Theme: Models of Care Year: 2022
Background:
Stigma and discrimination from the broader community and from health care providers exacerbates
mental health issues for people who inject drugs (PWID) and leads to further isolation and
deterioration of symptoms. Counselling services are typically based in traditional primary healthcare
settings which PWID may choose not to access and therefore their mental health needs often go
unmet.
Description of model of care/intervention:
KRC South is a stand-alone primary NSP program which implemented an onsite counselling service
for clients who may not usually access counselling. Preliminary consultation was undertaken to
assess need and interest in providing counselling services onsite. Support was overwhelming. NSP
staff promoted the service to walk-in and outreach clients. NSP staff managed appointments for
counselling sessions, originally on a fortnightly basis. The low-threshold service has few barriers and
provides easy access to counselling for alcohol and other drug (AOD) problems, trauma, and mental
health issues.
Effectiveness:
From inception (May 2020) to March 2022, 34 clients (mean age 45 years, 65% male, 15% Aboriginal
and Torres Strait Islander) accessed counselling and case management. All clients reported mental
health issues (i.e., depression, anxiety, interpersonal issues) and contact with the justice system (i.e.
offending) was common (85%). The main drugs used were heroin (56%) and methamphetamine
(24%). Due to established trust with NSP staff, clients who may have previously foregone counselling
were more open to being referred to a counsellor for support. Due to demand, the availability of onsite counselling was increased from fortnightly to weekly.
Conclusion and next steps:
The need for this kind of integrated service within a harm reduction setting clearly exists for PWID.
We plan to expand the counselling service to clients on Opioid Agonist Treatment (OAT) in the
community who may not otherwise attend primary care services and who have no case
management/counselling in place.
Disclosure of Interest Statement:
PR has received research funding from Gilead Sciences, as well as institutional and individual
honoraria from Gilead Sciences, Abbvie and MSD.