Social Development

[1] There are currently 8 treatment facilities in Mitchell’s Plain. These treatment facilities render treatment services at various intervention levels, namely Inpatient [4]; Halfway Houses [1]; Community Based Organizations [3].

[2] None of these centres are registered. For an application to be considered by the Department of Social Development, it must meet the City of Cape Town’s zoning requirements.  The majority of these facilities do not have the correct zoning. Where applications had been received, there are still various outstanding documents such as health clearance, fire clearance and other requirements and policies as prescribed by the Regulations of Act 70 of 2008. As part of the provincial implementation plan of the Prevention of and Treatment for Substance Abuse Act 70 of 2008, focus was placed on the registration of inpatient treatment facilities at first to expedite the legitimisation and registration of unregistered inpatient treatment facilities. Community Based Organizations in the implementation plan is scheduled to start with the 2016/17 financial year.

[3] The Department of Social Development has a standard operating procedure in terms of the registration process which is as follows:

• Facilities are sent a notification that includes the application package, legislation and policy guidelines, and a simplified process to be followed. This includes all the required supporting documentation they need to submit before being considered for registration. Clear timeframes are communicated for the return of applications and subsequently afford them the opportunity to align their existing services with the prescribed norms and standards as per the Regulations of Act 70 of 2008.
• Designated officials work on facility registration at the provincial office who assists facilities with administrative guidance and support with regards to their application for registration.
• Continuous follow ups are conducted to ensure that facilities comply with the prescribed timeframes.
• Preliminary assessment visits are conducted to ensure compliance with non – negotiable minimum norms and standards.
• A comprehensive database is updated and maintained continuously to ensure completed and accurate information and progress of unregistered and registered facilities.
• We furthermore rely on civil society, other government departments and funded organisations in the substance abuse sector to inform us about operational treatment facilities that we are not aware of.

[4][a] In the Province the Department of Social Development spent R56 387 047 for substance abuse services in the financial year 2015/16, which was allocated accordingly:

• Inpatient Services:  5 funded facilities with a total expenditure of R13 322 160 to reach 595 beneficiaries [23% of the budget]
• Community-Based services:  11 organisations with 24 sites are funded and amounts to R22 399 752, with a target to reach a number of 3554 beneficiaries.
• Prevention/Awareness: The Department funds 3 organisations for preventative services with a total budget of R 2 571 219 to reach 5999 beneficiaries.
• Early Intervention: 19 Organisations with 26 sites are funded for early intervention services with a total budget of R8 411 636 to reach 3950 beneficiaries.
• Aftercare: 11 organisations with 18 sites are funded with a total budget of R4 706 823 to reach 2220 beneficiaries.
• The Department further wishes to increase the capacity of staff so that it can deal more efficiently with substance abuse cases. Therefore, the Department will spend R4 975 842 for 66 students to obtain specialised training at universities.

Four facilities in Mitchell’s Plain receive funding from the Department of Social Development. One facility renders an Opiate Substitution Therapy program, 2 organisations render community-based treatment, 2 organisations renders early intervention services and 2 organisations provides aftercare services. The total expenditure for this specific area amounts to R5 149 552 to reach a total of 1204 beneficiaries. The Department of Social Development office in Mitchells Plain is also responsible for rendering early intervention and aftercare service as prescribed by the Annual Performance Plan.

[b] Unit cost is determined by the type of treatment and the intensity of treatment.

• Inpatient = R20 709. 22
• Community-based services depends on the length of the program and ranges from R3 333.70 to R6 000.
• Post funding is utilized for early intervention and aftercare services with a cost of R167 321.00 for social workers and R72 243.00 for social auxiliary workers.

[c] An annual target for the number for inpatient treatment for the 2015/16 financial year was 1 395 (including the public treatment centres).

Community-based services have a target of 3 554 beneficiaries for the 2015/16 financial year.

Early intervention services have an APP target of 6644 and aftercare services a target of 2 440 for the mentioned period.  

[d] The Department is still in the verification period for the final quarter of the 2015/16 financial year. To date for the three quarters at the funded facilities 439 beneficiaries accessed inpatient treatment, 2 132 service users accessed community based treatment, 3 035 beneficiaries accessed early intervention services, and 1 020 accessed aftercare services.

[e] Success rates in the context of substance abuse and addiction recovery is very difficult to define as different facilities define treatment success differently e.g. a facility might view success as treatment cycle completion, whereas another facility might view success as service user being abstemious but global social functioning of such person has improved in all life domains such as socially, financially, vocationally, psychologically etc. Another school of thought might view total abstinence as being a measure of success. Most centres do not measure success as a longitudinal exercise. On treatment completion the department can report 64.5% success in treatment cycle completion to date for the first 3 quarters of the 2015/16 financial year. The Department of Social Development has initiated a process to commission research into community-based treatment to conduct a longitudinal study to measure impact of the provided service.

[f] 106 service users did not complete inpatient treatment at the funded treatment facilities in the province. Organisations do not report on service users who do not complete the other levels of treatment.

[5] The Minimum Norms and Standards as per the Regulations of the Prevention of and Treatment for Substance Abuse Act 70 of 2008, prescribe referral to alternative services in the case of any expulsion and further require the appropriate follow up service to those who self – terminate services to motivate them to re-admission. Section 52 of the mentioned Act clearly stipulates processes to be followed when dealing with voluntary and involuntary service users who abscond from treatment options.

[6] There is no formal program in place. The Department of Social Development funds a certificate course in conjunction with the University of the Western Cape to train lay counsellors in the field of substance abuse. Various other facilities involve their service users in other services such as public speaking, door to door campaigns, collecting collateral information, conducting home visits etc., whilst a minority is often employed at private treatment facilities. Notably, during the transition from treatment to recovery maintenance, it is of crucial importance that such persons focus on his or her individual recovery.