A systems approach to estimating the required capacity of alcohol treatment services

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1 British Journal of Addiction (1990) 85, COMMENTARY A systems approach to estimating the required capacity of alcohol treatment services BRIAN RUSH Addiction Research Foundation, Community Programs Evaluation Centre, University of Western Ontario, London, Ontario N6A 5B9, Canada Summary This paper describes a model for estimating the required capacity of alcohol treatment systems at the local or regional level. Previous attempts at developing comprehensive forecasting models for addiction services are briefly described. The four steps followed in the development of the present model are then outlined. In many respects, the resulting model is specific to Ontario, Canada. However, the general approach, and many of the underlying concepts and assumptions, may have wider application in assessing the need for alcohol treatment services. Background and introduction Over the past decade, a systematic plan for the development of addiction services has been pursued in Ontario by the Addiction Research Foundation (ARF). A systems approach to planning was advocated by an ARF Treatment Task Force (Marshman, 1978). A large scale community development project was then mounted to develop a fully accessible continuum of care, within all local planning areas of the province (Ogborne, Rush & Dwyer, 1985). Each treatment 'system' was to have the basic components of comprehensive assessment and referral, cost-effective ambulatory treatment, case management and aftercare. Provision was also to be made for community-based residential care where it was needed (e.g. detoxication, short-term treatment, recovery homes). Expensive, hospitalbased inpatient programs were de-emphasized. The local community development efforts to establish this complement of services were subsequently reinforced in 1985 by a government Addictions Services Policy (Ontario Ministry of Health, 1985). Although the community treatment model advocated by the ARF and the government's Addictions Services Policy highlighted the need for a full range of ueatment services, its utility for making funding decisions was limited by the lack of quantitative guidelines for determining local needs for each type of service along the treatment continuum. What was required was a quantitative planning model that would indicate how much of each type of treatment was required per population base, or per estimated number of people in need. It was anticipated that estimates of the required capacity of the treatment network would be useful for two different purposes. First, estimates would be applied at the local level as a standard part of need assessments. Second, they were to assist in the distribution of government funds according to need. At this central level, the estimates were to indicate the needs for a program within a given jurisdiction relative to: (a) the needs for other kinds of services in that same jurisdiction, and (b) the needs for that same type of service in another jurisdiction. How have other areas dealt with this problem of allocating treatment resources on a systematic basis? An exhaustive overview of need assessment methods employed in the United States was prepared in 1982, for the National Institute on Alcohol Abuse and Alcoholism (NIAAA) (Kaelber & Nobel, 49

2 50 Brian Rush 1982). Of the 51 states reviewed, only four reported state-level capacity estimates that were developed from a comprehensive forecasting model (Nebraska, Colorado, Massachusetts and New Jersey.* Almost all of the remaining states did use some method for estimating the size and nature of the target group for alcohol treatment services (i.e. the 'in-need' population). In these areas the most commonly used methods for translating prevalence to need (1) The size and characteristics of the 'in-need' population were compared to the size and characteristics of the population in treatment. States adopting this approach used a periodic statewide survey of programs to collect treatment data. The comparisons of treated versus in-need populations were used to gain an impression of unmet need and to set funding priorities for underserviced populations or areas. (2) A severity index was calculated for each local planning area based on social indicators (e.g. housing density, income levels) and/or alcoholspecific indicators (e.g. DWI arrests, liver cirrhosis deaths). The local planning areas were then ranked on this index to gain an impression of relative need, and funds allocated to the most needy versus least needy areas. (3) The responsibility for need assessment was completely decentralized and rested with local planning bodies rather than a state-level organization. In these jurisdictions, a variety of methods was used, including population surveys, community forums, key informant