HEALTH PLANNING and Kor RESEARCH UNIT Christchurch

rR, HEALTH PLANNING

and E koR RESEARCH UNIT Christchurch

A BRIEF HISTORY OF ALCOHOLISM TREATMENT SERVICES IN NEW ZEALAND, 1965-1983

Tor Wainwright

September 1985 Planning and Research Series No. 19

------A BRIEF HISTORY OF ALCOHOLISM TREATMENT SERVICES IN NEW ZEALAND, 1965-1983

Tor Wainwright

Health Planning and Research Unit P.O. Box 1876 Christchurch Planning and Research Series No. 19

September 1985

The Health Planning and Research Unit has staff funded by both the Canterbury Hospital Board and the Department of Health. ACKNOWLEDGEMENTS

This review could not have been undertaken without the co-operation of the people involved in alcoholism co-ordinating committees and treatment agencies throughout New Zealand who responded to the request for information - their help was very much appreciated. Particular thanks to Helen Orchard, Tom Joll, Roy Johnston, Clint Miller, Patsi Davies, Gary

Harrison. I

The advice and support of Dr Elisabeth Wells of the Christ- church. Clinical School and of colleagues in the Health Planning and Research Unit is gratefully acknowledged, as is the work of Julie Fussell and Maureen Parkyn in typing the drafts. and final copy, and Lesley Symingtons work in getting the report printed. . The responsibility for any errors in the final report remains that of the author. CONTENTS

Page 1. INTRODUCTION AND METHODOLOGY 1

2. THE DEVELOPMENT OF THE DIFFERENT TYPES OF FACILITY 2

a) Introduction b) The psychiatric hospitals c) Other hospital board services d) The N.S.A.D. centres e) The Salvation Army Bridge Programme f) Other voluntary agencies

3. THE DEVELOPMENT OF SERVICES WITHIN EACH REGION, 1965 - 1983 6

- Auckland, Northland and Coromandel - Tauranga and Whakatane - Waikato - Gisborne and Hawkes Bay - Taranaki - Manawatu - Wairarapa - Wellington - Nelson and Blenheim - Canterbury - West Coast - Tirnaru and Oamaru - Otago - Central Otago - Southland

4. ADMISSIONS OVER TIME TO INPATIENT FACILITIES LINKED TO THE HEALTH DEPARTMENTS PSYCHIATRIC REGISTER 34

5. EVENTS SINCE 1983 38

REFERENCES 39

I LIST OF TABLES

Page TABLE 1 Summary of Alcoholism Treatment Services in New Zealand, 1953 - 1983 21

a) Psychiatric Hospitals

b) Other Hospital Board services

C) The NSAD Centres

d) The Salvation Army Bridge Programme Network

e) Other Voluntary Agencies (by Region)

TABLE 2 Admissions to Psychiatric Hospitals and 35 Psychiatric Units Within General Hospitals for Alcoholism and Alcoholic Psychosis, 1964 - 1982 (First Admissions and Readmissions Combined)

TABLE 3 First Admissions as a Percentage of all 37 Admissions for Alcoholism and Alcoholic Psychosis, Selected Hospitals, 1964 - 1982 1.

1. INTRODUCTION AND METHODOLOGY

Treatment facilities for alcoholism have sprung up rapidly in New Zealand over the past ten to fifteen years. This paper, which is part of a larger study, attempts to sketch the outline of this growth; a full account of the personalities and events of this period is still to be written. The aim of the larger study is to investigate the trends over time in the utilization of alcoholism treatment services in New Zealand, using data obtained from the New Zealand Health Departments psychiatric register (see Wells and Wainwright, 1985). This register, which was set up in 1967, can provide information on the admission histories of cohorts of individuals through time. Since changes in hospital admission figures are very much dependent on changes in the services available at each hospital, information was sought on the opening and closing dates of alcoholism treatment services around New Zealand, to aid in the interpre- tation of the data used in the main study. This historical data forms the basis of the present paper.

The ALAC Directories of Treatment Services and national newspaper clippings from 1978 to 1983 (using the Health Departments clipping service) were used to compile an initial list of facilities. In late 1983 letters were sent to individual treatment agencies and co-ordinating bodies asking for information on their local area. Admission figures for inpatient services administered by the hospital boards and several other organisations was obtained from the Health Departments yearly Mental Health Data series, and information on hospital board outpatient admissions for 1983 was obtained from a compilation of figures made by Helen Orchard, research officer of ALAC. Admission figures for agencies not linked either to the Health Departments psychiatric register or to ALACs data collection system for outpatient centres were not sought.

Part 2 briefly outlines the development of the different types of facility: psychiatric hospital units, other hospital board services, the NSAD centres, the Salvation Army Bridge network, and other voluntary agencies. A brief description is given in Part 3 of the services that were set up within each region between 1965 and 1983. This information is summarised in Table 1. In Part 4 published inpatient data from the Mental Health series are summarised to show changes over time in admission patterns for individual hospitals and units. 2.

2. 1 THE DEVELOPMENT OF THE DIFFERENT TYPES OF FACILITY

a) Introduction

The evolution of New Zealands alcoholism treatmentfacilities mirrors the changes that have occurred over time in our societys attitudes towards the alcoholic. The view, common in the late nineteenth and early twentieth centuries, that the only hope for the drunkard lay in hard work and prayer, was embodied in the early Salvation Army institutions on Rotoroa and Pakatoa Islands, which the Army ran in conjunction with the Justice Department. Apart from the care given to psychotic or demented alcoholics by the psychiatric hospitals as part of their general psychiatric treatment, Salvation Army homes provided the only help available specifically for the alcoholic until after the second world war. In 1946 Alcoholics Anonymous came to New Zealand, bringing a new view of alcoholism as a disease which needed treatment, rather than a problem solely for the courts or churches. With other interested individuals, AA formed the National Society on Alcoholism (NSA, later NSAD), a national body that worked actively towards the general social acceptance of alcoholism asa major health problem. The gradual success of this campaign, boosted by the setting up in 1976 of the Alcoholic Liquor Advisory Council, had by the early 1980s resulted in the establishment of hospital board treatment facilities in most areas of the country, as well as the upgrading and expansion of Salvation Army services and an upsurge of activity by other voluntary organisations. The spread of new services is still continuing, albeit with somewhat less emphasis on the medical aspects of treatment and more interest in the contribution of other disciplines, such as behavioural psychology, family-orientated social work and community-based preventive work.

b) The Psychiatric Hospitals Since their inception in the late nineteenth century, all the major psychiatric hospitals have provided a basic service for people suffering from acute alcoholic psychosis or long-term alcohol-related dementia. However their willingness to accept people for detoxication or for the treatment of alcohol dependence has fluctuated over time, dependent largely on the personal interest of a few individual staff members. Growing public pressure in the 1950s from the National Society on Alcoholism and other bodies led the Minister of Health to request hospital boards to provide better services for alcoholism treatment. Little came of this, however, probably partly because psychiatric hospitals at that time (and until 1972) were administered not by local hospital boards but by the Health Department, and perhaps partly because the psychiatric setting was not always seen by those lobbying for better treatment for alcoholism as the most appropriate place for such treatment. In the vacuum created by a lack of inpatient treatment facilities and in response to growing public demand, Queen Mary Hospital at Hanmer Springs began to specialise in the treatment of alcoholism, taking referrals from around New Zealand. This hospital, established later than the main psychiatric hospitals, had previously admitted people on a voluntary basis only for psychoneurotic conditions. Many of the alcoholism referrals came from NSAD centres and general practitioners, and by 1972 the hospitals programme was aimed solely at people with alcohol problems. 3.

The passing of the Alcoholism and Drug Addiction Act in 1966 made formal provision for the voluntary or involuntary committal of people to a registered institution for the treatment of alcoholism. This Act, which came into force on January 1st 1969, acted as an incentive for the establishment of programmes in several psychiatric hospitals, notably Sunny .- side and Kingseat. The development of programmes in the other psychiatric hospitals registered under this Act appears to have been more variable over time and place.

