Chapter 12
Voluntary In-patient Treatment and Rehabilitation
Hong Kong's voluntary in-patient treatment is carried out by two voluntary agencies-the Society for the Aid and Rehabilitation of Drug Addicts and the Hong Kong Discharged Prisoners' Aid Society. Both of them are heavily subsidized by the Government. Addicts who seek assistance from these two agencies are provided with medical treatment and rehabilitation services at in-patient treatment centres, as well as after-care following their discharge from the centres. During the year under review, the two agencies treated and discharged 2,690 addicts, including 142 females.
Society for the Aid and Rehabilitation of Drug Addicts (SARDA)
2. In 1960, a group of prominent citizens, who were concerned about the need to provide voluntary treatment for drug addicts, formed the Society for the Aid and Rehabilitation of Drug Addicts, commonly known as SARDA. Since then, SARDA has developed a sophisticated network of treatment, rehabilitation and after-care facilities, mainly with financial subsidy from the Government. At present, it has two in-patient treatment and rehabilitation centres, one for men on the outlying island of Shek Kwu Chau and other in Wan Chai on Hong Kong Island. Linked with these two centres are six regional after-care centres, three units for the intake of patients and two hostels. In addition, it operates two clinics which render services in pre-admission medical examination, pre-admission methadone therapy, nalline tests, urine tests and post discharge medical care.
The Shek Kwu Chau Male Treatment Centre
3 The Shek Kwu Chau Male Treatment Centre was officially opened in April 1963 by the then Governor of Hong Kong, Sir Robert Black. In the intervening years, some 15,000 cases have been handled at the centre, which has a capacity for 500 addicts and 93 staff members.
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At its inception, Shek Kwu Chau started as a barren island with 50 detoxified addicts transferred from the Castle Peak Hospital and a small staff who had little experience of the problems that they were to deal with. Over the years, as a result of trial and error, and above all an immense amount of hard work, the island has developed not only its extensive facilities but also its rehabilitation pro- gramme, so that today it supports a thriving therapeutic community in an attractively conducive environment.
5 The development of the island itself, together with the programme which the centre offers, is a continuing process in which addicts under rehabilitation play a very active part. They are strongly encouraged to see the island as their responsibility in regard to day-to-day management and planning. In this way it is aimed to foster both personal and community responsibility. The results of this policy have been rewarding, unequivocally demonstrating that addicts are very prepared to accept responsibility for the community in which they live and for themselves.
6 In order to achieve these objectives, it is essential to play down the authorita- tive functions of the staff, to place increasing emphasis on management participation on the part of the addicts, and to aim for integration between them and th taff. It has been most gratifying to see the results of the gradual application of these measures.
Indications of success
7 During 1976, 2,392 addicts were treated and discharged from Shek Kwu Chau. It is noteworthy that over the past three years, there has been a progressive decrease in the number of new addicts coming forward for treatment. In 1974, the number of "first timers" entering Shek Kwu Chau was 1,864 representing 69 per cent of the total admission. In 1976, the number was down to 1,030 which was 44.3 per cent of the total admission. (See Appendix 6.) Meanwhile, the number of young addicts under 19 years of age who were admitted to Shek Kwu Chau also declined from an all-time high of 12.5 per cent in 1969 to 4 per cent in 1976. (See also Appendix 6.) When considered together with the significant improvement in the success rate of SARDA's after-care programme as well as a steady decrease in the number of young addicts admitted to the drug addiction treatment centres of the Prisons Department (see paragraph 10 of Chapter 11), these developments indicate that Hong Kong is achieving a con- siderable degree of success in its overall efforts against the drug problem. 8 Some effect on the number of admissions to Shek Kwu Chau was noted after the opening of the Government's methadone detoxification centres in June. The island, which has a maximum permitted capacity of 500, had 500 patients in residence in May, 423 in July, and at the end of the year the figure was 344.* It is, however, somewhat premature to draw definitive conclusions at this stage. As mentioned in the above paragraph, there has been a marked improvement in SARDA's after-care programme. This is believed to be largely the result of the adoption of a new approach. Since late 1975, SARDA has been placing more emphasis on group work in its after-care service, which has resulted in a better 'integrated approach' whereby case work, group work and community develop- ment methods are applied regionally and flexibly. This new approach came into full swing in 1976 and brought about very encouraging results. During the year, 38.4 per cent of the normal dischargees (those who completed a full treatment course of five months) abstained from drugs at the end of their two-year after- care, compared with about 25 per cent in 1975. For those who did not complete a full treatment course, the abstinence rate also improved from about 10 per cent in 1975 to over 18 per cent last year. On the other hand, the attendance rate at SARDA's male after-care centres also increased by about 50 per cent as compared with the previous year. As far as the after-care caseload in 1976 was concerned, it was in the region of 4,000, roughly the same as in previous years.
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The Women's Treatment Centre of SARDA
10 During the year under review, 97 female patients were treated and discharged from the Women's Treatment Centre of SARDA, which has a capacity for 30 patients. The rehabilitation programme of the centre was improved by the intensification of group counselling, and by the addition of various educational
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*At the time of printing this Report Shek Kwu Chau was operating at a maximum capacity.
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