surveys, social indicators, and treatment utilization data. (4) Some attempt was made to predict levels of demand for the coming year based on the past year's rate of utilization. This was done, however, without the aid of a complex forecasting model (i.e. linear projection was used). (5) A forecasting model was used, but covered only a limited range of treatment alternatives (e.g. bed capacity for residential treatment only). Within the four American jurisdictions utilizing a comprehensive forecasting model, the technique that was used can be summarized as either demandbased or systems-based. A demand-based forecasting model projects a wide range of service needs at the local/regional *It is unknown to what extent Che results of the 1982 review by NIAAA are still current. level on the basis of historical patterns of utilization, as described in a large scale national data base. The methodology reported by Kaelber & Nobel (1982) for the state of Nebraska is an example of this type of procedure. The procedure was first published by Ford & Luckey (1983). The model has undergone one major revision and is described in its current form by Ford & Schmittdiel (1983), and Ford (1985). In the most recent version, a predictive model was first developed using population data, alcohol-related indicators from the national census, and data from a national survey of alcoholism programs (NDATUS). Having developed a predictive model on the basis of the national data, the capacities for a range of treatment services for a given planning region may then be estimated. Local data on population size, alcohol consumption levels, and so on, are incorporated into the regression equation, thereby predicting local treatment needs. The main limitation of this approach, and any such demand-based projection technique, is that it assumes that historical utilization (i.e. demand) accurately refiects client need, both at the time services are delivered and during the period of time for which the projections are made. As stated by the originators of the model "it does not specify how things ought to be, rather it refiects how they are" (Ford & Schmittdiel, 1983, p. 1083). Consequently, any current inefficiencies or deficiencies in the treatment system on which the predictions are based, are projected into the future. This limitation also applies to a comprehensive demand-based model recently developed by NIAAA's Alcohol Epidemiology Data System (Ryan, 1984/85; Alcohol Epidemiology Data System, 1982). As with the Nebraska model, a projection is made for the expected level of service in the planning area, based on the level of service provided in the past, in jurisdictions of similar size and with a similar degree of problem severity. In sharp contrast to the demand-based model of Ford and colleagues or AEDS, systems-based models project services on the basis of what should be rather than what currently exists. Following an estimate of the size of the population in need and an estimate of the proportion of this population which should be treated in a given year, the resulting number of treatment cases is apportionated into the treatment system according to specific percentages for the different types of care. The planning models reported in the NIAAA review (Kaelber & Nobel, 1982) for the states of

3 Estimating the required capacity of alcohol treatment services 51 Colorado, Massachusetts and New Jersey are the best examples of the systems-based approach. Each model begins with a general prevalence estimate (5%-8.4% of the population) and an estimate of the percentage of this population which should be treated each year (20%). The models then diverge with each using different categories and definitions of services, and different percentages of cases allocated to the various treatment settings. The main limitation of the systems approach is that opinions on what types of treatment settings should be provided vary substantially, depending on one's training, experience, and personal beliefs about the nature of alcohol problems {cf. Cook, 1985). High quality empirical research is not available to assist in making judgements about all aspects of the ideal alcohol treatment system. Thus, some expert and clinical opinions must be sought, and such opinions may be questioned by others holding a different view. Developing the Forecasting Model for Ontario A systems-based approach was adopted for the province of Ontario. The basic steps followed in developing the model were similar to the general steps recommended by Ford & Luckey (1983) for all forecasting models for alcohol treatment services: (1) Determine the geographic area and size of the population to be served; (2) Estimate the number of problem drinkers and alcohol dependent drinkers within each population unit (i.e. the in-need population); (3) Estimate the number of individuals from step two that should be treated