TCIE 3 The Policy Context (Spain)

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III .The policy context of therapeutic communities, giving examples of different treatment methods, what type of patients are tipically admitted to TCs, and where TCs fit into a comprehensive system of health care.

The TC\'s political approach

During the first years of drug dependence in Spain, (1977-1983), the directors of the TCs had to undertake the role of being the main individuals dealing with this social problem that affected and worried many drug addicts and their families and they were able to implicate little by little the different private and public organizations and entities. Their policy consisted in raising awareness and in moving the Spanish society to action. This activity helped to begin to break with a very common fatalistic stereotype at this time: "the drug addict is irrecoverable", "what we have to do is separate them from society". During these years there was no public funding available, TCs could only obtain financial support from the capacity of fund-raising activity of the responsibles of the centers and from the financial help of the families.

When the "National Plan Against Drug Addiction" (PNSD) was created in 1985 a public funds budget was made available and at the same time the idea of accreditation and authorization of the centers was promoted. The TCs, the NGOs and the programs on treatment and prevention of drug addictions began to receive grants in accordance to the terms of the PNSD. The creation of the Association of Professionals of the TCs and the promotion of a Standard System of Evaluation between the TCs was an indication of the need of assesing quality performance. In 1984 the first Proyecto Hombre TCs were opened. An important element to emphazise is the implication of volunteers in the work with drug addicts specially promoted by Proyecto Hombre at its centers. They are not only reducing costs but over all they are a way of raising awareness and inviting society to solidarity towards this group of people. At the same time for the clients, the volunteers are a point of reference of human solidarity and cost-free status.

Since the nineties there is a "normalization" of the problem of drug addicts, new profiles of addicts appear and the PNSD promotes the Methadone and Harm Reduction Programmes. This means that addicts are taken care of by the Government\'s health and social security. Public financial support diversifies, other kind of treatments are funded by Government and the TCs suffer important deficit. Some of them are forced to close. The policy of some of the TCs, amongst them Proyecto Hombre, is to diversify and request funding from different sources in order to avoid economic dependance from one only source.

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