Admission and discharge information on patients has been collected from all New Zealand psychiatric hospitals (both public and private) by the National Health Statistics Centre since 1953, and reported in a yearly series Mental Health Data. From 1967 this information was compiled in the form of a psychiatric register at NHSC (see Table la, p.21). c) Other Hospital Board Services

General hospital psychiatric units: during the 1960s and early 1970s many hospital boards opened psychiatric units within their major general hospitals. From 1967 onwards information from these units was included in the national psychiatric register and reported in the yearly Mental Health Data series. While these records show that all of these units admitted people with a diagnosis of alcoholism or alcoholic psychosis, few, if any of them, provided a separate treatment programme for alcoholism. As with the psychiatric hospitals, the treatment received by alcoholics in these units probably varied considerably over time and place.

General wards within general hospitals: the 1960s and 1970s saw some initiatives taken by staff within the general medical wards of several hospitals to provide an alcoholism treatment service. Interested medical and other staff at Auckland, Palmerston North, Nelson and Southland hospitals, for instance, offered detoxication, counselling and referral to their alcoholic patients. Records of the number of people receiving care in this way are not easily obtainable, however, being incorporated into the records of the general medical wards, and these services moreover tended to lapse after the individuals concerned left the hospital.

Outpatient assessment centres: the setting up of the Alcoholic Liquor Advisory Council in 1976 represented a definite government commit- ment to provide better treatment services for alcoholism. With encourage- ment from the Council, hospital boards around the country began to set up specialist outpatient centres offering assessment, counselling and referral both to people referred from general practitioners, probation and other agencies, and to people "off the street". Some of the bigger centres were sited in the community, away from the general hospital (e.g. Christchurch, Wellington, Dunedin, Palmerston North), while others were situated within a general hospital with access to beds for detoxication (e.g. Invercargill, Stratford). In some cases the setting up of the centre was achieved initially with the help of staff from NSAD and other voluntary organisations until the hospital board took on responsibility for funding (e.g. Stratford, Napier). In the case of some smaller hospital boards (e.g. Tauranga, Blenheim) the establishment of an

I 4.

alcoholism service had by 1983 gone only as far as the appointment of a co-ordinator who worked with existing hospital staff to provide a detoxication and assessment service. The development of services in these smaller boards in particular was still actively continuing in 1983. (See Table lb).

As these outpatient centres opened from 1977 onwards, ALAC encouraged them to adopt a standardised recordkeeping system to enable the collection of national data on outpatient admissions. An initial comppilation of these data was made by ALACs research officer for the 1981-82 years (see Valentine, 1983), and a more comprehensive report was produced for the 1983 year (see Orchard, 1984). In 1984 a report undertaken for ALAC on the feasibility of incorporating outpatient data with existing inpatient data in a register system concluded that the setting up of such a register would not be worthwhile, but that extending the out-patient data collection to include "voluntary" (i.e. non hospital board) agencies would be worthwhile. (See Wagemaker, 1984). d) NSAD Centres

Apart from the network of Alcoholics Anonymous and Alanon groups, the information centres of the National Society on Alcoholism and Drug Dependency were the first treatment service to be set up in many parts of New Zealand. The offices of this voluntary organisation, which opened in many cities and towns from the late 1950s onwards, provided information, education, assessment, counselling and referral to alcoholics and their families, and worked in closely with AA and Alanon. The Society, in the past through its local branches and more recently through its national centre, has played a major part in lobbying the Health Department and Hospital Boards to take responsibility for alcoholism as a major health problem and to set up adequate treatment facilities, and in urging Government to adopt an official policy on the treatment and prevention of alcoholism. As hospital boards began to provide outpatient services in the late 1970s and early 1980sNSAD closed some of its offices. As well as encouraging the development of hospital board and other facilities, the Society had also set up and managed its own residential facilities in some areas. These are: Matt Talbot House in Invercargill, Viard House and Aspell House in Wellington and a treatment centre in Featherston. (See Tables lc and le). e) The Salvation Army Bridge Programme Rotoroa Island, opened by the Salvation Army near Aucklandin 1909, was al- most the first alcoholism treatment facility to be set up in New Zealand. The Armys emergency night shelters in the main centres offered accommodation to men suffering from alcoholism as part of their service to the general population. In 1959 the Army set up residential treatment

The very first recorded treatment facility for alcoholism in New Zealand was set up by Dr Truby King at Orokonui Hospital near Dunedin in 1902. This remained open until 1904 (See Appendix to the House of Representatives, 1904, H-22A, "Home for Inebriates", by F. Truby King for an interesting description of this unit). 5. facilities for alcoholism in Wellington and Christchurch. The Bridge Programme, as this network was called, was gradually extended in both cities to cover a full range of services for men, including detoxicatjon, shortterm inpatient treatment and to a lesser extent outpatient treatment, halfway hostels and longer term sheltered accommodation and residential care for the more disabled. In 1972 a Bridge Programme unit was opened in Auckland, and in 1982 Rotoroa Island was incorporated into this Pro- gramme. From 1980-81 the Bridge in all three centres began to admit women as inpatients. During the 1976s each of the Bridge facilities were registered under the Alcoholism and Drug Addiction Act (Rotoroa Island from 1969); patient data from each facility were incorporated into the Health Depart- ments national psychiatric register from the time of their registration under this Act. (See Table ld). f) Other Voluntary Agencies

Most of the services provided in 1983 by voluntary agencies other than NSAD and the Salvation Army consisted of post-treatment hostels and halfway houses, longterm rehabilitation centres and private detoxication facilities. Shortterm or longer inpatient treatment programmes were provided by the Presbyterian Support Service Centres in Auckland, Totara Trust in Mastertori, Huntsbury House and Vincentian Recovery Centre in Christchurch, and (as part of its general psychiatric service) Ashburn Hall in Dunedin. The Alcohol Counselling Centre in Christchurch, funded by a grant from ALAC to a Canterbury University Psychology Department staff member, provided outpatient counselling as part of its function as a training programme for clinical psychology students. Of all the voluntary services, only Totara Trust, Huntsbury House and Ashburn Hall are linked to the Health Depart- ments national data collection system, the former two agencies because they are registered under the Alcoholism and Drug Addiction Act, and the latter because it is a private psychiatric hospital. (See Table 1e). 6.

THE DEVELOPMENT OF SERVICES WITHIN EACH REGION, 1965-1983

AUCKLAND, NORTHLAND AND COROMANDEL REGION

(Auckland, Northland and Thames Hospital Board areas)

The Situation in 1965 The first Alcoholics Anonymous group had been established in Devonport in 1951 and by 1965 there were 21 groups in the Auckland area. NSAD had started up in 1956 in Auckland and worked in co-operation with the Auckland Alcoholism Trust Board until February 1974, when NSAD abandoned its autonomous branches to change to central funding control. The Auckland Alcoholism Trust Board had been set up in Auckland in 1958 and with NSAD it ran a recovery centre, Mairangi House, from 1959 to the mid 1960s. Residential treatment or care for men only was available from the Salvation Army on Rotoroa Island which had been used for alcoholics since 1909. The adjacent Island, Pakatoa, had catered for women inebriates from 1908- 1946.

The Baptist City Mission provided counselling at their drop-in centre from 1960 and short and longterm accommodation at their hostel in 50 Ponsonby Road from 1963. Basic drying out services were available at Kingseat and Oakley Psychiatric Hospitals. Some discussion groups for alcoholics took place atOakley, and aversion treatment was used spasmodically for some years at Oakley and Kingseat. Longterm care for the severely brain damaged was provided at Kingseat and Oakley as part of their general psychiatric services. Dr Lindsay McDougal provided a very small outpatient alcoholism clinic at Auckland Hospital from 1956-1978, after the Minister of Health asked all Hospital Boards in 1956 to set up alcoholism treatment units. The Salvation Armys Epsom Lodge, a short-term emergency accommodation centre, provided basic shelter for many alcoholics. The St. James Presby- terian Centre ran hostels from 1958 through to mid 1960s in Beresford and Hopetoun Streets mainly for alcoholics.