in a given year (i.e. the demand population); (4) Estimate the number of individuals from step three that will require service from each component of the treatment system. In the remaining sections, each of these steps is more fully described. STEP J: determine the geographic area and size of the population to be served Forty addiction planning areas were defined, corresponding closely to the boundaries of the District Health Councils across the province. These councils are responsible for analyzing local needs and making recommendations to the Ministry of Health on the need for new or expanded health services. Most of the councils have Addiction Committees which are responsible for reviewing the need for alcohol and drug services on a regular basis. Data on the size of the population 15 years and older were obtained for each of the planning areas from the 1986 Federal Census. STEP 2: estimate the number ofproblem drinkers and alcohol dependent drinkers within each population unit (i.e. the in-need population) In Ontario, a broad framework for planning addiction services has been adopted which links various types of community intervention to different levels of risk of alcohol problems (Ontario Ministry of Health, 1989). This framework builds on previous work reported by Simpson & Rush (1985). In the Ministry's framework, each risk category is associated with an estimated level of weekly alcohol consumption (no risk = O drinks; low risk=l-14 drinks; moderate risk =15-34 drinks; high risk = 35 or more drinks). For present purposes, it is important to note that the high risk group is the target for treatment/rehabilitation and includes not only those individuals who are alcohol dependent, but also a substantial proportion of individuals with less severe alcohol-related disabilities. This mix of prospective clients, in terms of problem severity, must be refiected in the mix of treatment resources in the community (e.g. outpatient versus inpatient). Furthermore, the method for estimating the size of the high risk target group must be sensitive to this range of problem severity. A variety of methods have been used in the alcohol field to estimate the number of problem drinkers and/or 'alcoholics' in the population, this number then being interpreted as the size of the target population for treatment services. The three most commonly used methods are based on: (a) mortality rates in the general population for causes of death that are substantially elevated among heavy drinkers (Jellinek, 1959; Schmidt & delint, 1970). (b) local projections based on national population survey data concerning the level of alcohol consumption and/or negative consequences of alcohol use (Marden, 1974). (c) the average level of consumption of alcohol in the general population which, in turn, is estimated from alcohol sales data (Schmidt & delint, 1970). At the present time in Ontario, the alcohol con-

4 52 Brian Rusk sumption method is the only viable alternative at the county level for estimating the number of individuals who are drinking at the various levels of daily or weekly consumption. Prevalence estimates obtained via this method have been adopted, pending the outcome of future population surveys in Ontario which may yield new estimates by more direct means (e.g. Marden, 1974). The assumptions and limitations of the alcohol consumption method are acknowledged, in particular, the assumption that the variance of the distribution of alcohol consumption in the general population is approximately uniform in all planning areas; the lack of specificity to important population sub-groups; the potential bias created by inter-county travel for alcohol purchases; and the lack of data on the home brewing of wine and beer at the county level. These limitations notwithstanding, the reliability and validity of the approach is considered to be sufficient to justify its use in providing the required estimates of the in-need population for this type of system-level planning. In apphcations such as this, the method has the following advantages. It produces local estimates which are likely to be conservative compared to estimates based on mortality rates (Schmidt & delint, 1970; Single, 1979).* The prevalence estimates require data that are readily available at the county level, easily updated and more reliable over time than the data required for other estimation procedures (Furst & Beckman, 1981). Finally, the per capita consumption of alcohol at the county level in Ontario is highly correlated with a range of alcohol-related health and social problems and thus serves as a useful proxy for the level of these problems in the same population (Adrian, 1983; Rush, Gliksman & Brook, 1986). Based on the per capita annual rate of alcohol consumption in each planning area in 1985/86, the procedure yielded an estimate of the number of persons aged 15 and over, consuming 35 or more drinks per week (approximately 475 gms. or more absolute alcohol). This is the cut-off point for the 'high risk' target group, defined as being in need of advice/treatment from specialized alcohol services. Simpson & Rush (1985) and Rush (1987) provide background information on the methodology employed in deriving these estimates. For the province as a whole, this represents about *The degree of correspondence between estimates obtained by the alcohol consumption method and those obtained by direct survey will obviously depend on what cul-off points are ased in each of the two procedures. 