services offered by sedqa

Services offered by sedqa – Jesmond Schembri (Operations Director)

SERVICES OFFERED BY SERVICES OFFERED BY sedqasedqa


Situation preceding Situation preceding sedqasedqa

• Historically, in Malta the services related to drugs and alcohol started and evolved separately.

• The Alcohol Services started as an offshoot of the Mental Health Services at Mount Carmel Hospital in the early 1980s.– A unit called “the Rehabilitation Unit” (RU) used to house

resident male clients and female clients used to spend the day at this unit and sleep at a psychiatric ward. Therapy used to focus mainly on group work.

• Until the mid-80s, officially Malta did not have a drug problem; therefore no state services were made available.– Caritas (Malta) was the pioneer of drug services in Malta, with

the opening of the San Blas Therapeutic Community and also with a prevention team.

– The first drug-related state service was the Detox Centre. It was inaugurated in April 1987.


sedqasedqa

• Aġenzija sedqa, the national agency against drug and alcohol abuse and copulsive gambling was officially founded on 26th June 1994 following the Meli Report which was commissioned by the Ministry responsible for social policy. One of the aims of this report was to devise a unified and comprehensive service related to addictive behaviour (at that time mainly drugs and alcohol).

• Today, sedqa makes part of the Foundation for Social Welfare Services together with APPOĠĠ and Sapport.


Primary Prevention Primary Prevention (1)(1)

• Primary Schools– “Tfal Favur Ambjent Liberu” Programme including:– BABES (Year 3)– BABES Follow-up (Year 5)– “Qed Nikber” (Year 6)– Parental Skills: Inrabbu ‘l Uliedna Aħjar (2 different courses:

0-10, 11-16 years)– Skola Sajf

• Secondary Schools– Crossroads: Forms 1-3– “Jien u l-Oħrajn”: Forms 3 (2-day seminars)– “Għini Nikber”: Forms 1-3 (Skills-based seminars)– Prefect/Leadership Course (1-day seminars for prefects)– Information & Awareness Seminars– School Development & In-service Training


Primary Prevention Primary Prevention (2)(2)

• WorkplaceSubstance Abuse-Free Employees:– Phase 1: Exhibition– Phase 2: Awareness to Managers to recognise signs and

symptoms of abuse– Phase 3: Employee Awareness– Phase 4: Introducing a Policy on the Use of Alcohol and other

Drugs at the Workplace.

• Community– Niltaqgħu fil-Pjazza (Community Contacts)– Taħriġ Azzjoni Volontarja– Post-Secondary (MCAST) & Students’ Councils– Basic Course– Joint Project with Parl. Sec. MEYE


Continuum of Services Continuum of Services Offered by Offered by sedqa’ssedqa’s Care Care ServicesServices


A Trans-Theoretical ModelA Trans-Theoretical Model

•Prochaska and Di Clemente (1982) proposed a model that predicts that drug misusers will pass through five stages of change:

1. Precontemplation: Client is resistant to change.

2. Contemplation: Client rehearses the pros and cons of change.

3. Preparation: Client makes some small behavioural change.

4. Action: Client engages in deliberate strategies to achieve a target consumption level.

5. Maintenance: Client is vigilant against relapse.


Drugs ServicesDrugs Services

• Drugs Community Team: This team assesses the needs of persons who are referred for services at the agency due to drug-related problems and refer accordingly. They also offer support to persons who stay in the community during their drug rehabilitation period and also the families of these persons.

• Detoxification Units: Offer both in-patient (Dar l-Impenn - SMIPU) and out-patient (Substance Misuse Out-Patients Unit) services to persons experiencing both drug and alcohol related problems.

• Drugs Residential Rehabilitation Programme: Currently based at Kommunita’ Santa Marija. It includes the orientation (Merħba), formation (Formazzjoni) and re-entry (Sfida)phases.


Drugs Community Drugs Community ServicesServices

• Offer individualised support to drug users and their significant others with the aim of motivating individuals to commit themselves to major lifestyle changes and assisting them in achieving and maintaining abstinence from drugs.

• Services offered by this Team include:– Assessment;– harm reduction;– crisis intervention;– support to families and significant others;– assistance at the Law Courts;– advocacy;– aftercare and social re-integration; and – preparation of those individuals who choose to do a

residential rehabilitation programme.


Percentage of individual new clients attending DCT

in 2008 and 2009 by age

0%

5%

10%

15%

20%

25%

30%

35%

40%

<19

20-2

4

25-2

9

30-3

4

35-3

9

40-4

4

45-4

950

+

Not sp

ecifie

d

% o

f cl

ients

2008 2009


Percentage of individual new clients

attending DCT by primary drug reported

0% 20% 40% 60% 80%

Heroin

Cocaine

Cannabis

None Used

Ecstasy

Alcohol

Distalgesics

LSD

Other Opoid

Barbiturates

% of clients2007 2008 2009

Percentage of individual known clients

attending DCT by primary drug reported

0% 20% 40% 60% 80% 100%

Heroin

Cocaine

Cannabis

None Used

Ecstasy

Alcohol

Distalgesics

LSD

Other Opoid

Barbiturates

% of clients2007 2008 2009


Substance Misuse Substance Misuse Out-Patients Unit Out-Patients Unit

(Detox)(Detox)• Officially opened in April 1987, SMOPU was the first

of the drug-related services provided by the national health services.

