A survivor of a highly controversial religious rehabilitation facility in Perth's hills says it's disappointing the state government has largely failed to regulate similar centres.
More than 70 witnesses appeared before the 2022 inquiry into the Esther Foundation, detailing practices ranging from exorcisms to gay conversion therapy and to tying patients to their beds for extended periods.
Survivor Gabriel Osborne formed Flying Free to advocate for people who had experienced harm from mental health and/or alcohol and other drug services in Western Australia.
He says recent allegations of patient mistreatment at a private facility north of Esperance, on WA's south coast, show the government needs to act on regulating the sector.
Multiple former Adult and Teen Challenge residents spoke to the ABC last week about their concerns with the facility, including poorly trained staff, restricted medical services and unaccountable spending.
Adult and Teen Challenge WA executive director Steve Hall vowed to review the program.
The ABC does not suggest that the practices at the Esperance facility are comparable to those at Esther House.
But Mr Osborne said the residents' experience highlighted the urgent need for regulation.
"People who have addiction issues and who have mental health issues are people, and they deserve to be treated well," he said.
"The government is showing currently that it doesn't care [about them] enough."
The Esther Foundation inquiry found that alcohol and drug treatment services that do not receive government funding were unregulated.
The same was true of mental health services that do not receive government funding, with private psychiatric hospitals the sole exception.
The government vowed to reform the sector, but that is yet to happen.
"Work to progress updated legislation is ongoing," a WA Health spokesperson said.
"[It] aims to introduce mechanisms to ensure the efficient and effective regulation of private health facilities, including mental health and alcohol and drug services."
'It's a really harmful practice'
The ABC has seen evidence that one former Adult and Teen Challenge resident, who did not wish to be named, tried to raise concerns with government agencies and regulators.
She has been told there is little they can do until WA changes laws around unlicensed alcohol, drug and mental health treatment providers.
Mr Osborne said the lack of action was disheartening.
"To see nothing change, it really feels like a punch in the face," he said.
He said his organisation had been contacted by concerned former residents from about six unlicensed alcohol and drug services.
He said many had concerns about staff having been residents themselves until recently.
"It's a really harmful practice because there's also residents who are then actually committing harm, unknowingly, to other residents of these services," he said.
"And it becomes a vicious cycle."
Mr Osborne believes part of the state government's hesitancy to reform the sector was because it risked widening the gap between demand for rehabilitation services and the beds available.
But he said many operators should be able to adapt to meet future regulatory requirements.
"There needs to be a lot of education," he said.
"The service providers and the people already treating people aren't going to suddenly know how to do good practice — there needs to actually be training."
Mr Osborne also pointed out many people had good experiences with unlicensed alcohol and drug rehabilitation services.
"[But] that doesn't discount the experiences where people feel like they've been harmed," he said.
Regulatory process will take time
Western Australian Network of Alcohol and other Drug Agencies (WANADA) chief executive Jill Rundle said staff and skills shortages were a broad problem in the sector.
She said most services typically employed qualified counsellors, who she would expect to have alcohol or drug expertise.
She also said most were actively expanding their capability to address areas like mental health.
"[But] this all depends on resourcing [and an] available workforce to ensure it can happen," she said.
"The mental health sector also needs to build its capability to be responsive to co-occurring niche issues and needs."
Adult and Teen Challenge said it has Institute for Healthy Communities (IHCA) accreditation.
Ms Rundle said while this did not negate the need for regulation, it was "definitely a clear move towards demonstrating a commitment to continuous improvement".
She said it was "incredibly encouraging" the government had vowed to introduce regulation and noted the process would take time.
"It's not just something you flick a switch and it happens," she said.
Adult and Teen Challenge director Steve Hall said he would support the introduction of regulation, but believed it was important the sector was still able to offer a variety of treatment models.
"[Regulation] wouldn't make much difference to us at all," he said.
"But we would welcome it."