Developments Since 1965

Auckland

Assessment/Referral/Counselling (Non-Residential) With the establishment of Auckland Hospital Board services in the early 1980s, NSAD moved to the South Auckland area where it has operated since. From 1976 to 1981, Carrington Hospital operated a referral service at North Shore and in January 1979 Carrington Hospital opened the Community Alcohol Services Centre in its grounds to provide assessment, referral, follow-up and education. In April 1982 Auckland Hospital opened a similar outpatient centre, Eden Clinic, in a leased Mater Hospital building with specific responsibilities to service Auckland and Greenlane Hospitals and their catchment areas. 6.

3. f THE DEVELOPMENT OF SERVICES WITHIN EACH REGION, 1965-1983

AUCKLAND, NORTHLAND AND COROMANDEL REGION

(Auckland, Northland and Thames Hospital Board areas)

The Situation in 1965 The first Alcoholics Anonymous group had been established in Devonport in 1951 and by 1965 there were 21 groups in the Auckland area. NSAD had started up in 1956. in Auckland and worked in co-operation with the Auckland Alcoholism Trust Board until February 1974, when NSAD abandoned its autonomous branches to change to central funding control. The Auckland Alcoholism Trust Board had been set up in Auckland in 1958 and with NSAD it ran a recovery centre, Mairangi House, from 1959 to the mid 1960s. Residential treatment or care for men only was available from the Salvation Army on Rotoroa Island which had been used for alcoholics since 1909. The adjacent Island, Pakatoa, had catered for women inebriates from 1908- 1946.

Developments Since 1965

Auckland

Hostels, Half-way Houses, Night Shelters

Two Baptist hostels provided short and longterm accommodation for men at Ponsonby Road and Balmoral from 1963 and the mid 1970s to 1980 respec- tively. The St. James Presbyterian Centre opened a halfway house in View Road, Mt. Eden in 1969 which operated mainly as a follow-up house for Kingseat Hospital. This was taken over by the Presbyterian Support Services Association in 1978, who also opened 2 three-quarter houses in Mt. Eden and a house for frail ambulant alcoholics in Papatoetoe, later moved to Epsom. The Salvation Army used Cornwall Lodge as a nine bed hostel from 1975 until 1980 when it was used as part of their treatment facilities. They opened Bridge House in Grafton as a post-treatment hostel in 1980. The Vincian Trust opened the Quo Vadis rehabilitation centre in West Auckland in 1981 with 14 beds for alcoholics, primarily longterm residents. Liston Hostel was opened in 1972 by a combined church trust board to provide short and longterm accommodation for homeless men, many of whom were alcoholics. Epsom Lodge continued to serve a similar role.

Long-Term Care for the Severely Brain Damaged

The Quo Vadis Rehabilitation Centre provided some longterm accon)modation beds from 1981. Kingseat and Oakley Hospitals continued to admit people for long stay psychogeriatric care during this period. A few local rest homes like Takrouna Lodge on Waiheke Island chose to specialise in Korsa- koffs or severely brain damaged alcoholics.

Northland

Apart from the services provided by Auckland agencies, the only specialist service for alcoholism in this area was AA, until March 1981 when the Northland Hospital Board set up an Alcohol Addiction Service at Northland Base Hospital. This unit provides an outpatient and referral service, with access to detoxication beds in the hospital as needed.

Thames

There have been no specialist treatment services in this area apart from AA. 9.

TAURANGA/WHAKATANE REGION

(Tauranga and Bay of Plenty Hospital Board areas)

The Situation in 1965

AA/Alanon provided the only specialist alcoholism service in this area in 1965.

Developments Since 1965

NSAD opened a centre at Kawerau in 1982 and at Tauranga in 1981 to provide outpatient help and referral. In 1972 a psychiatric unit was set up in Ward 17, Tauranga Hospital, and in 1976 a similar unit started at Whakatane Hospital. These units provided outpatient help and detoxication in an emergency as part of their general psychiatric services, but did not have a specialist alcoholism programme. Both before and after the opening of the psychiatric wards, beds had been available in the medical wards for detoxication. In 1982 the Tauranga Hospital Board appointed a Co-ordinator of Alcoholism Services, based at Tauranga Hospital, to provide outpatient assessment and referral with access to detoxication beds within the hospital.

WAIKATO REGION

(Waikato and Taumarunui Hospital Board areas)

The Situation in 1965

AA/Alanon provided the only main specilist treatment services for alcoholism in the Waikato area until an NSAD centre opened in Hamilton in 1956. Referrals for inpatient treatment were made to Queen Mary Hospital at Hanmer and Rotoroa Island near Auckland. The main psychiatric hospital for the region, Tokanui Hospital, admitted people for detoxication and provided longterm care for the severely brain damaged but did not offer any specialist alcoholism treatment.

Developments Since 1965

Hamilton

St. Vincent de Paul Society provided a night shelter for men in about 1965. Anchorage Christian Rehabilitation Centre opened in 1973 to provide support- ive hostel accommodation for people with a range of problems, including alcoholism. 10.

In 1974 Tokanui Hospital started an alcoholism programme in Ward 3, which remained in operation until early 1982. In 1978 Waikato Hospital opened a psychiatric unit which treated alcoholics mainly as outpatients as part of its general psychiatric service. In 1975-76 NSAD opened a halfway house in Hamilton. In 1982 the Waikato Hospital Board appointed a co-ordinator of alcoholism services and an aftercare organiser/counsellor.

Rotorua

An NSAD office opened in 1980.

The Riverholm Community Alcohol Service Centre, attached to Rotorua Hospital) was opened by the Waikato Hospital Board in late 1980 to provide outpatient assessment and referral.

Tokoroa

An NSAD office opened in 1980. From about 1984 Tokoroa Hospital provided detoxication.

GISBORNE, HAWKES BAY REGION

(Hawkes Bay, Cook and Waiapu Hospital Board areas)

The Situation in 1965

In 1965 there were no specialist services for alcoholism in the region, apart from AA/Alanon, an NSAD office at Hastings (established 1957) and a NSAD field officer in Gisborne (from 1960).

Developments Since 1965

Napier

In 1975 a local group, with the help of NSAD, set up the Hawkes Bay Addiction Centre Trust in Napier to provide outpatient help and referral. In 1977 the Hawkes Bay Addiction Centre Trust opened a 12 bed inpatient unit in Annex 2 nurses home, leased from Napier Hospital. This unit also provided daypatient and outpatient services. In 1980 the Hawkes Bay Addiction Centre Trust transferred its inpatient service to the Springhill Centre in Napier to provide outpatient services and 15 residential beds. In 1982 the clinical services of the Spring- hill Centre were taken on by the Hawkes Bay Hospital Board, while the hostel section was retained and managed by the Trust. 11.

In early 1980 the Hawkes Bay Hospital Board set up an Extra-mural Additions Team to provide assessment and counselling within Napier Hospital in conjunction with the Springhill Centre. In 1.980 the Hawkes Bay Rehabilitation Trust, a local voluntary organisation, set up a 10 bed centre in Napier providing longterm treatment for men and women.

Hastings

Emergency detoxication and outpatient services were available from the psychiatric unit which opened in Hastings Hospital in 1967, but this did not provide a specialist alcoholism programme. In 1979 Akron House was opened in Hastings by a local group to provide a five-bed halfway house for men and women. This remained open until late 1982. A night shelter run by the combined churches of Hastings provided five beds mainly for longterm chronic alcoholics until its closure in April 1982.

Gisborrie and East Cape

In 1973 psychiatric beds were set up at Cook Hospital in Gisborne. This hospital admitted some alcoholic patients, including people under the Alcohol and.Drug Addiction Act, but did not operate any services specifically for alcoholism. In 1980 the Waiapu Hospital Board opened the Whai Ora Alcohol Centre at Te Puia Springs to provide six treatment beds.

