Why doesn't Guernsey have a rehab facility?

Friday 21 December 2018

With Guernsey's courts jailing a number of people for drug offences this year, one question asked has been, why doesn't the island have a rehabilitation facility to treat those with severe addiction and dependency issues?

The answer according to those working in the area, is that the economies of scale in such a small island prove it isn't necessary - and for those who want help, there are a number of services available to them.

Psychiatrist Greg Lydall told Express that "the economies of scale are just not there, because of a relatively low demand for complex high need residential care.

"High quality services in the community are available and in patient detox is available if needed.

"The evidence is that good community treatment is a good alternative to rehab, and it is more cost effective."

Without focusing on any specific case, Guernsey's courts have heard tales of individuals with severe drug dependency issues throughout 2018, with some people receiving rehabilitation services and then falling 'off the wagon'.

Mr Lydall said there are very small numbers for rehab in Guernsey though. Fewer than a handful of people have needed rehab services over the last three years, with them being sent to off-island residential rehabilitation facilities that best suited their needs. Sometimes a facility in Jersey is used, other times places in the UK are.

He said that while a residential rehabilitation facility can help some people, for many people community treatments work as well or even better to address the root cause of an individual's issues. "Especially for those who are motivated" added Mr Lydall.

Pictured: The Oberlands mental health facility. 

With clear overlaps between mental health issues and drug and alcohol dependencies, teams of staff at different organisations work closely together - with many under the umbrella of Health and Social Care.

Charities also do a large chunk of the work to help people with addictions, without resorting to off island rehabilitation facilities, including the Guernsey Alcohol Advisory Service.

It's based in two former private houses at the top of the Grange, which for almost three decades has offered a roof to people with alcohol dependency issues who know they need help to address their problems.

The service is run by Dave Newman, who also said that a dedicated rehab facility isn't needed in Guernsey.

Pictured: The GAAS house at the top of the Grange. 

Mr Newman has worked for the Guernsey Alcohol Advisory Service for 25 years and said he has seen pretty static engagement levels over the years.

He said it is not a rehab facility although it is a rehabilitation dry house for those with alcohol dependency issues.

"It's not a structured treatment programme. What we do have is what we call an alcohol rehabilitation centre, a six bedded dry house for people who have lost everything through alcohol.

"The idea is that they live here, alcohol free and try and rebuild their lives. I've been running this service now for 25 years....some people do really really well, some people sadly don't."

With two elements to its service, GAAS offers therapies including acupuncture alongside its advocacy work, to help people rebuild their lives. The other side of the service is an open ended referral process, which anyone can access if alcohol is negatively impacting on their lives, without seeking rehab. It's not done through a doctor, as people can self refer, but most people are seen within 48 hours of first making contact.

Mr Newman said in his 25 years in Guernsey, there has been an average of between 80 and 100 clients a year, with up to five residents living in at any one time usually.

With each individual being treated on a case by case basis, Mr Newman said they target programmes to suit them, and sometimes it can be a very long process. He doesn't think the island needs an on-island dedicated rehabilitation facility as the work they're currently doing helps those people who ask for help, which is the first step for any addict wanting to recover.

Pictured: Guernsey's court. Some people with alcohol and drug dependency issues end up before the island's courts.

Mr Newman said while the number of people seeking help from GAAS hasn't really changed over the years, there have been changes in clients average ages, and their needs and wants, but he believes in general people are seeking help earlier on nowadays. Alongside an increasing number of referrals for assistance from the courts and probation service Mr Newman said the service is accessible to anyone who needs it.

Anyone can call GAAS for help and Mr Newman said they will arrange a meeting as soon as possible to work out an individual treatment plan.

Pictured: Does Guernsey need a rehab facility?