their loved ones. We have also been signposting clients to Inspire who offer a zoom family support group,and find this has been a good resource and support for some family members.
Step 2 Young People Services – (11-25 year olds) Southern HSCT
Service users (SU’s) described as an 11 to 25-year-old with substance mild to moderate substance use/misuse concerns.
To date there have been 2190.5 hours provided to 311 SUs, each SU receiving an average of 7 hours of support. This includes 225 referrals received 22-23 and provision of continued support to those referred 21-22-total of one-to-one hours provided to service users include follow up for appointments, check ins, social service support, supervision, session planning and admin write ups. One to one provided to service users are comparative to previous year. More service users have been availing themselves of group work alongside one to one support. Whilst the one-to-one therapy allows for in-depth exploration of sensitive issues, the groupwork offers diversity of viewpoints and peer support. Peer support and feedback from the group may account for the reduced requirement for one-to-one therapy.
Group work:
This year has seen a significant uptake in groupwork with 11 group workshops completed- (4 x 4-week duration, 5 x 6-week duration and 2 x 8-week duration) 150 young people were provided with groupwork, 27 of which did not register with the service for additional 1-1 support.
In association with the Arts Council NI, DA-FACTS worked in collaboration with a choreographer and drama facilitator to deliver a workshop to a group of young people exploring the pressure of being a young person, of wanting to fit in with the crowd yet accepted for being unique. These drama therapy workshops supported and allowed the young people to develop self-awareness, express emotion, increase their self-esteem and confidence and improve relationships with self and others. Different drama techniques, activities and exercises were incorporated to help the young people explore their emotions and work through challenging life experiences.
6
On completion, the group produced a short movie depicting their interpretation of the topics explored and presented it to their friends and family at a celebratory event.
Family Support:
Family support has been provided to Engaged, families with a young person attending the service and non-Engaged, families that do not have a young person attending for support.
53 Engaged Families provided with support; with a total of 431 hours delivered to families equating to 8.1 hours of support per family. A family can be defined as having more than one person, a total of 92 family members have received support. Some of this support has been one off interventions, sign posting, awareness raising and providing a safe space to offload.
Non-engaged family support to 43 families, a total of 397.25 hours for support equating to 9.2 hours of support for each family. It is reported by staff that families are consistently requesting additional sessions as they feel 5 is “just not enough” This is especially the case when the problematic substance user is at precontemplation stage.
Online support has been offered to families and this blended approach offers flexibility to suit the needs of working parents/grandparents. As well as online, the support provided has been via telephone and text along with hours provided for appointments or other work that supports a service user’s / family recovery care plan. This has included attendance at case conferencing, leaving & aftercare reviews, Criminal Justice / Social Services reports and step up / down handovers, peer support / supervision meetings and clinical supervision.
Problem Gambling Service- Nationwide
Since 2008 Dunlewey Addiction Services have been providing services to individuals experiencing issues with problem gambling across the island of Ireland. We have also provided accredited Problem gambling awareness training to staff in bookie shops, credit unions and banks and community and voluntary organisations
From 1[st] January 2022 – 31[st] December 2022 there were 3860 calls made to the problem gambling helpline.
The calls were made up as follows: -
70% Brief interventions & Health & wellbeing
20 % Referred 1 to 1 counselling.
10 % Other
7
30% of calls were made by a family member+
Dunlewey Addiction Problem Gambling Service offered 1365 counselling sessions to 230 service users.
The majority of service users were self-referral (64%).
The majority of service users attending the counselling service were male
(77%) compared to females at (23%).
25-44 years old was the highest age category representing (68%) of all service users.
The highest presenting gambling activity was Online Betting (27%) followed by (21%) betting on horses at the bookies. 25% of service users gambling activity was in house machines at bookies, arcades and casinos.
Over 88% found the counselling service to be very helpful.
New ARCH Programme
The New ARCH programme is funded by the National Lottery to support clients in recovery from substance misuse. The aim of the programme is to provide tailored support to individual’s needs to enhance their recovery journey. Support includes weekly well-being activities, one to one mentoring and coaching, group-based sessions and family and peer support. It is targeted at people who have experienced significant problems as a result of their addiction and requires additional support to ensure that they remain in the recovery process.