TARANAKI REGION

(Taranaki Hospital Board area)

The Situation in 1965

AA/Alanon provided the only specialist help for alcoholism.

Developments Since 1965

In May 1979 the Taranaki Hospital Board in co-operation with NSAD opened an Alcoholism and Drug Dependence Unit within Stratford Hospital to provide outpatient services and six detoxication beds. From 1981 the NSAD Director became a Hospital Board appointment. From about 1979 the Stratford Hospital unit also provided an outpatient service at New Plymough and Hawera Base Hospitals. 12.

In September 1980 the Ngaere Suport Centre Inc., a local voluntary organisation with a strong base in the Baptist Church, opened Triumph House in Stratford to provide a 16 bed halfway house for men.

MANAWATU REGION

(Palmerston North and Wanganui Hospital Board areas)

The Situation in 1965

AA/Alanon provided the only specialist help for alcoholism in the area. Lake Alice Psychiatric Hospital provided some detoxication services and longterm care for the severely brain damaged, but no specific alcoholism programme.

Developments Since 1965

Wanganui

From 1968 to 1979 NSAD provided a representative in Wanganui. The Wanganui Hospital Board set up an Alcohol Assessment Unit at Wanganui Hospital in late 1979 to provide a detoxication and outpatient service within the hospital.

Palmerston North/Levin

NSAD operated an outpatient service in Palmerston North from 1967 to 1978 when it transferred its field officer to establish a service in Taranaki. In 1972 the Manawaroa psychiatric unit was opened in Palmerston North Hospital. This unit admitted alcoholic patients but did not operate any programme specifically for alcoholism. In 1976 a nine bed detoxication and assessment unit was set up in Ward 5 of Palmerston North Hospital. In 1976 a hospital board worker was appointed as replacement for the NSAD worker and in 1977 a Hospital Board social worker was appointed to provide outpatient services at an Alcohol and Drug Centre in Palmerston North, detached from the hospital. In Levin the Citizens Advice Bureau provided an information and referral service linked to the NSAD and Hospital Board services in Palmerston North. In 1981 a Hospital Board worker was appointed to Horowhenua Hospital at Levin.

I 13.

WAIRARAPA REGION

(Wairarapa and Dannevirke Hospital Board areas)

The Situation in 1965

Apart from AA/Alanon the only specialist help for alcoholism in this area was provided by a NSAD field officer, appointed in 1958,

Developments Since 1965

In 1979 the Totara Trust was set up by a local voluntary organisation to provide a 30 bed treatment centre for men and women, including detoxication beds and a post-treatment hostel. In May 1983 NSAD opened the Johnston Therapeutic Centre, a 25 bed treatment centre at Featherston.

WELLINGTON REGION

(Wellington Hospital Board area)

The Situation in 1965

Assessment/Counselling/Ref erral (Non-Residential):

The national centre for AA had been set up in Wellington in the late 1940s, and in 1956 NSAD opened its Wellington office which later became the National Office for the Society. The Salvation Army Bridge programme (established 1959) also provided some outpatient services but was primarily a residential treatment centre.

Detoxicat ion:

The Bridge provided social detoxication services in Wellington as part of its treatment programme from 1959 onwards. Porirua Psychiatric Hospital and Wellington Hospital provided detoxication services in emergency but no alcoholism programme.

Residential Programmes:

The Bridge provided a residential treatment programme for men based in Wellington and from 1964 also at the Arawhatu Centre near Upper Hutt. Porirua Hospital admitted people with alcoholism but did not provide a special alcoholism programme.

Hostels and Night.Shelters:

The Bridge provided a post-treatment hostel in Wellington for men on the Bridge programme from 1959 and also operated a general night shelter. The City Mission also managed a night shelter. 14.

Longterm Care for the Brain Damaged:

Longterm accommodation was available at Porirua Hospital as part of the general psychiatric service, and also at various local rest homes. The Salvation Army provided longterm sheltered care for men at their Miramar Home, opened in 1910.

Developments Since 1965

Assessment/Counselling/Referral. (Non-residential):

The Wellington Hospital Board set up a psychiatric unit at Wellington Hospital in 1967 which treated alcoholics as part of its general outpatient psychiatric services but had no programme specifically for alcoholism. In 1978 the Wellington Hospital Board opened the Adelaide Assessment Centre to provide specialist outpatient services.

Detoxication:

Viard House, a St. Vincent de Paul retreat house, accepted people for detoxication during the early 1970s. Sladen Private Hospital provided nine beds for detoxication from 1976 to December 1982. Wellington Hospitals psychiatric unit admitted people for emergency detoxication and treatment, but had no specific alcoholism programme. Kenepuru Hospital at Porirua made four beds available for detoxication in late 1982.

Residential Treatment:

Porirua Hospital was registered under the Alcohol and Drug. Addiction Act in 1969 and from then until July 1979 alcoholic patients were admitted to Villa 6. However the hospital did not operate a programme specifically for alcoholism. The Bridge received registration under the Alcohol and Drug Addiction Act in 1972 and expanded and upgraded its facilities at Arawhata. in 1975. In December 1979 Aspell House Treatment Centre was set up by NSAD to provide 14 treatment beds for men and women. This transferred to Plimmerton in 1981.

Hostels and Night Shelters:

The Bridge hostel for men on the Bridge Programme expanded its number of beds over the period. In 1977-88 the Wellington Hospital Board opened Linden House, providing eight post-treatment beds. In 1974 Joans House, run privately, was set up to provide accommodation for 14 men, and in 1981-82 Paddy and Joyces House also provided accommodation for nine men. 15.

In 1970 the existing combined churches night shelter was upgraded. NSAD operated Viard House from 1979 to 1982 and the Sir Charles Burns Recovery Centre from approximately 1982 to 1984, both as post-treatment hostels.

NELSON/BLENHEIM REGION

(Nelson and Marlborough Hospital Board areas)

The Situation in 1965

AA/Alanon provided the only specialist help for alcoholism until NSAD set up an office in Nelson in 1958 which operated until about 1964. Ngawhatu Psychiatric Hospital near Nelson admitted people for detoxication and for longterm care, but had no services specially for alcoholism, apart from some AA groups.

Developments Since 1965

Blenheim

Wairau Hospital admitted patients to a general ward for detoxication and treatment during 1974-75 on the initiative of an interested doctor. In 1979 the Marlborough Hospital Board appointed an Addictions Worker based at Wairau Hospital to provide outpatient services with access to detoxication beds in hospital as needed.

Nelson

In 1978 Nelson Hospital set up an alcoholism outpatient unit which operated till 1980. In 1982 the Hospital Board appointed a Co-ordinator of Alcoholism Services and paid a local general practitioner for 1/10 time for alcoholism referrals.

CANTERBURY REGION

(North Canterbury and Ashburton Hospital Board areas)

The Situation in 1965

Assessment/Counselling/Referral:

AA/Alanon provided the only specialist help for alcoholism in the area until NSAD set up a centre in Christchurch in 1956. 16.

Detoxication

An emergency service was available at Sunnyside psychiatric hospital and Christchurch Hospital. The Salvation Army Bridge provided social detoxication as part of its treatment programme from 1959.

Residential Treatment:

The Salvation Army Bridge programme for men had been set up in 1959. Queen Mary Hospital at Hanmer Springs was operated by the Health Department until 1972 and provided an inpatient psychiatric service for people from all over New Zealand that was coming more and more to specialise in alcoholism.

Hostels and Night Shelters

The Salvation Army provided a post-treatment hostel attached to the Bridge from 1959 and a short-term general night shelter. The Anglican City Mission provided a night shelter and some sheltered housing.

Longterm Care for the Severely Brain Damaged:

Sunnyside Hospital provided longterm care as part of its general psychiatric service. Various local rest homes and the Salvation Army provided longterm sheltered accommodation.

