Advocates for increased addiction treatment services need to seek out natural allies and leaders in their community and involve them as partners, according to participants at Join Together's recent Demand Treatment! institute in Tempe, Ariz.The institute brought together representatives from 15 Demand Treatment! communities, funded through Join Together by the Robert Wood Johnson Foundation (RWJF) to implement an array of strategies for increasing treatment access and resources.
David Rosenbloom, director of Join Together, opened the meeting by noting that long experience with another RWJF-funded initiative aimed at alcohol and other drug abuse -- the Fighting Back program -- proved that "leadership really matters" in determining the fate of community-based advocacy efforts.
A year into their projects, Demand Treatment participants say they are finding leaders and allies in many places. Tucson, Arizona, for instance, has a 25-member community commission that includes consumers, psychiatrists, businesspeople, funders (including the local United Way), managed-care organizations, and treatment providers.
Each Demand Treatment! project faces unique challenges, however. In Trenton, N.J., for example, the goal of the Demand Treatment project is to increase services for pregnant women who are addicted to alcohol or other drugs. "It's a lot harder than we imagined it would be," said April Aaronson, director of the City of Trenton's Department of Health and Human Services. "A lot of treatment programs don't want pregnant women."
"In building a coalition, relationships are everything," said Karen Plavan, a consultant to Pittsburgh's Coalition for Leadership, Education, and Advocacy for Recovery (CLEAR). While CLEAR has had the same director for 25 years, however, other Demand Treatment groups are building relationships and coalitions from the ground up. In these communities, said Rosenblooom, Demand Treatment leaders need to ask themselves -- and their allies, staff, board members, and anyone else who's interested -- who their local allies might be.
Many communities are finding political leadership is particularly important. Denver, Colo.'s Mayor Wellington Webb has been a driving force behind the local Demand Treatment project to increase screenings and brief interventions for addiction in the city's health-care system. In Boise, Idaho, Mayor Brent Coles "has been vocal about his stance on alcohol and other drugs," said Jon Hoffman, community substance abuse treatment coordinator for the City of Boise. And Trenton Mayor Douglas Palmer has also played a key role in getting his city's Demand Treatment program off the ground, crossing political lines to work with the local county executive on the project.
Demand Treatment leaders stressed the importance of recruiting people in recovery as advocates for increased treatment services. "We need a community voice beyond our own vested interests," said Joan McNamara, director of Tucson, Ariz's Compass Health Care, Inc. The Tucson Demand Treatment coalition, for example, includes not only the recovery group Speak Out For Addictions Recovery (SOFAR), but also local advocates for people with disabilities, who have a higher-than-average rate of addiction problems.
Like some other Demand Treatment communities, Trenton has struggled to get physicians involved as leaders in their coalition. "Most doctors have no idea what it means to advocate in the public interest," said Kenneth Thompson, director of the Institute for Public Health/Psychiatry at the Western Psychiatric Institute and Clinic in Pittsburgh.
Experts at the conference suggested that advocates having trouble recruiting doctors take the emphasis off individual physicians and instead work through their professional organizations. Join Together's Rosenbloom added that local recovery groups could also be a good source for finding physicians and other leaders with an interest in treatment issues. He pointed out that many communities have recovery groups aimed specifically at doctors, lawyers, and other professions.
If they can't get doctors, coalitions could try recruiting their patients: Paul Hedquist, CEO of Employee and Family Resources of Des Moines, Iowa, noted that employee health-care coalitions are beginning to form in communities around the country to advocate for improved services and curbs on managed care. "They can be an ally," he said. "We should get our views in front of them."
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