Between April 22 and March 23, 118 referrals were received for the New ARCH programme. Of the referrals received 46% (54) were from the South Eastern Trust, 43% (51) from the Belfast trust and 11% (13) from the Southern Trust. 100 % referrals were for aftercare treatment for those in recovery. As this is a new programme no family referrals have been received this year. The gender of referrals to the New ARCH programme was 35% (41) for females of the overall referrals and 65% (77) for males.
Alcohol continues to be the preferred drug of choice with 59% (69), prescription medication was 13% (15), cocaine 10% (12), cannabis 6% (7), Heroin 3% (4) and gambling 1% (1), unknown 8% (10).
The age range of referrals were the highest for the 25 to 34 age group at 31% and 57% of all referrals were aged between the 25 and 44 age range. Referrals for the 18 to 24 age group was 5% (6), for the 25 to 34 age group the referrals were 31% (36), 26% (31) of all referrals were between 35 to 44 age group, the 45 to 54 age group was 22% (26), the 55 to 64 age group was 12% (14) and 64 + 1% (1) and age unknown 3% (4).
Referrals to New ARCH were received by a number of different services. The highest referrer to the New ARCH programme was Dunlewey counselling services
8
with 40% (47) of referrals, followed by self-referrals with 25% (30) and then CAT at 17% (20). Other referrals were received by Extern 8% (10), Other HSC 3% (4), Carlisle House 3%, (3) SMLN 2%, (2) CMHT 1% (1) and PBNI 1% (1).
Follow-on support for New ARCH participants
Fifty-five of the participants that completed the new ARCH programme werreferred onto the New ARCH monthly support group.
Twenty-eight of the previous New ARCH participants were referred to the Experts by Experience group developed by Dunlewey to provide an opportunity to engage in healthy social activities.
Eleven New ARCH participants were referred to the focus group which meets every two months to discuss the New ARCH groups and any ideas or changes that may need to happen to ensure the programme meets the needs of the participants.
Eighteen previous New ARCH participants felt that further counselling would be helpful for them. Some participants became more aware of their issues while completing the New ARCH group and wanted to explore this further.
Seven of the previous New ARCH participants completed Level 2 OCN in peer support.
Communications
A range of communication platforms including website, social media, local newspapers enabled us to circulate key information regarding our services.
We also attend networking opportunities to enable staff to circulate key information about our services.
We actively promoted, participated in and contributed to a range of public consultations, events and workshops and actively engaged with stakeholders from key statutory agencies.
Financial review Principle Funding Sources.
Dunlewey addiction Services secured funding from a number of sources during this period covered by this report including: BHSCT, PHA, PCSP, Gambling Awareness Trust, Big Lottery, Homeless Prevention Fund, LFT.
Partnership Working.
9
We maintain excellent working relationships with all our stakeholders and partner agencies.
Reserves Policy
Dunlewey Addiction Services have a detailed reserve policy in place which is subject to annual review. The policy aims to have £400,000 of cash reserves which approximates to six months of outgoings including potential redundancy costs.
Plans for Future funding.
.During this year Dunlewey Addiction Service celebrated 35 years of supporting individuals affected by substance misuse. The occasion was celebrated with a Gala Ball at Belfast City Hall. The theme of the evening was “Celebrating Recovery” and was inspired by the many service users we have supported during this time. service users past and present played an active and vital role in planning and preparing for the event and proactively engaged in various activities such as art, poetry, writing, singing, and drama This culminated in the production of our “ Stories of Recovery” Book that encompassed contributions from clients who shared their journey of recovery in the hope that it can help inspire others wo are starting on their recovery journey.
It is expected that the New Substance Misuse Strategy Commissioning Framework will be published this year and in accordance with this we will re-tender for existing services and also develop new applications for further programmes.
We will build on our knowledge and experience and continue to apply to a range of other funding streams.
Declaration
This report was approved by the Board on 20[th] December 2023 and thereafter signed on its behalf by:
10
Jo Daykin-Goodall
Chairperson Dunlewey Addition Services
Date:
11