Developments Since 1965

Assessment/Counselling/Referral:

In 1978 the (North) Canterbury Hospital Board set up the Alcohol Assess- ment Centre to provide outpatient services. In 1979 the Alcohol Counselling Centre was set up by a member of the Psychology Department of the University of Canterbury with a grant from ALAC to provide an outpatient counselling service combined with a training course for psychology graduate students. A specific focus of the service was to offer help to young problem drinkers. In 1981 the NSAD centre closed.

Detoxication:

In 1967 Princess Margaret Hospital opened a psychiatric unit which admitted people for detoxication and outpatient treatment, but had no programme specifically for alcoholism. In March 1980 the ten bed Kennedy Detoxication Unit was opened at Sunny- side Hospital.

Residential Treatment:

In 1969 Sunnyside Hospital received registration under the Alcohol and Drug Addiction Act and in 1971 Mahu Clinic was opened as a 33 bed specialist alcoholism unit at the hospital. 17.

Around 1972 Queen Mary Hospital began to specialise solely in alcoholism treatment, and in 1976 the 12 week programme was changed to eightweeks. In 1981 the Bridge programme expanded into new buildings and began to admit women to the programme. In 1979 the Vincentian Recovery Centre was set up by a local voluntary organisation to provide eight beds for men. In September 1982 Huritsbury Home was opened by the Nova Trust to provide 30 beds for people who had previously been in treatment and who were committed voluntarily under the Alcohol and Drug Addiction Act.

Hostels and Night Shelters:

In the mid 1970s Mahu Clinic opened several halfway houses for people leaving the programme. In about 1973 Elm Lodge was opened by a local voluntary organisation to provide nine beds for people leaving local treatment programmes, particularly Queen Mary Hospital. The Vincentian Centre from 1980 included a halfway house for men, which expanded to several houses and flats by 1982. The City Missions night shelter was upgraded in 1970, and by 1979 included a sobering-up area.

Longterm Care for the Brain Damaged:

From 1977 Ward A at Sunnyside Hospital provided 20 or so beds for people suffering from Korsakov psychosis for whom rehabilitation was thought possible. In 1980 this was relocated in Kennedy villa.

WEST COAST REGION

(West Coast Hospital Board area)

The Situation in 1965

AA provided the only specialist help for alcoholism until NSAD opened an office in Greyrnouth in 1965. Seaview Psychiatric Hospital admitted people for detoxication and also provided longterm care for the brain damaged, but had no programme specifically for alcoholics.

Developments. Since 1965

The NSAD office was closed in 1970, and since then help and referral came primarily from AA/Alanon and interested individuals, particularly within the Probation Office and the Hospital Board social work department. 18.

TIMARU/OAMARU REGION

(South Canterbury and Waitaki Hospital Boards areas)

The Situation in 1965

AA/Alanon provided the only specialist help for alcoholism. Timaru Hospital provided detoxication in emergencies.

Developments Since 1965

Timaru

Timaru Hospital opened a psychiatric unit in 1967 which admitted patients but had no programmes specif±caily for alcoholism. From 1967 to 1981 Ward 6 of the Hospital was used to provide beds for alcoholism treatment. In 1981 the South Canterbury Hospital Board opened the Alcohol and Drug Referral Centre in Timaru to provide outpatient services with access to beds in Timaru Hospital as needed. In June 1982 Claremont Recovery Centre was set up near Timaru by a local voluntary organisation to provide 20 longterm rehabilitation beds for men and women.

Oamaru

In the 1970s the Waitaki Hospital Board opened the Family Health Counselling Centre in Oamaru to provide general counselling services. This provided the main outpatient alcoholism service in the area, with access to detoxicatiori beds in Oamaru Hospital.

OTAGO REGION

(Otago and South Otago Hospital Boards areas)

The Situation in 1965

AA/Alanon provided the only specialist help for alcoholism until NSAD set up its first New Zealand office in Dunedin in 1956. Cherry Farm Psychiatric Hospital admitted people for detoxication and provided longterm care for the brain damaged but had no programme specifically for alcoholism. Ashburn Hall private psychiatric hospital also admitted a few people for inpatient treatment as part of its psychiatric service.

Developments Since 1965

Dunedin

In 1967 a psychiatric unit was opened in Ward 10 of Wakari Hospital. This unit admitted alcoholic patients for detoxicatiori and outpatient treatment as part of its general psychiatric services but did not provide a specialist alcoholism programme. 19.

In 1968 an inpatient treatment programme was started in Villa 1 o Cherry Farm Hospital, and in 1969 the hospital received registration under the Alcohol and Drug Addiction Act. The length and nature of the programme has varied since its inception. In 1979 the Otago Hospital Board opened the Centre for Alcohol- related Disabilities to provide an outpatient assessment, counselling and referral service in the city. NSAD staff were seconded to the Hospital Board service. The St. Vincent de Paul Society opened Boswell House in 1979 to provide seven short-term hostel beds for men.

Balciutha

In 1981 the South Otago Hospital Board appointed a social worker with responsibility for alcohol-related problems, based at Balclutha Hospital.

CENTRAL OTAGO REGION

(Vincent and Maniototo Hospital Boards areas)

The Situation in 1965

AA/Alanon provided the only specialist help for alcoholism in the area until NSAD provided representatives in Gore, Tapariui and Alexandra in 1957.

Developments Since 1965

There have been no additions to local alcoholism services since 1965, apart from greater contact with the services in Dunedin and Invercargill, particularly the NSAD centres, and then from about 1979 onwards with the Hospital Board assessment centres in these cities.

SOUTHLAND REGION

(Southland Hospital Board area)

The Situation in 1965

AA/Alanon provided the main alcoholism service in the Southland area until 1966 when NSAD opened an office in Invercargill. t4øp

Developments Since 1965

In 1967 a psychiatric unit opened at Southland Hospital in Invercar- gill,-which admitted alcoholic patients for detoxication and outpatient treatment as part of its general service but did not operate a programme specifically for alcoholism. In 1977 NSAD established and moved into Matt Talbot House in Invercargill, a centre that provided 15 treatment beds for men and women, with special emphasis on young people. This centre remained open until March 1980 when NSAD staff were seconded to work in the SUBs Alcohol Assessment Unit. NSAD involvement in the Unit ended in mid 1981 when these appointments were taken on by the Hospital Board. From 1977, six beds were provided for detoxication within Southland Hospital, initially in Ward 3 and later in Ward 11. In 1979 an Alcohol Assessment Centre was set up in Southland Hospital to provide an outpatient service with access to detoxication beds as needed. TABLE 1 - SUMMARY OF ALCOHOLISM TREATMENT SERVICES IN NEW ZEALAND, 1953 - 1993 a) Psychiatric Hospitals

Date of No. of Date Date Date of Joining ADA Act Admissions Hospital Service Service Type of Service (1982) NI{SC 1982() Started Ended Register isaon or 1983 Kingseat Hospital: - general wards by 1953 ) Detox. and acute/longterm psychoses, general psych. ) service only, sporadic treatment specifically for ) 32 alcoholism 1953 1969 - alcoholism unit 1967 1980 Inpatient alcohol programme )

Oakley Hospital: - general wards by 1953 > Detox. and acute/longterm psychoses, general psych. ) service only, sporadic treatment-for alcoholism ) ) 1953 1969 81 - Ward M2 1966 1974 Inpatient alcohol programme, mainly men (shifted to ) Carrington in 1974) ) - Carrington Hospital: Wolfe Home . __1974-_ Inpatient alcohol programme (44 beds, 8 weeks) 1974 1974 273 - Community Alcohol 1979_ > Outpatient assessment/treatment/referral (free- - - 859 Services Centre standing)

Tokanui Hospital: - general wards by 1953-______> Acute/longterm psychoses, general psych. service only 1953 1969 49 - Ward 3 1974 1982 Inpatient alcohol programme

Lake Alice Hospital: - general wards by 1953 > Acute/longterm psychoses,.general psych. service only 1953 16

Porirua Hospital: - general wards by 1953 > Detox. and acute/longterm psychoses, general psych. ) service only ) 60 ) 1953 1969 - Villa 6 1969 1979 Inpatient alcohol programme (content and resources ) fluctuated) - ) Date of No. of Date Date Date of Hospital Service Service Type of Service (1982) ADA Act Admissions Started Ended Register Registratk or 1983 Ngawhatu Hospital: - general wards by 1953 > Detox. and acute/longterm psychoses, general psych. 1953 - 25 service only

Seaview Hospital: - general wards by 1953 Detox. and acute/longterm psychoses, general psych. 1953 - 21+ service only

Queen Mary Hospital: - all wards by 1953 > Inpatient alcohol programme, 115 beds, 8 weeks (12 weeks 1961 - 741 UP to 1978). Specialised wholly in alcohol/drug treatment from 1972.

