By Jordan Baker and Perry Duffin
In a neighbourly gesture, a suburban rehabilitation centre threw open its doors for a day. The property used to be a brothel, which was once promoted by famous Hollywood madam Heidi Fleiss, so locals were keen to spot any relics from its bordello days. They were not disappointed.
The patients, many bailed there by courts, slept in windowless dorms with mirrors on the walls and ceilings. There were dancing poles, spas and statues of naked women. The old bar was there, with poker machines and a pool table. There didn’t seem to be much evidence of drug and alcohol treatment. Still, the centre operated for a year and closed only when police charged the owners with hiding a meth lab on the premises.
This brothel was operating as a rehab facility until a meth lab was discovered on the premises.
Anyone can open a private rehabilitation centre. “You could set up a rehab tomorrow,” says Ruth Limkin, founder of Sana Health Group. No licence or qualification is required. Private operations range from high quality to wild west. Private facilities can charge what they choose, provide what treatment they want and expel at will while keeping the money. There’s little protection for victims of unscrupulous operators, whose families are so desperate for help amid an acute shortage of beds that they don’t read the fine print (if there is any).
A Herald investigation has heard allegations of serious problems in NSW’s private industry, which can include centres operated by fringe charities as well as for-profit businesses; centres that take bribes to overlook positive drug tests, or turn a blind eye to sex workers, or refuse to provide prescribed medication because recovery is in God’s hands. “It’s quite scary,” said the manager of a respected, publicly funded facility in Sydney, on the condition of anonymity so he could speak freely.“[Many centres] have all these people with no qualifications doing who knows what.”
Some private operators have identified a lucrative market; people facing criminal charges, often serious, who are willing to pay high fees to avoid prison remand. Their lawyers argue they deserve a shot at rehabilitation in a more supportive environment than prison, and they sometimes offer the court extra reassurance in the form of a privately monitored ankle bracelet, paid for by their client. Treatment is important, courts are busy and the judiciary must make decisions using the information they have in front of them, with no regulator to vouch for the centre’s quality.
But this mix of under-regulated rehabilitation and privatised bail alternatives can be dangerous. That became evident in January, when a man facing serious drug-smuggling charges allegedly fled a private rehab facility that was already facing questions about its security (Hussein Chamas, whose brother had put up a $3 million surety, made a run for Indonesia, before being intercepted). Authorities belatedly realised the company operating his ankle monitor, BailSafe, appeared to no longer be operating.
Victoria has done a major review of its private rehab industry, prompted in part by scandals such as the bordello-turned-rehab-turned-meth lab. Western Australia promised regulation after an inquiry into the Esther Foundation, a private rehab, uncovered allegations of exorcism, gay conversion therapy and faith healing. But despite stories of similar problems in NSW, and calls for urgent reform, there has been no action here.
Alleged drug importer Hussein Chamas allegedly fled a NSW rehabilitation centre without any notification from the BailSafe ankle monitor on his leg.
“There’s a complete lack of accountability; no oversight, no regulation, and it’s dangerous,” says NSW Greens justice spokeswoman Sue Higginson. “The government needs to establish, with urgency, a comprehensive review into anybody out there offering [private] rehabilitation centre services, and particularly ones that are connected with the justice system. It’s time to close that dark side of the sector down once and for all.”
The Herald has heard serious allegations from patients, their family members and their lawyers of unscrupulous practices at NSW private rehabilitation centres, which have no interaction with authorities because they are not government-funded.
Multiple sources said they have witnessed or been told first-hand about open drug use within facilities, which is either tolerated by management, or which flies under the radar due to poor supervision. The drug known as liquid G (or GHB) is especially popular, as it’s not picked up on standard drug tests. Several sources said centres had been known to accept money in return for overlooking positive drug tests; others said patients with drug addictions had been allowed to openly drink alcohol.
A West Australian inquiry heard allegations of exorcism, gay conversion therapy and faith healing conducted on the premises of the Esther Foundation, a private rehabilitation facility.
Industry sources also claimed some accused criminals were lying about having a drug addiction so they could live on bail at a rehab facility instead of within a remand centre, and that details of less rigorous facilities were shared in prisons so they knew which centres to choose. ”The guys who are making lots of money [out of allegedly supplying or smuggling drugs], they’re not taking drugs,” said one veteran of the industry. “You make bad decisions when you use the product.“
Parents and patients were also concerned about extreme religious practices at private facilities, such as talking in tongues over patients, pressure for immersion baptism and compulsory church attendance. “I have had many people on the end of my phone talking to me about their loved ones’ experiences within private rehab centres, saying they were forced to engage in really inappropriate religious programs,” says Higginson.