7.2% of the population aged 15 years of age and over, or 8.6% of the drinking population. It must be noted, however, that the actual percentage of drinkers in each planning area which exceeds this cut-off point varies, depending on the per capita consumption level in the area. This is an inherent feature of the estimation procedure. Table 1 shows the resulting number of individuals in need within each of the local addiction planning areas. STEP 3: estimate the number of individuals from step 2 that should be treated in a given year (i.e. the demand population) In this stage of the procedure, an estimate is made of the proportion of the in-need population which should be planned for on an annual basis. This population is referred to as the target or the demand population. Ford (1985) described a method of deriving this estimate. In his research, an estimate of 20% of the in-need population was obtained by considering the following information: (1) Two-thirds of alcoholic clients drink again within one year of treatment. (2) The rate of increase in alcoholism is around 10% per year. (3) Considering the rate of recidivism and to keep even with this 10% rate of increase, 30% of all alcoholics should be treated in a year. (4) This figure should be divided in two because alcoholics constitute only half the in-need population. Thus, 15% of the overall in-need population should be treated in a year. (5) Add a 5% buffer to do more than keep pace with the growth of the problem. Therefore, 20% of problem drinkers per year are considered as the target population. Although this 20% is used in most of the American forecasting models (Kaelber & Nobel, 1982), it is important to note that it may represent a reasonable but still hypothetical target value at which a treatment network should be aimed. It does not represent an estimate of the actual proportion of problem drinkers who currently seek care in specialized resources. There is evidence that this proportion is somewhat lower than 20%. Estimates in the 5-15% range are the most common in the research literature, when the criteria for alcohol problems were sufficiently broad to include non-dependent problem drinking (e.g. Smart et al., 1980; Hingson et al, 1980).

5 Estimating the required capacity of alcohol treatment services 53 Table 1. Population 15 years of age and over and estimated number of individuals in need of specialized alcohol treatment for each addictions planning area Planning area Perth Huron Thames Valley Grey-Bruce Kent Lambton Essex Brant Waterloo Haldimand-Norfolk H ami lton-wentworth Niagara Wellington-Dufferin Halton Peel Region Simcoe Metro Toronta Etobicoke York City of Toronto North York Scarborough East York York Region Durham Muskoka Haliburton, Kawartha, Pine Ridge Hastings, Prince Edward Frontenac, Lennox & Addington Lanark, Leeds & Grenville Ouawa-Carleton Seaway Valley Renfrew Parry Sound Timiskaming-Nipissing Sudbury-Manitoulin North Cochrane South Cochrane Algoma Thunder Bay Kenora Total Population 15 years and over 51,468 43, , ,152 82,056 95, ,149 82, ,587 69, , , , , , , , , , , ,071 88, , ,950 32, , , , , , ,994 69,188 26,846 91, ,036 31,088 40,304 99, ,304 58,718 7,145,324 Number in need of specialized alcohol treatment' 3,230 2,660 24,860 8,280 5,900 7,130 17,290 5,290 18,030 4,600 23,540 21,600 8,580 14,090 25,880 17,330 17,560 8,090 37,700 33,130 25,710 6,360 12,450 16,430 5,340 15,900 8,510 9,810 7,740 32,370 7,250 6,060 2,990 7,640 13,335 2,800 3,640 8,780 11,740 7, ,840^ 'Rounded to the nearest 10. ^This value is the sum of the number in need for all planning areas combined. It varies slightly from an estimate made directly from the total population (N= 513,040). In the forecasting model developed for Ontario, a range of values was employed. Use of this range is meant to indicate that the proportion of the in-need population for which treatment services should be planned is not a fixed value. Indeed, this proportion is likely to vary across different areas of the province depending, for example, on the nature and extent of outreach and case identification programs and the level of awareness of existing treatment services. Low, middle, and high values of 10%, 15%, and 20% are used; the 20% value being a maximum, hypothetical target as described above. Based on this range, statistical tables subsequently generated for each local planning area contain a low, medium and

