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international medical graduates
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medical marijuana
Medicare Locals
men's health
mental health
MyHospitals website
National Commission of Audit 2014
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naturopathy
NDIS
NHMRC
non communicable diseases
nurses and nursing
oral health
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out of pocket costs
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paramedics
pathology
Pharmaceutical Benefits Scheme
pharmaceutical industry
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Turning up for practice and research in drug and alcohol care

If you’ve been following Croakey’s coverage of the 2020 Symposium Series for the Centre of Research Excellence: Indigenous Health + Alcohol (CRE), bookmark this Thursday October 1.

In the third webinar of the series, Gundungurra woman and CRE PhD candidate, Gemma Khodr-Purcell will present on cultural approaches to offering alcohol care, and Associate Professor Scott Wilson will discuss practice and research in partnership.

For the highlights, don’t miss Dr Tess Ryan’s live-tweeting of the event, 11am-12pm AEST. Follow @TessRyan1. You can also follow the hashtag #2020ResearchExcellence and this Twitter list.

Below to whet your appetite for what excellence in drug and alcohol care looks like, we profile Scott Wilson and his work with the Aboriginal Drug and Alcohol Council, SA (ADAC), ahead of the day.


Ruth Armstrong writes:

 In 1993, Scott Wilson was living in Adelaide. He and his partner Helen were heavily into university student politics, running on-campus activities and supporting a young family on Abstudy.

Then he got an offer he couldn’t refuse.

Recognising the younger man’s abilities in administration and leadership potential, the coordinator of a newly formed peak body, the Aboriginal Drug and Alcohol Council, SA (ADAC), invited him to apply for the position of the organisation’s administration officer.

The idea of paid work was appealing, but there was one problem. Employees of ADAC needed to sign a sobriety clause, and that wasn’t a state that came naturally to Wilson. But he got the job, signed on the dotted line, and from that day on stopped drinking.

Signing that contract also marked the beginning of a career that has lasted almost 27 years and taken him all around the world, as well as to scrubby recesses in the Adelaide parklands, remote communities, and families who needed help. The work has led him to reunions and gravesides; celebrations and desperate conversations.

Importantly he’s brought his valuable lived experience and perspective to his workplace and extended environment, such as research collaborations and the many tables of government he’s held a seat at. This has greatly informed his work in drug and alcohol research, policy and practice.

This Thursday October 1, Scott Wilson, now CEO of ADAC, will present at the third of a series of symposia for the Centre for Research Excellence (CRE) in Indigenous Health and Alcohol, where he is an Associate Professor and Co-Director.

***

Scott Wilson spent much of his childhood in Darwin and has strong bonds with the local mob, the Larrakia, but his family had been fractured by the stolen generations – his Arrernte grandmother separated from her children, who were taken to Darwin then moved to two different states after the World War II Japanese bombing of the city.

After seeing active military service in Korea and Vietnam, his father moved his young family back to Darwin. At the age of 36, Wilson’s mother died. Aged 13 at the time, he recalls that this was around the time he started drinking, a behaviour that was largely unchallenged in NT in the 1970s.

He left school young and worked at a variety of jobs such as labouring and cattle handling. But come knock-off time a pattern of heavy drinking, recreational drug use, dangerous driving and other risky behaviour set in. As a teen he spent nights in the adult lock-up and had his 18th birthday in a cell at Fannie Bay Prison. A couple of short stints in custody followed.

It was a lawyer assigned to help him defend one of his charges who first suggested he do something about his “problem”.

Soon after, he sought care from the emergency department at Royal Darwin Hospital after a series of minor head injuries left him with a persistent headache. Overhearing the nurses dismissing him as a drunk, he stopped in at the hospital’s detox unit on his way home. A few days later he checked in.

Seeing the consequences of alcohol dependence on the older clients and meeting his now partner Helen in the weeks that followed, provided an incentive to give up the substances, but even when the couple started a family and moved to Adelaide, he hadn’t managed to make that a reality. Signing off on the ADAC clause finally gave him permission.

It gave me an out. I could then say to people, well no I don’t drink. Sometimes family and friends can be your biggest downfall. All of a sudden I was able to say no and as long as I kept saying no, eventually they stopped asking.”

Turning up for harm minimisation

A couple of years after his 1993 appointment, Wilson became ADAC’s Director and began to steer the organisation towards a harm minimisation approach.

ADAC had been set up in the wake of the Royal Commission into Aboriginal Deaths in custody. Community members from across South Australia met following the commission’s report, to discuss how they should respond to the finding that people who died were often in custody for drug and alcohol-related reasons. Unique in Australia as a community-controlled peak body for drugs and alcohol, ADAC now employs 69 people across the state.

Of ADAC’s reorientation, Wilson says,

If we’re just looking after people based on abstinence we’re missing out on all of these other people who are trying, or who might just want to come down. And so our focus went from sobriety to harm minimisation.”

As well as residential and day programme rehabilitation, much of ADAC’s work involves turning up to provide care, food and company. With this comes the opportunity of tapping people into drug and alcohol specific services.

At their Stepping Stones day centres in Port Augusta and Ceduna, people receive meals, as well as help with their social and medical needs: in Ceduna, an award-winning collaboration with the local paramedics has seen gains in medication management for those with chronic illnesses, as well as vastly improved relationships between the emergency services and the local community.

For a decade ADAC held barbeques every Friday in the Adelaide Parklands.

Wilsons says,

We weren’t there to talk to people about drug and alcohol. We were there to feed them. There was one guy who used to be one of the park people and he was a heroin addict. He now works as a senior drug and alcohol worker. He would’ve overdosed and died in the parklands, but because he saw us coming every week, he eventually approached us one day about his problem. We were then able to get him into detox; into rehab and the rest is history. Even though the focus wasn’t drug and alcohol, the fact that we were there and we were visible gave him that opportunity.”

