News

Annual Review 2019

Words from the Chair

It is with great pleasure that we in Saoirse can present our 2019 annual review. The greatest challenge of 2019 was continually developing Saoirse. This was achieved through the work and dedication of the Board of Saoirse and the Management and Counselling team.

Saoirse was established principally to address the need for a non-residential day treatment programme in the City of Limerick and across North Tipperary and Clare.

Saoirse principally provides addiction counselling, programmes based on harm reduction and abstinence.  Saoirse has succeeded in delivering services to 463 individual clients across the region from 2nd January 2019 through to 24th December 2019. 

The Board of Saoirse are conscious that the greatest challenge ahead is one of funding, certainly not one of demand and need for our services.  We will remain steadfast in our pursuit of funding and the resources required to keep Saoirse operationally sustained and viable.

In the pages that follow you will read of the services we offer, how we offer them and the detail of the clients that accessed our services from 2nd January 2019 to 24th December 2019. 

Noel Whelton - Chairperson

 

Saoirse Mission Summary Key Operational Objectives 2019

The Mission of Saoirse Treatment Center is to provide treatments to substance abusing clients and their families utilising both Harm Reduction and Abstinence principles in the provision of that service.

 

This was achieved in the year through the following key actions:

 

  • Provision of 1:1 counselling
  • Provision of Initial Day Programme
  • Provision of Abstinence based Recovery Day Programme 
  • Provision of After care for clients post treatment
  • Provision of a Family Programme to family members and concerned persons
  • Development of networks and projects as appropriate with other agencies

 

Values on Which the Saoirse Service Provision is Founded:

 

Autonomy

                          

   Respect

                                               

Commitment

                                    

Saoirse Services operating in 2019

Saoirse Treatment Center currently offers the following services as part of the overall service provision in the year under review.

 Day Programme Provision

This programme is delivered in two phases The Initial Programme and the Recovery Programme. The Saoirse Initial Programme is based on a harm reduction philosophy and the Recovery Programme is based on abstinence.

The integration of harm reduction and abstinence-based substance abuse treatment is more powerful than either model separately. The ultimate abstinence goal provides more room for the more abstract harm reduction work to occur. The accepting atmosphere of harm reduction with the addition of the clarity of the goal of abstinence promotes client retention better than either philosophy separately. The implications of this integration are that harm reduction can be more accepted and powerful in the overall treatment model and in the overall successes for clients in achieving abstinence.  

 

Saoirse Initial Treatment Programme

The Saoirse Initial Programme is a programme based on the principles of Harm Reduction that is described as a concept aiming to prevent or reduce negative health consequences associated with certain behaviours (WHO 2003). The Initial treatment programme allows for the following in terms of overall treatment outcomes –

  • Immediate engagement with clients in that they can be admitted to a programme structure immediately upon screening. This effectively means that Saoirse Treatment Center has no waiting list for programme entry.  
  • The Initial Treatment programme structure allows for clients to achieve stability and build trust in the overall treatment process.
  • The Saoirse Initial Treatment Programme allows for a client to achieve stability and cut down or minimize their use of their drug of choice in a supported environment.
  • The Initial Treatment programme facilitates a period where a client is engaged with and the client’s specific needs are identified and actioned; these may include referral to residential detoxification in other centres or residential treatment.   
  • Where clients engage, GP intervention would be actively encouraged so as a detoxification if appropriate can be monitored and facilitate the clients progression.

 

The Saoirse Recovery Programme

The Saoirse Recovery Programme is an abstinence based programme and clients access this programme either from the Saoirse Initial or directly from other services/counselling if referred appropriately. The following would apply to the Saoirse Recovery Programme –

  • Admission to the programme would be either through the initial or interim treatment programme or appropriate referrals from other services. 
  • Admission is based on an agreement to random testing for drugs and alcohol.
  • The programme will run for 6 weeks, 3 mornings a week (subject to change) with random testing throughout the 6-week period.
  • Intensive 1:1 counselling is part of each client’s treatment plan.
  • Clients move to aftercare groups upon completion of the Saoirse Recovery Programme. The option to extend time on the recovery programme also exists if the clinical director in conjunction with the case counsellor agrees that is what is warranted.
  • Linkage with other services would be made during the time a client would be on the Saoirse Recovery Programme – This interagency work would be considered paramount in terms of the best progression routes for client or indeed additional supports required

 

Saoirse Family Programme

Empirically it is evident that the family members of those that abuse substances require and benefit from a high level of support and access to counselling to facilitate their own recovery. The provision of a family programme in parallel to the addicted client’s programme provisions facilitates a more comprehensive support model and lends itself to a greater outcome.

The detail of the family programme is as follows:

  • The programme is based on a psychotherapeutic group that would be open to family members of substance abusers, whether the substance abuser is receiving treatment or not.
  • Each member of the family support group would also have access to 1:1 counselling as required.
  • The family programme operates on a roll over basis.
  • A family aftercare group will operate for one session a week in parallel to the family programme.

 

1:1 Addiction Counselling

Currently in Saoirse, all clients are engaged in at least three sessions of counselling following the initial screening in Saoirse. This has proved to be a very effective strategy and has enabled clients to settle into the service and more importantly given very clear objective direction in terms of their own treatment. Addiction counselling is provided to all clients on an on-going basis as part of their treatment in Saoirse.    

 

Saoirse Aftercare

Currently three aftercare programmes run in Saoirse, one during the day and two in the evening.

  

Saoirse Client Data Summary 2019

Breakdown of clients presenting to Saoirse:

Of the 429 clients that received service from Saoirse in the period under review - 383 substance misusing clients accessed the Center in Davis Street directly, 14 clients presented with a gambling problem and 32  family members and concerned persons contacted and engaged in the service.