6 54 Brian Rush high estimate for the required capacity of each part of the treatment continuum. STEP 4: estimate the number of individuals from step 3 that will require servicefromeach component of the treatment system The service categories for which estimates were made are listed below with their definitions. Assessment/referral. Systematic procedures for the identification of a client's major strengths and problem areas culminating in a treatment plan and referral(s) for assistance. Detoxication. Services provided to clients intoxicated or in withdrawal from alcohol and/or other drugs. These may be provided under medical supervision or in a non-medical detox centre. Case management. The process of monitoring, tracking, and providing support to a client, throughout the course of his/her treatment and after. Outpatient treatment. Treatment provided on an non-residential basis, usually in regularly scheduled sessions (e.g. 1-2 hours per week). Day treatment. Intensive, structured non-residential treatment, typically provided five days per week (e.g. 3-4 hours per day). Short-term residential treatment. Treatment provided for an intensive, structured period of time while the client resides in-house. The length of stay is typically less than 30 days. Long-term residential treatment. Treatment and/ or rehabilitation services provided for a period of time typically longer than 30 days. These programs include recovery homes, halfway houses and three-quarter-way houses. Aftercare. Resources or services that provide continuing encouragement and additional services as needed, following a client's completion of a treatment plan. Fig. 1 illustrates how clients' progression through this continuum of care was conceptualized. Briefiy, of the total population of problem drinkers and alcohol dependent persons in need of treatment, some proportion should be planned for and treated at specialized addictions services. The remaining, and largest, proportion of those in need will either not seek any therapeutic contact, or will have some potential therapeutic contact at general health and social services or self-help groups. Of those presenting at specialized addictions programs, some will enter detox programs directly, while others will present to specialized assessment and/or treatment programs. From each of these two entry points, cases filter through various components of the treatment continuum including case management, assessment, treatment settings (outpatient, day, short and long term residential) and aftercare. Two points of drop-out are included in the model, the first being after assessment and before treatment; the second during treatment but before aftercare. Fig. 1 also shows the proportions estimated at each point of the planning model (e.g of the demand population going directly to detoxication services) and the capacity estimates resulting from the application of these proportions to a hypothetical target population of 10,000 individuals. The estimates for allocating individuals to the various treatment categories were made with varying degrees of confidence. Sources of information used to make these estimates were; (i) published research literature on patient characteristics, the cost-effectiveness of treatment, and rates of completion from treatment (ii) a client monitoring system operated by the ARF for assessment and referral services in Ontario (iii) a detoxication reporting system operated by the Ontario Ministry of Health (iv) a triennial provincial survey of alcohol and drug programs in Ontario conducted by the Addiction Research Foundation (v) informed opinion from clinical and research experts in the addictions field in Ontario (vi) the system-based forecasting models used in American jurisdictions The underlying rationale was that these sources of data would assist in establishing the level of service which ought to be provided in the optimal treatment system. The general strategy was to rely, where possible, on the empirical research literature to yield the best possible estimate of a given parameter in the model. For example, research on matching clients to treatment suggests that outpatient services may be most cost-effective for clients of high social stability and low levels of alcohol dependence (Miller & Hester, 1986). Given that about half of the target group of the overall planning model are considered to be non-dependent problem drinkers, it was estimated that about half the cases referred to treatment should be allocated to outpatient programs. Similarly, our literature review of rates of completion from treatment showed that about 15% to 30% of clients will drop-out and therefore not participate in aftercare programs (e.g. McWilliams

