Ridgewood Addiction and Mental Health Services will welcome the first clients next week to a revamped addictions treatment program.
Instead of a structured, group-centred approach, Ridgewood's new "concurrent model rehabilitation treatment program" will be individualized, longer, and include more services, like those for mental health issues.
The first four clients will arrive next week at the 12-bed unit, said Holly Richards, the nurse manager for the new program.
"We're not bringing everybody in on Day One because it's the rolling admission model," she explained.
The plan is to gradually fill the other eight beds in the coming weeks and always keep the beds full.
Under the old program, which wrapped up its final session last week, all 12 beds filled up on the same day with either all men or all women — with the gender-specific groups alternating.
The group-centred program progressed for 28 days on a set schedule for everyone. If people dropped out along the way, their beds would sit empty until the next program began.
"By moving towards this new model, if somebody leaves for any reason, then once that bed's available, we can bring in the next person on the wait list, which is going to move things quicker for clients that we serve," said Richards.
In the last group that ended last week, for example, there were four empty beds by the end of the 28 days. Richards said there were empty beds in almost every session.
"There's going to be less of a wait time, so we're going to be able to flow through that wait list way more fluidly, and where we're not gender specific anymore — previously you had to wait two months for the next men's group or two months for the next women's group."
From 28 to 90 days
The program is also moving from 28 days to 90 days, depending on the person's needs. Richards said a team of professionals will work with the individual to determine when they're ready to leave the program.
She said the government has provided additional funding to add new professionals to that team. Ridgewood will now have a psychiatrist, psychologist, and occupational therapist on site. That's in addition to more nurses on staff.
"Our goal is to be able to treat any mental illness that a client has, and any addiction issues a client has concurrently. So that's the goal. So we'll be able to take more complex clients than we have in the past with this new program," said Richards.
"When they come in, we'll be building a personalized care plan and they'll be identifying what goals they wish to reach during the program. So they could reach that goal within 30 days. It could take longer. The client's the driver in this new program. It's what they need."
Richards said Horizon hopes to soon increase the number of beds at Ridgewood. Renovations are currently underway at the 75-year-old facility to fix what's there and expand its capacity.
Changes 'make complete sense'
Eric Weissman knows about addiction treatment — he's studied it, written about it, documented it, and taught about it.
But most importantly, he's lived it.
Alcohol, marijuana, cocaine, heroin. As long as it was around in the 1980s and '90s, you name it, he's done it — and a lot of it "because anything that I did, I did to the extreme," said Weissman, an assistant professor at the University of New Brunswick's Saint John campus.
He spent years addicted to a number of drugs, was often homeless, frequently evicted, and by 1990, he was getting all of his calories from alcohol.
He did well academically until it all came crashing down. He went from a PhD program to welfare.
For a short time, his family couldn't find him, and for a long time, he couldn't find his way.
It took stints in detox, treatment centres, and rehab — plus one relapse — before he got clean.
He gives a lot of the credit to one particular residential treatment facility in Ontario, where participants could stay up to two years if they needed it.
Weissman didn't need that long, but says some people do.
"Sometimes it takes that long to adjust and to learn how to change old behaviours."
Based on his experience, Weissman said the changes to Ridgewood's treatment program "make complete sense."
He said it's important to address mental health needs, and that the program be client-focused and not constrained by delivering programs to the whole group on a set schedule in order to complete everything within 28 days.
"The most successful recovery programs that I know include those elements — the place I went to included those elements, all of those elements. The difference is that we had a chance to stay longer."
That program usually saw people stay at least three months. Weissman said that's the minimum most people need to get on the right track.
"The opportunity to stay in a program longer … is always better." - Eric Weissman
He's pleased Ridgewood has extended its program, but "I think it would work better if they had a six-month program."
Other places, for example, operate a three-month program, but at the end of three months, health-care professionals could recommend a person stay another three months — but it would be up to the person to decide to stay longer.
"So as long as that option exists at Ridgewood, it will be even more effective if people can stay longer than three months," he said.
"To me, the opportunity to stay in a program longer, with the intensive supports, is always better. But three months is a definite improvement over 28 days."
He also said "the longer option tends to lead to longer periods of abstinence." Plus, he said, rehab doesn't always work the first time.
"It didn't in my case, and I was lucky to have the opportunity to go again. But I've known people who needed to go three or four times before it took. A long abstinence is a very difficult thing to achieve in the long term."
He said that's why it's important to have strong after-care programs when people leave Ridgewood, including family, friends and community-based programs.
Julie Dingwell, the executive director of Saint John's harm reduction organization, Avenue B, is part of that after-care system. She is also pleased with the longer program at Ridgewood.
"So often in the past, somebody just gets rolling along, you know, things are going pretty good, and they maybe have been there a week, week and a half, and it's like, 'OK, you're going to go home now,' but they're not ready for that."
Dingwell said the longer you can keep a person in a program, the more successful they will be. It gives them a chance to get on an addiction-treatment drug like methadone or suboxone, and to address contributing factors like mental health issues.
"In many cases, we're working with people that have undiagnosed mental health issues, and it's been undiagnosed since they were, perhaps, teenagers, so we really need to do a lot of work with people."
Others, she said, may have experienced chronic homelessness and "maybe they've never been accustomed to being around people in a good way."
Dingwell said it's akin to the school system, where "there's extra people that go in and help with things like reading programs, math comprehension or speech pathology.
"So I think that that's what we need to be doing. We need to be looking at what this person really needs to be better able to move forward," said Dingwell.