 

Gender:

Of the 429 clients who presented for treatment 277 or 65 % were male, and 152 or 35 % were female. Of the 32 family members that engaged with Saoirse, 23 or 72 % were female and 9 or 28 % were male.

 

Ages of those presenting:

As can be seen from the table below  215 or 50 % of clients that presented to Saoirse  were in the 18 to 35 category while 214 or 50 % presented were 35 or over representing an even spread. 

                                   

Age Group

Number

18-25

61

26-30

73

31-35

81

36-40

78

41-45

44

46-50

30

51-55

19

56-60

18

61-65

12

65+

13

Total

429

 

  Age by Gender of clients presented:

Of the 429 clients that presented in Saoirse.

Age Group

Female

Male

Total

18-25

18

43

61

26-30

19

54

73

31-35

22

59

81

36-40

28

50

78

41-45

14

30

44

46-50

18

12

30

51-55

8

11

19

56-60

12

6

18

61-65

6

6

12

65+

9

4

13

Total

154

275

429

 

Across the age categories both genders are represented. Males were greater in the majority of categories with females being greater in the, 46-50, 56-60, and 65+ brackets.

 

Demographic Origination of Clients:

Of the 429 clients that presented -

56 % of clients originated from Limerick City (Including suburbs) with 60 % of those originating from regeneration areas. Saoirse also engaged with transient families and individuals in relation to the regeneration areas in Limerick. 23 % originated from County Limerick, 14 % from Co. Clare, 4 % from Co. Tipperary and 3% from other counties. In all 79% of the clients that presented were from Limerick with 21 % coming to Saoirse from surrounding counties.

 

Clients presenting issue:

 

Primary Substance

In 2019, the clients presenting were predominately drug dependant. Of substances of choice 195 presented with alcohol, 73 with Cocaine, 49 with Cannabis, 26  with Benzodiazapine, 17 with heroin, 12 with Prescription Medication, 4 with Amphetamines, 2 with Codeine, 2 with Ecstasy, 2 with crystal meth and 1 with Crack Cocaine

 

Poly-Substance Use Presenting in Saoirse

Of the 383 clients that presented for treatment in 2019, 277 or 72% presented with poly-substance use.  Of that 72%, the most prevalent secondary drug used was Alcohol with 84 clients, followed by Cocaine with 64 clients and Cannabis with 56 clients.       

 

Other Prescribed Medications

Of the 383 substance using clients who presented to Saoirse for Treatment, 239 or 62% reported taking prescribed medications which ranged from Xanax to Librium. Some of the medications related to co morbid mental health issues’ such as depression, which was the most common, through to schizophrenia. The prevalence of prescribed medications meant that client care often involved planning around the use of the prescribed medications; especially for those with presenting drug use issues and also that the secondary issue is the prevalence of mental health issues for clients.  

 

Prevalence of Legal Issues for Clients

Of the 383 clients that presented to Saoirse for treatment, 209 or 55% would have reported having legal difficulties ranging from drunk and disorderly charges through to possession offences.

  

Other Treatments

Of the 383 substance mis-using clients that presented to Saoirse, 177 or 46% of clients had previous treatments. Although this may seem inordinately high it does indicate the prevalence and likelihood of relapse if proper and managed aftercare facilities, post treatment are not available. Most of the clients would have cited the lack of post treatment supports as a significant factor.

 

Prevalence of Suicidal Ideation

Of the 383 clients that presented to Saoirse, 255 or 67% of clients reported suicidal ideation. Of this 255, 82 or 32% have either self-harmed or have had past attempts to commit suicide.

 

Referring Organisations to Saoirse

Interestingly, 227 or 53% of clients were self-referred to Saoirse and these referrals generated from clients already attending the service, family members and the individuals presenting themselves. 56 or 13% were referred  through other (Court, Community service, Hospitals, Employee Assistance Programme,  Newspapers, Solicitors, Colleges, Defence Force and a Transition House )  54 or 13% through General Practitioners,  17 or 4 % through agencies, 15 or 3 %  through probation, 14 or 3% through HSE Mental Health, 14 or 3% through treatment centres, 9 or 2% through counsellors,  9 or 2% were referred through TUSLA the child and family agency, 6 or 1% were referred the  Drug and Alcohol Service 4 or 1% through Alcohol Anonymous and 2 or 0.46% each  through a housing body and Narcotics Anonymous.

 

Treatment Outcomes in Saoirse 2019

The treatment outcomes in Saoirse in the period under review are based on the National Drug Treatment Reporting System, Health Research Board. Of the 429 clients that attended Saoirse in 2019, 180 clients achieved their short to medium term goals and 111 clients completed treatment and engaged in aftercare.

 

Treatment Perception Questionnaires 2019

Saoirse on a monthly basis circulates Treatment Perception Questionnaires in groups and to individuals in Saoirse. The Treatment Perception Questionnaires are satisfaction questionnaires which give a reasonable measure of a client’s satisfaction with their treatment in Saoirse. The questionnaire is divided into three parts namely, Your Treatment, About Yourself and Feedback on this service. The overall satisfaction rating is in the 90th percentile.

 

A Final Word!

Saoirse as an organisation depends on funding for its survival, this for us is the greatest challenge and one we hope doesn’t impede the work we have done and have yet to do. But the reality is that we need funding to continue to provide the services we do.

In this document we have endeavoured to present the work done in Saoirse in the 12 months to December 2019. We hope you can see the work which was achieved. 

We would like to say a big thank you to all that have contributed to the Saoirse journey over the last 12 months, to those that have worked, funded and supported Saoirse to be able to offer the services that we do.

Sincerely,

 

The Saoirse Team