7 Estimating the required capacity of alcohol treatment services 55 (A. 10,000) (0.85) NO THERAPEUTIC CONTACT (112} (0.10) PROBLEM DRINKERS AND ALCOHOL DEPENDENT INDIVIDUALS (0.15) ANTICIPATED DEMAND FOR SPECIALIZED TREflTUENT (B-I500I (0.33) POTENTIAL THERAPEUTIC CONTACT PBIVATE MEDICAL PRACTICE COMM UNITY HEALTH CENTRES HOSPITALS SELF HELP PROGRAMS SOCIAL COF^RECT^0^J*L AGENCIES SELF-HELP PSYCHIATRIC CARE SOCIAL NEEDS CRISIS NTERVENTION CUSTODIAL CARE g CASE;MANJ\GEMEN" (248) / TOTAL SENT TO TREATMENT FROM I ASSESSMENT/CASE T TO OUTPATIENT ro DAY TREATMENT TO SHORTTERM MANAGEMENT 3RT.1 (862)\ TO LONG. TERM RESIDE (0"5) (0^30) RESIDENTIAL DENT (0.05) D.1C i U A PROPORTION OF REFERRED CLIENTS DROPOUT AT THIS LEVEL DIRECT TO LONG- TERM TREATMENT AND REHAB (0.25) (0.80) (0.80) (0.80) (0.80) (0,65) A PROPORTION OF TREATED CLIENTS DROPOUT AT THIS LEVEL (0.75) (0.80) I (0.85) I (0.70) A F T E R C A R E (575) Figure 1. Schematic diagram of client's progression through a comprehensive continuum of care. & Brown, 1977). If the empirical research did not exist to help set a particular parameter in the model, or if the research was judged to be of too low a quality, the next option was to look at current levels and patterns of service delivery and make adjustments where necessary. Adjustments were based either on need assessment data from various studies in Ontario or the United States, or qualitative judgements of need from individuals knowledgeable in that particular aspect of the alcohol treatment system in Ontario.* With respect to the development of these estimates it should also be noted that for each parameter of the model, there is really a hypothetical range of values, and the estimate selected at this time is the best estimate available for the mid-point of this range for the province as a whole. For example, the model estimates that 55% of the cases requiring specialized treatment following assess- *More details on the background information used in setting the various parameters are available from the author upon request.

8 56 Brian Rush ment, should be treated on an outpatient basis. This is selected as the best estimate available for the province. It could be argued with some justification that a slightly lower figure may be more reasonable for parts of the province with low population density and where travel to treatment is made difficult by road and weather conditions. Consideration will be given in future revisions of the model as to the need to develop slightly revised versions based on key demographic and geographic characteristics of the local addictions planning area. For the present, one model was developed for the province as a whole. Application of the model Are the results of the model readily generated for a given jursidiction and easily incorporated into a local or regional need study? Fig. 1 showed the results of the forecasting model as applied to a hypothetical population of 10,000 individuals in need of specialized treatment. Table 2 shows these results converted to a tabular format for easier application. Note that three capacity estimates are provided, corresponding to the range of estimates incorporated in Step Two for the size of the demand population, 20%, 15%, and 10%. The second row of Table 2 is reserved for an estimate of the current capacity of available services. The third row would show the net need which is the difference between the capacity estimates and current supply. Since this is obtained by straight subtraction of the first two rows, a high, medium and low estimate of unmet need is also obtained. These results would show, on a quantitative basis, those parts of the treatment continuum with the largest relative need, in terms of the number of individuals requiring treatment. A final step is then required to translate the number of individuals requiring treatment, to program operating units such as bed capacity and number of outpatient counsellors required. Summary and discussion This project arose from a very practical problem faced by government. How can funds for the treatment of alcohol problems be allocated on a rational and equitable basis to achieve the maximum benefit? There are two general approaches to this problem. The first is to develop a demand-based projection of the required capacity a projection based on historical patterns of utilization in areas of similar population size and severity of alcohol problems (e.g. Alcohol Epidemiologie Data System, 1982; Ford & Schmittdiel, 1983). The alternative approach is to develop a systems-based model of how an optimal treatment network should be structured based on research and informed opinion. Each approach has its advantages and disadvantages. The system-based approach was considered to be the most appropriate for Ontario, in large part because relevant government policy was calling for a new direction in the delivery of services. For example, a demand-based approach would not have been useful in