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(*Not In Anyone's Back Yard) "The Vancouver Police estimated that roughly a third of all police calls dealt with the mentally ill."-- Vancouver Sun February 14th 2008.
Without objective measurement of outcomes no one will ever know. The City of Vancouver needs to provide the public an independent objective assessment. The Fraser St. Current Operational Management Plan approved by City Council does not provide a proper, objective analysis as defined by standards of medical evidence for addiction treatment.
In August 2007 the 30 unit "abstinence-based" transitional supportive apartments for mentally ill drug addicts began operating. Fraser St. costs approximately 766,500 dollars a year to operate. 1
In 2004 it was estimated that the cost of this model of supported housing is approximately $70 per day per mentally ill drug addict. 2
That's $25,550 per drug addict per year or $$$$$ since Fraser St. opened August 1, 2007.
5616 Fraser St. is the first publicly funded abstinence-based supportive housing for mentally ill drug addicts. And, as the City of Vancouver is planning to build and disperse more of these "abstinence-based transitional drug addict supportive housing" projects, the citizens of Vancouver expect scarce healthcare dollars to be used responsibly, effectively and efficiently. The potential costs of this supportive housing strategy could run into the millions and millions of dollars yet there is no evidence for its effectiveness. (Learn more »)
Taxpayers of Vancouver are right to be skeptical about the effectiveness of addiction treatment programs including those with supportive housing like the RainCity Housing Center on Fraser St.
In 2007, The Journal of Substance Abuse Treatment says:
"There is reason to be skeptical about the performance and accountability of addiction treatment programs." 3
"... Indeed the calls for improved accountability and better outcomes have come from virtually every participating agency and organization within the addiction treatment field including the addiction treatment providers." 4
Mr. Califano of the National Center on Addiction, which focuses on research and public policy, said that "the entire [addiction] treatment system is run with a lack of professional standards that would be unacceptable in any other field of medicine." He has tried to get rehabilitation centers to give his group data to analyze their effectiveness.
"Objective analysis would require knowing everything that is done with that person in rehab, and following them for six months to a year and do an actual urine or hair test." he said, "No one let's us do that." 5
What is the tax payer getting for their money?
Will Fraser St. be responsible, effective and efficient?
To determine the RainCity Housing operated Fraser's Street effectiveness or any other drug rehabilitation program with or without supportive housing, the following critical objective outcomes need to be independently collected and analyzed:
Fraser St. Supportive Housing must have frequent, random drug testing to show that its "abstinence based" supportive housing with off site treatment programs work.
"Indeed abstinence from all substances has been considered a proxy for good function in the other domains of function that comprise recovery." 6
The National Institute on Drug Abuse (NIDA) Principles of Effective Treatment #11:
Possible drug use during treatment must be monitored continuously. Lapses to drug use can occur during treatment. The objective monitoring of a patient's drug and alcohol use during treatment, such as through urinalysis or other tests, can help the patient withstand urges to use drugs. Such monitoring also can provide early evidence of drug use so that the individual's treatment plan can be adjusted. Feedback to patients who test positive for illicit drug use is an important element of monitoring.
Yet, The City of Vancouver has no plans for random drug testing at Fraser St. for all tax payers supported supportive housing tenants at Fraser St. (Learn more »)
As large supportive housing projects, regardless of the type of tenant, have been shown to increase crime. 7 (Learn more »)
It is important that an independent assessment on the impact of Fraser St. supportive housing on neighbourhood crime and safety be performed. At minimum:
Measuring Client satisfaction is a common but inaccurate and misleading way to assess drug treatment programs. Surveys will tell you nothing about whether or not a supportive housing program with community drug treatment programs are effective.
"Research shows that that although patient satisfaction is a very direct measure and important measure of whether a patient got what he or she expected, it is not well related to any other objective measure of good outcome from treatment such as urine tests or employment or rearrest rate ... satisfaction is not synonymous with good outcomes." 8
It's time for Vancouver City Hall to be accountable to taxpayers. Post the monthly Results of Measured Outcomes about Fraser Street supportive housing clients on the City of Vancouver and RainCity Housing Websites.
It is time for some accountability. Just like the Journal of Substance Abuse says:
"... Indeed the calls for improved accountability and better outcomes have come from virtually every participating agency and organization within the addiction treatment field including the addiction treatment providers." 9
The public awaits Fraser St. monthly outcome results on your websites.
Published August 15, 2007.