Profile - Substance Abuse Treatment and Rehabilitation in Canada

Standards, monitoring and evaluation

As the direct delivery of treatment services devolves to regional bodies, provincial ministries are becoming more involved in setting and monitoring service delivery standards, in both the prevention and treatment areas. Notably, the British Columbia government has contracted with CARF, the Rehabilitation Accreditation Commission, a U.S.-based organization, to manage a credentialling system in which treatment programs receiving government funds will, over time, be required to participate. Begun in 1991 as a pilot, 21 agencies have been surveyed and accredited. In Manitoba, there are standards for all services run by the Addictions Foundation of Manitoba and standards are part of new funding agreements for services funded by Manitoba Health. In spring 1997, the Nova Scotia government introduced treatment and prevention standards for substance abuse services delivered by regional health boards. No government currently oversees treatment delivery standards for private agencies where they exist. Plans for a province-wide policy in Quebec in the early 1990s did not materialize; however, several regions in that province are moving ahead to apply standards for private agencies.

Client information systems are in place in almost all jurisdictions. These systems typically capture basic intake (i.e., client characteristics) and service information. When fully developed, the systems in Ontario and Nova Scotia will also monitor service costs.

More intensive evaluations of service have been conducted in some provinces, particularly Manitoba, Alberta and Ontario. Efforts to increase program evaluation are underway in most other regions, as resources permit. Just under half of the programs responding to the program survey indicated they have conducted client satisfaction surveys, while 26% report having conducted quality assurance evaluations. Twenty-eight percent of agencies indicate that their own staff have conducted outcome evaluations, and 14% have had independent outcome evaluations conducted. CSC continues a long tradition of substance abuse treatment evaluation within the Canadian justice system (Ogborne, Smart & Rush, 1998).