projecting the need for specialized assessment/referral services or outpatient services designed for early-stage cases, since these types of programs have little or no historical basis in the province. In contrast to the demand-based methods, the systems approach was also viewed as the most appropriate vehicle by which to integrate new research findings in the alcohol field into government decision-making concerning the size and type of programs that will be funded. As new research data emerge concerning, for example, the matching of clients to treatment or the cost-effectiveness of different treatment settings, the model is fiexible enough to incorporate this information immediately into the planning process. Computer simulation of the model allows for efficient testing of hypotheses. Just as this approach provides a direct link from research to planning, it also shows how the planning process should contribute to the research agenda. For example, estimating the percentage of cases that should be treated on an outpatient or inpatient basis requires information about the client characteristics that are predictive of success in these different settings (e.g. level of alcohol dependence, social stability) and the distribution of these characteristics in the treatment population. Thus, research on the matching of clients to treatment can be undertaken with a plan in mind as to how the results will contribute to the funding and development of treatment services. How generalizable is the model developed in this project to other jurisdictions? In many respects, the model is specific to Ontario. For example, the recognition of two main entry points to the treatment network, non-medical detox programs and assessment/treatment programs, is not common to all treatment systems. Similarly, many parameters of the model should be sensitive to population density and other issues related to access to treatment services (e.g. weather conditions). Thus,

9 Estimating the required capacity of alcohol treatment services 57 U 3 y I "I 6 E ^ 1 1'^ Ct H Q ^ R n u - a u E.a III E 2 S- s E <J I J a 3 B t-.a E y "^ w fj O E "5. «3 -a ^ -S :- E * E oj.5 E '"C

10 58 Brian Rush the specific structure of the optimal treatment network and the values selected for all the parameters of the model may not be widely applicable in other areas. However, the general approach can be adopted and there are several features of the model which should be of interest to government funding bodies and local planning authorities (e.g. the underlying concept of a continuum of care, the importance of client assessment and the relative balance of residential versus non-residential treatment settings). The major limitation of the model at the present time is the exclusion of specialized drug treatment services. Consideration is now being given as to how the model might be expanded in this area. Estimating the prevalence of drug abuse and determining criteria for identifying the treatment needs of drug users, represent major hurdles. Work is also in progress to develop an alternative to the alcohol consumption method of estimating the prevalence of problem drinking at the county level. A methodology similar to that used extensively in the United States (Marden, 1974) is being explored, but is currently restricted by the lack of population survey data specific to Ontario. Studies attempting to validate some of the estimates made in this preliminary model for alcohol services are also under way. For example, we are seeking to establish the characteristics and optimal treatment needs of a cross-section of clients presenting to selected assessment/referral centres in the province. Preliminary data suggest that the model in its current form may be under-estimating the need for short-term residential treatment given the extent of crossaddiction, and other presenting problems such as psychiatric disability, in the client population. As noted above, the model will be revised on a periodic basis on the basis of new research data and experience gained in application. Finally, will such a systematic approach to planning new services actually work in a political environment with many competing perspectives on the nature of alcohol problems and the best treatment approach? This will depend on many factors, not the least of which is the commitment of local planning authorities and government funders to follow through on the results provided by quantitative planning models such as this. At the provincial level in Ontario, the results have contributed to the development of new priorities for program development by showing the striking imbalance in the current treatment network regarding residential versus non-residential treatment alternatives. The model is now being applied at the local level around the province and preliminary results show it can make an important contribution to the identification