Some claim rehab centres have allowed unsupervised weekends away in contravention of bail conditions, overlooked visits from sex workers, and turned a blind eye to sexual relationships with neighbours. There are claims that patients have been contracted to do manual labour and the proprietor has pocketed the fee.
When alleged victims were aware of the lax conditions or lack of serious treatment at a court-ordered private rehabilitation – particularly if the alleged crime against them involved domestic violence, assault or threatening behaviour – it could be deeply distressing, says Higginson. “It’s a gross injustice when you’re standing in the shoes of any victim,” she says. “Victims deserve and should be able to expect a system that’s based on principles of equity and accountability and transparency.”
The Victorian Health Care Complaints Commission uncovered alarming practices during its probe of the industry, which was funded by the state government. Its report details a litany of concerns, including a provider operating in several states even though it was banned in South Australia; the patient who spent six days a week doing manual labour at a property without payment, while also signing over his Centrelink benefits; and the woman who discharged herself after less than a day when she learned she was sharing the facility with accused criminals, but was not allowed a refund.
One woman paid $20,000 for a facility for addiction and mental health treatment after she attempted suicide, but she was not asked for a full medical history and was taken off most of her medication. She self-harmed three times, the report says. Another young man with a lifelong mental health condition paid $25,000 but found there was no psychologist on site, the centre altered his medication without his family’s knowledge and it did not have the expertise it advertised.
The report says private providers should be regulated in the same way as public ones. The intersection between extreme shortages of rehab services, “the vulnerability of clients, and the for-profit mode of treatment is the space where poor consumer outcomes occur”, it says. Many in the rehabilitation industry agree, including Richard Stirling, chief executive of the Network of Alcohol and other Drugs Agencies, which represents the not-for-profit sector. “Normally, what our sector sees is the aftermath of people coming into our services that have had bad experiences in private rehab,” he says.
Limkin’s Sana group is a private rehabilitation operator. She would like to see licensing, too, partly because unscrupulous operators give the sector a bad name, but mostly to protect patients. “It will make it much easier for people who are trying to select a treatment provider, to know that they’re selecting a quality provider,” she says. “For those of us who are in the sector and are passionate about quality, we would be welcoming that. There is a place for the non-government sector because the government is not providing enough resources.”
Police arresting Chamas and two others allegedly sailing to Indonesia from the Northern Territory late last month.
The courts are also frustrated by the lack of rehabilitation options, says one veteran of the rehabilitation sector. “They want an alternative to jail, but there aren’t any,” he says.
Barrister Brad Williams has directed many clients to rehabilitation, which he says is one of the best ways to protect the community. One of the purposes of sentencing is to try to stop people returning to the justice system. The public might want punishment, but there’s a strong link between drug use and offending. “The ability to actually send people to get the treatment they need [is] in the interest of public safety and health. It’s just not readily available.”
One of the practices supporting bail to private rehabs, self-funded ankle monitors, is already under the microscope. Chamas allegedly wore a BailSafe ankle monitor when he fled his facility in early January, but no alarm was raised. It wasn’t until February 4 that the Department of Communities and Justice notified the Law Society that BailSafe may have ceased operations without notice to either the court or the people being monitored. It’s unclear if BailSafe’s programs are continuing in the absence of the company itself. BailSafe’s email and phone number were no longer operating when the Herald attempted to contact the company.
The privatisation of bail options, in rehab and via ankle monitoring, go to another issue; equity. They cost tens of thousands of dollars, Williams says, and create a clear class divide. Poor people dry out on remand, while the richer pay for facilities with pools and tennis courts. “It’s about whether or not people can actually access it when they need to, and there’s just not enough places,” he said. “The public perception might be that it’s the easy way out, but it’s not an option that’s available to most.”
NSW Attorney-General Michael Daley has asked for urgent advice from the Department of Communities and Justice about options for better oversight of rehabilitation facilities in relation to bail, which would include ways the courts could get better verification from private providers before granting bail. The Bail Act Monitoring Group is also looking into private rehabilitation and ankle monitor providers.
Western Australia has still not regulated the private rehabilitation industry, although its health minister Amber-Jade Sanderson has promised to do so if Labor is re-elected. She has urged the public to avoid private rehabilitation facilities until it is. Since its review, Victoria has done “nothing”, says one person with in-depth knowledge of the state’s rehab sector, speaking on the condition of anonymity so they could speak freely.
“It’s been a handball between the feds and the state to say how this should be responded to. It continues to be a massive issue. It’s largely invisible because there’s no data kept on it. People with drug and alcohol issues, facing the stigma and the stress of their situation, aren’t going to have the ability or time to prioritise making complaints about private institutions. It’s a mess.”
NSW Health says it’s a matter for the NSW HCCC and Health Minister Ryan Park did not respond.
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