• This unit is manned by professional staff, mainly medical doctors and nurses. However, psychiatric and psychosocial support is also provided.

• Most of the clients attending this unit, go daily to collect methadone and other medicines (mostly of a psychotropic nature) as prescribed by their specialist doctor or psychiatrist.


Number of clients attending Substance Misuse

Out-Patients Unit between 2001 and 2009

1112

1085108610941074

1053

958

935 929

800

850

900

950

1000

1050

1100

1150

2001 2002 2003 2004 2005 2006 2007 2008 2009

Year

No. of cl

ients


Percentage of individual clients attending

SMOPU in 2007 and 2009 by gender

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

Male Female

% o

f cl

ients

2007 2008 2009


Dar l-Impenn (SMIPU)Dar l-Impenn (SMIPU)• This residential unit offers mainly

medical interventions in a safe and controlled environment primarily (but not only) to persons experiencing problems related to opiates and alcohol. These interventions include:– Detoxification (Alcohol & Drugs);

– “Time-out”;

– Methadone Reduction/Stabilisation;


Total number of individual clients who attended

SMIPU btween 2006 and 2009

0

50

100

150

200

250

300

350

2006 2007 2008 2009

Year

No. of

clie

nts


Kommunita’ Santa MarijaKommunita’ Santa Marija

• This drug rehabilitation programme offers a communal living environment with the aim of offering participants the opportunity of adopting a drug-free lifestyle.

• The services available include:

– Community living;

– Occupational activities;

– Behaviour modification;

– Group work;

– Adult education;

– Individual counselling and psychotherapy (serviced by Community-based units);

– Family therapy.


Percentage of individual clients attending KSM

in 2007 and 2009 by gender

0%10%20%30%40%50%60%70%80%90%

100%

Male Female%

of cli

ents

2007 2008 2009

Percentage of individual clients attending KSM in 2007

and 2009 by age

0%

5%

10%

15%

20%

25%

30%

35%

40%

% of c

lients

2007 2008 2009


Alcohol and Alcohol and Gambling ServicesGambling Services

• Alcohol and Gambling Community Team: This team assesses the needs of persons who are referred for services at the agency due to alcohol and/or gambling-related problems and refer accordingly. They also offer support to persons who stay in the community during their alcohol rehabilitation period and also the families of these persons.

• Alcohol Residential and Day

Programmes: These programmes are presently based at Dar Zerniq. Persons benefiting from these services are referred by and to the Alcohol Community Team.


Percentage of all clients attending AGCT in 2009 by age

0%

5%

10%

15%

20%

25%

30%

35%

40%

14-1

9

20-2

4

25-2

9

30-3

4

35-3

9

40-4

4

45-4

950

+

Unspe

cifie

d

Age category

% o

f cl

ients


Percentage of individual clients attending

AGCT in 2009 by gender

0%

10%

20%

30%

40%

50%

60%

70%

80%

Male Female

% o

f clients


Average number of clients attending the Alcohol residential

program each month from 2007 to 2009 by age

0

1

2

3

4

5

6

7

30-34 35-39 40-44 45-49 50+

No.

of cl

ients

2006 2007 2008 2009


2003 2004 2005 2006 2007 2008 2009

Females

Male01234567

8

No.

of

clie

nts

Average number of clients attending the Alcohol residential

program each month from 2003 to 2009 by gender

Females Male


Total number of sessions held at the Gambling

Community Services by year

0

50

100

150

200

250

300

350

2003 2004 2005 2006 2007 2008

Year

No.

of se

ssio

ns


Other ServicesOther Services

• Supportline 179: A 24-hour helpline to provide help in case of crisis intervention and to assist persons needing general information about social issues including drugs, alcohol and compulsive gambling. This service is currently managed by APPOĠĠ on behalf of FSWS.

• Family Services: Receives referrals from other teams within sedqa to help families in need of family therapy interventions.

• Psychological Team: Receives referrals from other teams within sedqa to help individuals (both clients and their significant others) in need of psychotherapeutic or psychological assistance.


Important ContactsImportant Contacts

• Website: http://www.sedqa.gov.mt• Supportline 179• Out-Patient Detox Centre: 23885300• In-Patient Detox (Dar l-Impenn): 21220408• Teen Support Services and Community Teams

(Drugs, Alcohol & Gambling): 23885110• Kommunita’ Santa Marija: 21244528• Żerniq: 21247630/21241887• Primary Prevention: 23885110

http://www.sedqa.gov.mt/


THANK YOU

FOR YOUR ATTENTION!

… any questions or clarifications?

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