and priorizing of local needs (Wellington-Dufferin District Health Council, 1987). It must also be recognized, however, that the results of a forecasting model such as described here, should not be used as the only indicator of need, but rather as information to complement other qualitative and quantitative data. Acknowledgements I would like to thank Robert Simpson, Alan Ogborne and Kate Graham for their ideas and comments during the development of this work. The collective contributions of staff of the Community Mental Health Program, Ontario Ministry of Health are also very much appreciated. The views expressed in this paper are those of the author and do not necessarily reflect those of the Addiction Research Foundation. References ADRIAN, M. (1983) Mapping the severity of alcohol and drug abuse problems in Ontario, Canadian Journal of Public Health, 74, pp ALCOHOL EPIDEMIOLOGIC DATA SYSTEM (AEDS) (1982) Procedures for assessing alcohol treatment needs (Rockville, MD, National Institute on Alcohol Abuse & Alcoholism). COOK, D. R. (1985) Craftsman versus professional: Analysis of the controlled drinking controversy, Journal of Studies on Alcohol, 46, pp FORD, W. E. (1985) Alcoholism and drug abnse service forecasting models: comparative discussion. International Journal of the Addictions, 20, pp FORD, W. E. &LUCKEYJ. W. (1983) Planning alcoholism services: a technique for projecting specific service needs. The International Journal of the Addictions, 18(3), pp FORD, W. E. & SCHMITTDIEL, C. J. (1983) Predicting alcoholism service needs from a national treatment utilization survey. The International Journal of the Addictions, 18(8), pp FURST, C. J. & BECKMAN, L. J. (1981) Alcohol-related mortality and alcohol consumption statistics. Journal of Studies on Alcohol, 42(1), pp HiNGSON, R., SCOTCH, N., DAY, N. & Ctn,BERT, A. (1980) Recognizing and seeking help for drinking problems. A study in the Boston metropolitan area. Journal of Studies on Alcohol, 41 (11), pp JELLINEK, E. M. (1959) The disease concept of alcoholism (New Haven, CT Hillhouse Press). KAELBER, C. & NOBEL, J. (1982) Procedures for assessing alcohol treatment needs (Rockville, MD, National Institute on Alcohol Abuse & Alcoholism). MARDEN, P. G. (1974) A procedure for estimating the

11 Estimating the required capacity of alcohol treatment services 59 potential clientele of alcoholism service programs. U.S. Department of Health, Education and Welfare (Rockville, MD, Alcohol, Drug Abuse & Mental Health Administration). MARSHMAN, J. (Chairperson) (1978) The treatment of alcoholics: An Ontario perspective. Report of the Task Force on treatment services for alcoholics (Toronto, Addiction Research Foundation). McWiLLiAMS,J, & BROWN, C. (1977) Treatment termination variables, MMPI Scores and frequencies of relapse in alcoholics, Journal of Studies on Alcohol, 38(3), pp MILLER, W. R. & HESTER, R. K. (1986) Matching problem drinkers with optimal treatments. In: W. R. MILLER & N. HEATHER (Eds) Treating Addictive Behaviors: processes of change, pp (New York, Plenum Press). OGBORNE, A. C, RUSH, B. R. & DWYER, D. (1985) The development of community-based treatment systems: an Ontario perspective, British Journal of Addiction, 80, pp ONTARIO MINISTRY OF HEALTH (1985) Addictions Services Policy (Toronto, Community Mental Health Program, Ontario Ministry of Health). ONTARIO MINISTRY OF HEALTH (1989) A Framework for the Response to Alcohol and Drug Problems in Ontario (Toronto, Community Mental Health Program, Ontario Ministry of Health). RUSH, B. R., GLIKSMAN, L. & BROOK, R. (1986) Alcohol availability, alcohol consumption and alcohol-related damage. I. The distribution of consumption model. Journal of Studies on Alcohol, 47, pp RUSH, B. R. (1987) Alcohol Consumption in Ontario's Counties and Regional Municipalities, , Internal Document No. 94 (Toronto, Addiction Research Foundation). RYAN, K. ( , Winter) Assessment of need for alcoholism treatment services: Planning procedures. Alcohol and Research World, pp SCHMIDT, W. & DELINT, J. (1970) Estimating the prevalence of alcoholism from alcohol consumption and mortality data. Quarterly Journal of Studies on Alcohol, 31(4), pp SIMPSON, R. & RUSH, B. R. (\985) A programmer's guide to alcohol consumption statistics. Internal Document No. 57 (Toronto, Addiction Research Foundation). SINGLE, E. W. (1979) Estimating the number of alcoholics in Ontario: A replication and extension of an earlier study, Journal of Studies on Alcohol, 40(11), pp SMART, R., GILLIES, M., BROWN, G. & BLAIR, N. (1980) A survey of alcohol-related problems and their treatment, Canadian Journal of Psychiatry, 25, pp WELLINGTON-DuFFERiN DISTRICT HEALTH COUNCIL (1987) Wellington-Dufferin District Health Council Addiction Services Review: Final Report (Guelph, Ontario, Wellington-Dufferin District Health Council).

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