The AOD Provider Collaborative (AOD Collaborative) is funded by Counties Manukau DHB and brings together 16 AOD treatment services, as well as interested stakeholders, from across Auckland to work together for system-level changes.

The AOD Collaborative wanted to identify the physical health concerns for people who use AOD services, and how to enhance the support that services provide. 

This occurred through: 

  1. A World Café co-hosted with Counties Manukau Mental Health and Addiction Partnership, focused on enhancing physical health, which 60 people attended. 
  2. Research into how AOD services currently support people’s physical health and how this could be enhanced, particularly in relation to the Te Pou 2017 evidence update on the physical health of people with mental health conditions and/or addiction

The key findings all strongly confirm the 2017 evidence update and are summarised below: 

What physical health support do people who use AOD services want?

People who access AOD services consider physical health to be very important to their wellbeing and recovery. They would like: 

  • Physical health support delivered within a holistic model of health that focuses on promoting healthy lifestyles 
  • Earlier identification and treatment of health problems.  
  • Discussion of physical health within a positive and culturally-responsive relationship.  
  • Services to support people to identify their own health priorities and to choose their own ways to address them.  
  • Health information and support provided by peers. 
  • Improved access to health resources and services, particularly general practices and dental care.  

The key challenges for people living in the Counties Manukau area to access health support are:  

  • Being unaware of the resources and services available. 
  • Financial barriers.  
  • Challenges building relationships with health service providers, including dealing with stigma and discrimination.  
  • The broader social determinants of health which people may need assistance with e.g., housing, education, employment and social connectedness.  

How do AOD services currently identify and support people’s physical health needs? 

AOD services are aware that addiction and physical health issues are closely linked. Most services include physical health goals in people’s treatment plans and provide support, such as health education, harm reduction, and liaison with other health services. However, there seems to be inconsistency about which health issues are raised, how these are identified and what interventions are offered. Services which have contact with people over longer periods of time, particularly residential services, are able to provide more direct support for physical health issues. Other characteristics which enable services to better support people with their physical health issues include: 

  • Having a holistic service model 
  • Providing mobile services 
  • Access to flexi-funding 
  • Having peer support services 
  • Co-designing health services with people accessing them. 

Challenges which AOD treatment services face when supporting people’s physical health needs include:  

  • Service contracts which don’t resource this work 
  • Identifying and collaborating with other health services 
  • Ensuring the workforce has relevant health literacy 
  • Identifying which health issues to routinely screen for 
  • How to use structured screening or assessment tools without undermining the therapeutic relationship, or overwhelming people or staff with information and options.    

How could AOD services enhance their support for peoples’ physical health? 

AOD services support people with their physical health concerns in many different ways with some variation expected, reflecting different treatment being provided in services. Consistency could be enhanced by using more holistic and wellness-focused approaches and screening and referring-on for common physical health issues. The AOD Collaborative, supported by the 2017 evidence update (Te Pou), have identified a range of strategies which services could consider implementing, if they aren’t already doing so, including:  

  • Organisational policies and practices which create health promoting environments.   
  • Providing access to peer health support. 
  • Providing access to wellness programmes, which include nutrition, physical activity, good sleep practices and smoking cessation. 
  • Earlier identification and intervention for common health issues (eg blood-borne viruses, dental problems, or metabolic syndrome) through screening, and supporting people to manage the risks and/or access health treatment.  
  • Improving people’s access to primary care and dental services.  
  • Supporting people to enhance their self-care through health literacy.  
  • Enhancing collaboration and sharing expertise with primary care services.  

Next steps for the AOD Provider Collaborative 

The AOD Collaborative has decided to initially focus on supporting people’s wellbeing and self-care and so aims to:  

  • Develop a resource that identifies key, accessible health and social services in the community; 
  • Develop a health and wellness check-list for people who access AOD services, so they can identify their health priorities. 

Written by Debby Sutton, Programme Manager, AOD Provider Collaborative (and Odyssey).