Wilson attributes the success of ADAC’s longest running programme, Makin’ Tracks, a mobile education and treatment program that visits remote communities, to the same sort of consistent yet flexible approach.

Established and funded since 1999 to help communities address petrol sniffing, the substances have changed over the years, but the team’s commitment to community has not.

Those fellas have been going back to those same communities year after year after year, says Wilson. You build up these long term relationships which make it a lot easier.”

ADAC Drugs and alcohol youth camp

Pioneers or settlers?

According to Wilson, there are “settler” organisations that keep their heads down, content to continue doing what they’ve always done.

Wilson explains that the ADAC, is a “pioneer” organisation – always on the lookout for developing situations, which is essential in the ever evolving arena of alcohol and drugs.

The organisation was quick to recognise that alcohol was harming the unborn foetuses of Aboriginal women. From as early as 1996, Wilson was able to push for more research and action on this issue, via his membership of the Australian National Council on Drugs (ANCD) and the National Indigenous Drug and Alcohol Committee (NIDAC).

ADAC staff also recognised that methamphetamine use and impacts were becoming increasingly prevalent in Adelaide, well before the government’s Ice Taskforce put it on the national agenda, developing resources such as the Don’t Mess With Meth comic and website from 2007.

Women receiving ADAC Drugs and Alcohol training certificates

The power of partnering for research

Wilson realised that in order to keep funding and sustaining ADAC’s activities, they needed to be able to prove that the projects were successful, and that any research or evaluation would have more credibility if it was done in partnership with respected academics.

For the Makin’ Tracks Programme they were able to partner with The National Drug Research Institute (NDRI) at Curtin University for ongoing evaluation.

Opportunities to collaborate presented themselves through Wilson’s appointment to the board of the ANCD, which had the ear of government and was stacked with highly qualified clinicians and researchers.

I got to know some of these experts, I started realising, from an Aboriginal perspective, we needed to get into that arena as well as doing our day to day work.”

In 2009, new Australian drinking guidelines were released. The then Prime Minister, John Howard, announced that ADAC had been tasked with adapting the guidelines to make them more acceptable and appropriate for an Indigenous audience. After national consultation, they produced a version for use on smartphone.

After that, I could see how you could then leverage other funding and opportunities from having good research but also evaluations, which is obviously what funders want.”

Skilling up to give back

The smartphone project led to another important collaboration with researchers from the University of Sydney and, ultimately Wilson’s co-directorship of the Centre of Research Excellence in Indigenous Health and Alcohol (the CRE).

In 2012 he presented on the smartphone guidelines at the NIDAC conference in Fremantle and afterwards got yarning to USyd’s Professor Kate Conigrave and Dr Kylie Lee about the possibility of applying for funding to develop an app to make it easier for Indigenous Australians to accurately report on their drinking habits.

It’s a tool that was much needed.

Things like patterns of drinking are fundamentally misunderstood, which Wilson says directly impacts on the appropriateness of services for Aboriginal people.

Most Aboriginal folk particularly in rural and remote communities don’t just go down to the pub on their own and have one beer and go home. It’s more like – look I’ve got five dollars, Joe’s got five dollars. That’s a cask of wine. And we tend to be group drinkers. The grog app shows that in the main people do drink like that – in the areas we’ve looked at anyway.”

The University of Sydney’s postgraduate courses in Indigenous Health (Substance Use) have provided the opportunity for a number of ADAC staff to upskill. When Scott graduated with his Masters, he was the first person in his family to to do so. Having his daughter graduate the same day was an added bonus.

Wilson teamed up with Kate Conigrave, Kylie Lee and others, and obtained funding to develop and test the grog app. After further collaboration, in 2017 they launched the CRE, with a mission to “build, grow and support an emerging generation of Indigenous researchers to develop solutions to alcohol-related harm in Indigenous people.”

One thing I’m interested in is making sure the research and the work continue as many of us get towards retirement age. With the CRE we’ve now got a cohort of Aboriginal folk who are coming through with those higher degrees. Hopefully down they track they’ll remember who gave them that and be able to say, well OK I can help that Aboriginal drug and alcohol service down the road do research on what’s working and what isn’t and to help them do evaluation.”

As for ADAC, despite a vicious funding cut to the peak body in 2018, which sees them having to charge administration fees for the programmes they run, the organisation is going about its work.

It’s work that has its own rewards.

Seeing people succeed and even if they’re not successful being able to say, ‘we’re here. You can come back’.

I’d love to see an ADAC all around the country because I think unless you’ve got a group that has that role of helping and coordinating, then you just have piecemeal attempts. Everyone’s just struggling in isolation.”


Photographs courtesy Scott Wilson, ADAC

Associate Professor Scott Wilson will present on the topic, Practice and Research in Partnership as part of the the 2020 Symposium Series for the Centre of Research Excellence: Indigenous Health + Alcohol.

Also presenting at the webinar, on the topic of cultural approaches to offering alcohol care, is Gundungurra woman and CRE PhD candidate, Gemma Khodr-Purcell.

The Croakey Conference News Service is producing a series profiling some of the speakers at the 2020 Symposium Series, and Dr Tess Ryan will also live-tweet each webinar. Follow @TessRyan1.

Previous articles relating to the series can be found here and here, and you can view recordings of all the webinars here.

The final webinar in the series, How mainstream approaches work for Aboriginal people, will take place on November 19, 2020.

On Twitter you can follow the hashtag #2020ResearchExcellence and this Twitter list.


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