Sunnyside Hospital: 1\) r) - general wards by 1953 Detox. and acute psychoses up to 1980, and longterm ) psychoses, general psych. services only ) - Mahu Clinic 1971— > In/day/outpatient alcohol programme, 33 beds, 8-12 70s weeks; hostel accommodation from mid ) 1953 1969 609 - Kennedy Detox. 1980— > Detoxication (10 beds) )

- Korsakov Rehab Unit 1 977— Rehab. programme for Korsakov patients (20 beds, S (A Ward, then Kennedy) 12-2+ months) ) Cherry Farm Hospital: - general wards by 1953 Detox. and acute/longterm psychoses, general psych. ) service only ) 1953 1969 195 - Villa 1 1968 ) Inpatient alcohol programme (48 beds, content and resources fluctuated) )

Data for 1982 is marked by an asterisk. All other data is for 1983. "Admissions" = both first and readmissions. Formerly called Seacliff Hospital until 1972. TABLE 1

b) Other Hospital Board Services

Date of No. of Date Date Joining Date of Admissions Facility Service Service Type of Service (1982) NHSCADA Act 1082( Started Ended istxation -, Register or 1903

Whangarei Hospital: - psychiatric unit 1967_ General in/outpatient psychiatric service only 1967 - 7

Northland Base Hospital: - Community Alcohol 1981_ > Detox. and outpatient assessment/treatment/referral - 114 Programmes

Auckland Hospital: -- psychiatric unit 1967- > General in/outpatient service only 1967 - 6 - alcohol unit 1956 1978 Detox. and small outpatient service based in medical - - N.A. wards (Dr McDougall) 1) Ji - Ward 5D 1978- > Detox., 6 beds (previously available occasionally in - - N.A. Wd1O) - Eden Clinic 1982_ ) Outpatient assessment/treatment/referral. Based in - - 499 Mater Hospital, also serves Greenlane Hospital

Middlemore Hospital: - South Auckland 1982_ > Detox. and outpatient assessment/treatment/referral - - 398 Alcohol Services (linked to Kingseat Hospital)

Tauranga Hospital: - , psychiatric unit 1967_ > General in/outpatient psych. service only. Detox. beds 1967 - 27 (Ward 17) available in medical wards before the psych. unit opened - Alcoholism Services 1981_ > Outpatient assessment/referral - - N.A. Co-ordinator

Whakatane Hospital: - psychiatric unit 1976_ ) General in/outpatient psych. service only 1976 - 34 Date of No. of Date Date Date of Joining ADA Act Admissions Facility Service Service Type of Service (1982) NHSC Started Ended Register or 1983 Waikato Hospital: psychiatric unit 1978— > General in/outpatient psych. service only. Detox. beds 1978 - Nil available from 1980 - Co-ordinator, 1982— )- Outpatient assessment/referral - - Nil Community Alcohol Services

Rotorua Hospital: - Riverholm Community 1980_ Detox. and outpatient assessment/treatment/referral - - 161 Alcohol Service (free-standing)

Cook Hospital: (Gisborne)

> General in/outpatient psych. service only 1973 28 J\j - psychiatric beds 1973_ 1975 -4:- within medical wards

Hastings Hospital: - psychiatric unit 1967. > General in/outpatient psych. service only 1967 - 1

Napier Hospital: - psychiatric unit 1967 1974 General in/outpatient psych. service only 1967 - - - Extramural 1980_ > Outpatient assessment/referral - - N.A. Addictions Team - Springhill Centre 1982_ > Inpatient treatment, 15 beds (run by voluntary trust - - 212 1977-1982)

Whai Ora Alcohol 1980_ > Inpatient treatment, 6 beds, 8 weeks - - 16 Centre (Te Puia Springs)

Stratford Hospital:

- Alcohol and Drug 1979- > Detox. and outpatient assessment/treatment/referral. - - 212 Dependence Centre Also serves Taranaki and Hawera Hospitals Date of No. of Date Date Date of Joining Admissions Facility Service Service Type of Service (1982) NHSC ADA Act 1982() • Started Ended Register or 1983 Taranaki Hospital: - psychiatric unit 1978- > General in/outpatient psych. service only - - 12 Palmerston North Hospital: - Manawaroa Psych. 1972- )- General . in/outpatient psych. service only 1972 - 1 Unit - Ward 5 1976- > Detox. and assessment, 9 beds - - N.A. - Alcohol and Drug 1977- > Outpatient assessment/treatment/referral (free- - - 1,656 Centre standing)

Horowhenua Hospital: (Levin) - general wards 1981- > Detox. and outpatient assessment/referral - - N.A. Wanganui Hospital: - Alcohol and Drug - 1979-3o Detox. and outpatient assessment/referral - - 82 Assessment Unit - psychiatric unit 1982- > General in/outpatient psych. service only 1982 - 3 Wellington Hospital: - psychiatric unit 1967- -_ Detox. and general in/outpatient psych. service only 1967 - 10 - Adelaide Alcohol 1979_ > Outpatient assessment/treatment/referral. (free- - - 815 and Drug Centre standing)

Kenepuru Hospital: • (Porirua) - general wards 1982-.- > Detox., tf beds - - N.A. Linden House: about.- - Post-treatment hostel, 8 beds - - N.A. (Wellington) 1978 Date of No. of Date Date Date of Joining Admissions Type of Service (1982) ADA Act Facility Service Service NHSC 1982() Started egistmtior or EndedRegister 1983 Wairau Hospital: (Blenheim) - general ward 1975 1975 Detox. and assessment/referral - - N.A. - Addictions 1979_ __) Detox. and outpatient assessment/treatment/referral - - 142 worker

Nelson Hospital: - alcoholism unit 1978 1980 Detox. and outpatient assessment/treatment/referral - - N.A. - Alcoholism 1982_ ___ Detox. and outpatient assessment/treatment/referral - - 253 Co-ordinator

Princess Margaret

Hospital: f\J (Christchurch) 0 - psychiatric unit 1967— ___> General in/outpatient psych. service only 1967 2

Alcohol and Drug 1978 - ____) Outpatient assessment/treatment/referral (free- - - 988 Centre: standing) (Christchurch)ch) Timaru Hospital: 1967_ ____ General in/outpatient psych. service only; detox. beds 1967 - 14 - psychiatric unit in ward 6, 1967-81, and as needed after that

Alcohol and Drug 1981_ ___._> Outpatient assessment/treatment/referral (free- - - 16 Referral Centre: standing) (Timaru)

Family Health about General outpatient counselling service, provides main - - 38 Counselling Centre: 1970_ ____) alcoholism service in the region (free-standing) • (Oamaru)

Oamaru Hospital: late - general wards 1970s ____> Detox. beds as needed - - N.A. Date of No. of Date Date Date of Joining Admissions Type of Service (1982) ADA Act Facility Service Service NHSC 1982() Started Registration EndedRegistr or 1983 Centre for Alcohol- 1979-- > Outpatient assessment/treatment/referral (free-standing) - - 208 Related Disabilities: (Dunedin)

Wakari Hospital: (Dunedin) - psychiatric unit 1967 > General in/outpatient psych. service only 1967 1 (Ward 10)

Baiclutha Hospital: - general wards 1981— ) Detox. and assessment/referral - - N.A.

