It Seemed like a Good Idea at the Time

Abstract

■ AIM Identify whether centralised assessment and intake programs are useful for alcohol and drug systems. ■ DESIGN Review of evaluation findings on centralised programs in Ontario, Canada, the USA and Victoria, Australia. ■ FINDINGS Models implemented in Canada and the US operated at local level and variations were a product of settings and stakeholders. Some advances were made. The assessment and referral centres (A/Rs) in Canada accounted for around one fifth of all case loads. A greater proportion of treatment naïve people attended A/Rs and these agencies had a considerable network of services. However, A/Rs were not the hub of the system; many agencies developed their own intake structures and A/Rs took on treatment functions. In the US, only some locations with centralised intake units (CIUs) reported a greater uptake of referrals and high needs clients were more likely to attend. Centralisation resulted in improved assessments and increased levels of client satisfaction but not treatment matching. Some treatment agencies in Victoria developed centralised models for screening / assessment while referral destinations were generally in-house. In rural settings, there was cross-agency centralisation. ■ CONCLUSIONS Centralised intake requires extensive implementation planning to counter pressures that impede the potential for systems change.