National census of UK alcohol treatment agencies: II. Differences between types of treatment agencies in England and Wales

From data provided by a national census of treatment for alcohol problems in 1996, this paper reports findings on differences between types of treatment agencies in England and Wales. The overall response rate was 44% but no significant differences were found between responding and non-responding agencies in size and composition of staff. The highest mean number of clients per day was seen in NHS trust services and charitable organizations. Private (for profit) agencies showed both the highest mean age of clients and the highest proportion of men among agency types, while NHS trusts saw the highest proportion of women. Charities and voluntary organizations reported higher than average proportions of clients living in insecure accommodation. Private (for profit) agencies showed both the lowest proportion of unemployed clients and the highest proportion of those on sickness or invalidity benefits. Seventy-three per cent of clients attending NHS trust services were seen by nurses, medical or non-medical professionals; only 8% of clients attending private (for profit) agencies were seen by these professional groups. Worries about physical health were far more common among clients attending private (for profit) agencies and legal/financial problems occurred much more often among those attending voluntary/statutory partnerships. The highest proportion of clients in residential treatment was shown in private (for profit) agencies and the lowest in voluntary/statutory partnerships and NHS trusts. Nearly all (90%) treatment carried out by voluntary/statutory partnerships was in the form of 'counselling', while approximately half the clients seen by charities and independent (non-profit) organizations were in day or residential treatment. While in the overall sample, the mean percentage of clients also attending Alcoholics Anonymous (AA) was 9%, this rose to 23% of clients attending independent (non-profit) agencies. The highest proportions of clients with reported illicit drug use was in voluntary/statutory partnerships and the lowest in independent (non-profit) agencies. This paper provides a 'snapshot' of the variation in treatment services for alcohol problems in England and Wales, which can be used to detect trends in treatment provision in the future.