Southland Hospital: 1) - - psychiatric unit 1967— ) General in/outpatient psych. service only 1967 10 - Alcohol Assessment 1979— )- Detox. and outpatient assessment/treatment/referral - - 305 Unit •- •- - - - - Ward 3, then 1977_ ). Detox., 6 beds - - N.A. Ward 11

= both first and readmissions.

Data for 1982 is marked by an asterisk (); all other data is for 1983.

N.A. = not available. TABLE ic - THE NSAD CENTRES

Date Date Date Date NSAD Offices NSAD Offices Opened Closed Opened Closed

Auckland 1956 - Nelson 1958 1964 Tauranga 1981 - Christchurch 1956 1981 Kawerau 1982 Greymouth 1965 1970 Hamilton 1956 - Dunedin 1956 1979 Rotorua 1980 Gore 1957 Tokoroa 1980 - Tapanui 1957 ? Gisborne 1960 7 Alexandra 1957 7 Hastings 1957 Invercargill 1966 1981 Stratford ro 1979 1981 cx Wanganui 1968 1979 Palmerston North (1967 1976 (1978 1979 Wellington 1956

Field officer only, no office In conjunction with Taranaki Hospital Board TABLE 1 d) The Salvation Army Bridge Programme Network

Date of No. of Date Date Date of Facility Joining ADA Act Admissions Service Service Type of Service (1982) Started Ended NHSC Pegistration 1982 Register Rotoroa Island 1909- 70 beds for short term (10 weeks) or long term (2weeks) 1969 1969 161 (Auckland) treatment, men only; integrated with Auckland Bridge 1982

Auckland Bridge 1972- 18 detox. and 21 treatment beds (2 weeks and 10 weeks), 1978 1978 322 short term accommodation from 1950s

Wellington Bridge 1959— 107 beds (detox. 1-2 weeks) treatment (8-20 weeks), 1972 1972 278 hostel, long term, geriatric

Christchurch Bridge 1959-->28 treatment beds (7-12 weeks), 7 hostel beds 1978 1978 15+

"Admissions" = both first and readmissions. Auckland, Christchurch, Wellington Bridge began to admit women as inpatients from 1980 or 1981.

In 1982 Rotoroa Island was incorporated into the Auckland Bridge. TABLE I

e) Other Voluntary Agencies (by Region)

Date of No. of Date Date Date of ALA Act Admissions Facility Service Service Type of Service (1982) Started Ended NHSC Regisiratim 9 Register Auckland Alcoholism and Dependency 1982----> Outpatient assessment/treatment N.A. Foundation 203 Detox (Anglican City Mission) 1981- -. Social detox., 8 beds N.A. Baptist City Mission: about - drop-in centre 1962- - Outpatient, drop-in support N.A. - hostels mid Longterm hostel (not just alcohol) N.A. 1 97Os 1980 1962 1980 30 beds, shortterm hostel, men only N.A. 0 James Liston Centre (combined 1972_ . 60 beds, short term accommodation, men N.A. churches trust) only (not just alcohol) Maranga House (Auckland Alcoholism 1959 mid Treatment centre N.A. Trust Board) 1960s Quo Vadis Hostel (Vincian Trust) 1981- - 6 beds post-treatment hostel (4-12 N.A. weeks), 10 longterm Korsakov beds Presbyterian Social Service Assn - St. James Presbyterian Centre 1958 mid hostels N.A. 1 960s 1969- -4 Post treatment hostel for Kingseat N.A. - PSSA 1978--7> 20 bed. inpatient . centre and several N.A. outpatient centres The Haven (Auckland Christian 1976 1982 12 bed hostel (8 weeks , not just N.A. Centre Trust) alcohol) Private Hospitals (e.g. Selwyn, 1960s Detoxication . . N.A. Mont le Grande, Uplands) - 1970s . .

Date of Date of No. of Date Date Joinngi Admissions Facility Service Servic Type of Service (1982) ADA Act NHSC I I 1982 Started Ended egisii tknj egist er Hamilton Anchorage Christian Rehabilitation 1973 -IO bed hostel, support (not just N.A. Centre alcohol) St Vincent de Paul 1965 Night shelter for men N. A.

Napier, Hastings, Gisborne Akron House (Hastings) 1979 1982 5 bed halfway house N. A. Hastings Night Shelter (combined ?1970s 1982 5 bed, became longterm N. A. churches trust) Hawkes Bay Rehabilitation Trust 1980 10 beds, longterm treatment N. A. - (Napier) Hawkes Bay Addiction Centre Trust (Napier): - Outpatient centre 1975 Outpatient assessment/treatment/referral N. A. - Springhill Centre 1977- 15 bed treatment unit and hostel. N. A. After 1962 treatment unit was taken on by llawkes Bay Hospital Board

Taranaki Triumph House (Ngaere Support 1980 16 bed halfway house N. A. Centre, Stratford)

Wairarapa Totara Trust (Masterton) 1979 30 bed detox. /treatment /hostel 1982 I 1982 73 (12 weeks) • Date of No. of Date Date Date of Joining ADA Act Admissions Facility Service Service Type of Service (1982) Started Ended:Registratim 9 Register Wellington Aspell House Treatment Centre 1979— -> 14 bed treatment unit N.A. (NSAD) Joans House 1974— - i+ bed halfway house, men only N.A. Paddy and Joyces House 1981 1982 9 bed halfway house, men only N.A. Sladen Private Hospital about 1982 9 bed detox. (1-2 weeks) N.A. 1976 Viard House (St Vincent de Paul; early 1979 detox. beds N.A. NSAD) 1970s

1979 1982 post-treatment support house (NSAD) N.A. 1)

Christchurch Alcohol Counselling Centre 1979 - outpatient assessment/treatment; N.A. (University of Canterbury) training of psychology students Elm Lodge about 9 bed halfway house, long and short term N.A. 1973 Huntsbury House (Nova Trust) 1982 - - 30 bed longterm (24-14 week) treatment 1982 1982 Night Shelter (Anglican City about - 33 bed: shortterm accommodation; 3 N.A. Mission) 1970s detox. beds by 1979 Vincentian Recovery Centre 1979— - 8 treatment (8-12 weeks), 10 rehab beds N.A. from 1980; men only

South Canterbury Claremont Recovery Centre (Timaru) 1982 - 20 bed longterm treatment (12-104 weeks) N.A. Date of No. of Date Date Date of JoiningADA Admissions Facility Service Service Type of Service (1982) Act Started Ended Register or 1983

Dunedin St Vincent de Paul:

- Boswell House 1979_ > 7 bed shortterm hostel, men only N.A. Ashburn Hall by 1 953---> Inpatient treatment (no alcohol programme 1953 8

Invercargill

Matt Talbot House (NSAD) 1977 1980 15 bed treatment unit N.A.

"Admissions" = first and readmissions N.A. = not available 34.

4. ADMISSIONS OVER TIME TO INPATIENT FACILITIES LINKED TO THE HEALTH DEPARTMENTS PSYCHIATRIC REGISTER

In Table 2 information from the Mental Health data has been summarised to show how the numbers of admissions for alcoholism and alcoholic psychosis to each hospital have fluctuated as programmes are set up or close down. Notable points include:

- the sudden increase in admissions to some but not all hospitals after the Alcoholism and Drug Addiction Act came into force in 1969.

- the sizeable number of people being admitted to some general hospitals (e.g. Auckland, Wellington) in the late 1960s and early 1970s.

In some cases the hospital or agency concerned was providing a service before the year in which figures are available through the register (e.g. the Salvation Army facilities, several of the psychiatric units in general hospitals).

Table 3 shows the percentage of people admitted to each of the major hospitals who came as first admissions, that is, had not been admitted previously to any psychiatric or Salvation Army facility in New Zealand for any illness. TABLE 2 - ADMISSIONS TO PSYCHIATRIC HOSPITALS AND PSYCHIATRIC UNITS WITHIN GENERAL HOSPITALS FOR ALCOHOLISM AND ALCOHOLIC PSYCHOSIS, 1964-1982 (FIRST ADMISSIONS AND READMISSIONS COMBINED)

Name of Hospital /Unit 1964 1965 1966 1967 1968 1969 197011971 1 972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 Whangaxei :1 2 1LI.1L, 12 6 2 5 7 Oakley (1969) 106 168 176 203 192 183 2l7J 172 209 279 80 58 4 46 82 81 Carrington (1 974 ) :: 222 31+1 312 309 368 273 Kingseat (1969) 14 100 214 183 145 260 1+20 1 535 623 442 407 283 266 325 21 32 Rotoroa (1969)121 112 106 101+ 96 79 61 80 112 177 161 Auckland Bridge (1978) ::::: :::: :::: 105 117 302 322 Auckland 25 42 34 131 13 9 25 17 5 1+ 6 8 6 Tauranga - 14 8 141 - 7 7 7 18 15 18 7 27 Whakatane 2 14 15 38 34 Tokanui (1969) 89.56.72. 74 76 62 69.78 . 127 158 139 49 :::•::.:::: : :::::::. :::::.::y.::.:.:.:.. : :::::.::::: J1 Waikato ...... 1 3 .. Cd 1 - Cook (1975) 2i 14 30 16 3 19 Cd 28 Napier:. 1 1 1 - i.:.:.::::::.::::.. - - Hastings 1 2 5 6 6 14 5 19 13 - 5 6 1 Taranaki 24 9 14 12 Lake Alice - 2 17 21 20 16 121 13 10 15 25 19 12 9 18 16 Wanganui 3 Manawaroa 2 10 1 - 4 11 1 1 Totara Trust (1982)::::.:::::::::::::::::: :.:.::::::::::::::::::: 73 Porirua (1969) 100 228 162 165 148 277 208J 175 138 136 119 116 111 105 61 60 Wellington Bridge (1972) 137 225 197 255 226 217 270 278 Wellington 81 61+ 76 35 30 62 95 63 11 12 15 10 Hospital/Facility 1964 1965 1966 1967 1968 1969 1970 1972 1974 1 1971 1973 975 1976 1977 1 1 978 1979 1980 1981 1982 Ngawhatu 8 12 8 17 22 17 8 10 13 14 23 39 37 35 31 25 Seaview 9 3 9 24 23 12 15 15 18 3 19 20 17 11 20 24 Queen Mary 127 174 159 149 195 191+ 276 343 390 427 461 655 749 773 655 71+1 Sunnyside (1969) 103 129 168 132 143 184 225 203 260 311 292 309 257 287 574 609 Christchurch Bridge (19ç?8) : 6+ 95 128 151+ rincessI1a.rgaret 13 7 13 15 9 5 11+ 22 11+ 16 11 L1. 2 Christchurch ::::::.:::::::::::.:::::::::::: ::::::::::::::::::::::::.::::: :::::•:.•::•::•:::•::::.:•:::. .... UI.....us..... Nova Trust (1982) 37 Timaru 23 20 18 8 12 9 19 15 z 17 18 10 14 27 z Cherry Farm (1969) 54 87 90 125 102 135 120 157 213 231 261 334 243 236 212 195 JJ Ashburn Hall 7 11 12 6 4 6 4 8 6 8 5 9 16 12 11 8 Walcari 3 7 6 - 3 - - 2 - 2 14 1 Southland - 9 8 33 6 6 1210

Total 748 970 1087 1246 1227 1637 1818 1905 22140 2396 21+96 28+3 2 3205 3294 27991 995

Note: The date in brackets refers to date of registration under the Alcoholism and Drug Addiction Act, 1966.

Source: New Zealand Health Department. Mental Health Data (yearly series 1964-1982), Wellington, Government Printer.

TABLE 3 - FIRST ADMISSIONS AS A PERCENTAGE OF ALL ADMISSIONS FOR ALCOHOLISM AND ALCOHOLIC PSYCHOSIS, SELECTED HOSPITALS, 1964-1982

Name of Hospital/Unit 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1971+ 1975 1976 1977 1978 1979 1980 1981 1982

Oakley 1+3 51 49 30 26 27 33 27 28 23 27 16 9 17 16 12 Carrington ::: 24 33 37 38 39 53 Kingseat 44 36 28 27 35 22 20 20 20 26 24: 26 24 19 2+ 28 Rotoioa 13 12 9 12 9 5 9 11 12 14 Ai.i11.arid Bridge :::::::::::: :::::::: 26 26 18 32 1) Tokanui 34 39 35 35 22 35 26 29 28 31 42 34 43 27 25 18 Totara Trust 41 . Porirua 42 30 28 23 28 28 22 30 27 17 20 . 17 15 27 16 20 Wellington Bridge:::::::: 23 16 16 18 20 21 27 30 Queen Mary 57 52 65 58 50 52 50 54 1+7 46 43 40 50 56 50 50 Sunnyside 34 33 23 35 31 27 22 17 31 26 18 25 37 30 23 24 Christchurch Bridge ::::::::::: :::::_:::.:.::::::: 1 17 12 . 29 Cherry Farm 57 46 38 36 24 33 33 25 22 29 22 17 23 23 20 25

Source: New Zealand Health Departments Mental Health Data (yearly series, 1964 - 1982), Wellington, Government Printer. 38.

5. EVENTS SINCE 1983

The bulk of the information collected for this paper was obtained in late 1983. Since then, however, several facilities have expanded or closed down. The following is a summary of major events to the end of 1984. It is not comprehensive, as the alcohol treatment field is still in a state of expansion and change, especially in the smaller hospital board areas.

Auckland

The Alcohol Dependence Foundation closed in 1984 and Quo Vadis had closed by 1985.

Northland

Presbyterian Support Services opened an outpatient service in Whangarei in 1983, which in 1984-5 was extended to the Bay of Islands (at Kawa- kawa), and to Kaitaia. These services are jointly funded by the North- land Hospital Board.

Thames

In 1985 an outpatient service was in process of being established from Thames Hospital.

Waikato

Hamilton Community Alcohol Service (a joint venture by Waikato Hospital Board and Presbyterian Support Services) was established in Hamilton in 1984 as an outpatient service. It was expanded in 1984 and 1985 with access to beds in the Waikato Hospital for detoxication. From 1984 Tokoroa Hospital also provided detoxication.

Wai rarapa

In 1984 NSADs - Johnston Therapeutic Centre at Featherston closed temporarily. From 1984 (and possibly earlier) a part-time NSAD field officer provided an outpatient service at Masterton.

West Coast

In late 1983 NSAD opened an office in Hokitika, which shifted to Grey- mouth in 1984. Plans to open a 6-bed treatment unit within Seaview Hospital were continuing.

Dunedin

The St. Vincent de Paul hostel, Boswell House, closed in 1984, and another hostel, St. Judes, was opened in the same year to provide 7-8 beds and a short-term rehabilitation programme. 39.

REFERENCES

Alcoholic Liquor Advisory Council. Directory of Treatment Facilities in New Zealand (1st, 2nd and 3rd editions, 1978, 1980, 1982), Wellington: ALAC.

New Zealand Department of Health. Digest of press clippings. (Clippings from 10 major New Zealand newspapers circulated regularly to Health Department staff. The years 1979 - 1984 were reviewed).

New Zealand Department of Health. Mental Health Data, (yearly series, 1964 to 1982) Wellington: Government Printer.

Orchard H. Alcohol/drug Hospital Board outpatient statistics, 1983. Wellington: ALAC, 1984.

Valentine J. A summary of Hospital Board alcohol and drug assessment centre client data 1981, 1982. (unpublished paper, no date). Wellington: ALAC.

Wagemaker H. A report on the feasibility of establishing a national alcohol client register. (unpublished paper). Wellington: ALAC, 1984.

Wainwright T. Social factors in the treatment of alcoholism: a comparative study of three organisations and their clients. (unpublished MA thesis, Sociology Department, Victoria University of Wellington, 1977).

Wells J.E. and Wainwright T. Readmissions for treatment for alcoholism in New Zealand. New Zealand Medical Journal, Vol. 98; No 781 500 - 503.