‘Complex needs’, ‘hard to reach’, ‘entrenched’ are just a few of the terms used to describe those who encounter difficulties with addiction. Services are geared up to meet the varying needs of individuals but quite often without a joined up approach, meaning they circumnavigate the individual.
My simplistic method to meet this type of need starts at a very basic level. A warm greeting, non-judgemental attitude and a genuine willingness to support a fellow inhabitant of planet Earth. Surely this is the basis by which we can positively influence the lives of those who have been damaged by addiction (and other streams of negativity that divert people from living a meaningful and productive existence)?
The service that I manage, a peer led drug and alcohol service user involvement team (SUIT) initially gave me an opportunity, in 2007, to share my experiences of addiction with others that had been blighted by a similar evil. Fresh out of detox, this time of my life primed me to professionalise my chaotic past in such a way that enabled others to gain hope and inspiration from ‘one of their own’. After a short time volunteering, I quickly progressed to my current position as manager of an innovative service providing a dynamic approach to supporting vulnerable people in society.
It soon became apparent that this service could not only provide a platform for service users to feed in to the system, but actually deliver immediate interventions, by trained individuals, to meet a wide range of needs that are present when people first access treatment services. With this emerging trend, I wanted to ensure that all areas of work were captured in a meaningful way. So, I developed a recording and monitoring system that allowed this to take place. Not just so that funders and other interested stakeholders could understand what was happening, but mainly because of an innate desire to understand the evolving needs and requirements of the ‘complex needs’, ‘hard to reach’ and ‘entrenched’ people, one of whom I used to be.
So in 2014/15 when we analysed the variety of needs that presented at SUIT, we counted 59 categories including bereavement, trauma, mental health, indebtedness, homelessness, unemployment, immigration, poverty, illiteracy, substance use and many more. This process highlighted that vulnerability comes in many shapes and forms. We delivered over 2600 interventions, to the equivalent 57 percent of the drug and alcohol service user population in our locality, with just 2.4 percent of the local budget allocation. We worked in collaboration with 364 different agencies, companies, departments and organisations to meet individual need. Additionally, we have supported 133 of our peers into employment in the past 4 and a half years.
With this increased variety of presentation came an opportunity to develop competencies, networks and the professional development regimes within our service, allowing for the delivery of effective multi-layered interventions. This approach would not be necessary if the multitude of services involved in supporting those affected by addiction worked in a synchronised fashion, but unfortunately this is rarely the case. I don’t feel that this is anyone’s fault in particular, as individual services with scant resources will inevitably deliver on what they are contracted.
Drug and alcohol treatment services’ main focus is to maximise successful completions and minimise re-presentations. There are of course other areas that are highlighted, for example reducing blood borne virus transmissions and reducing the number of drug related deaths. However, these examples hinge upon a partnership based approach which in itself can complicate the process and desired outcome. My personal belief is that there is a key word missing from the term ‘successful treatment completion’, namely ‘quality’. For me a quality successful treatment completion is when an individual leaves treatment services, not only with control over their substance use, but with increased positive social networks, safer & more comfortable housing, higher levels of education/training, lower levels of indebtedness, increased personal resilience, increased employability awareness, more confidence, and overall better connectivity with society. For this to take place within a single treatment episode depends on the motivation, aspiration and knowledge of the service and staff involved, as well as the service user themself.
Far too often services operate in silos, which can be detrimental to those that they collectively support, advise and guide. At the very least, there should be a cross partnership approach where joint outcomes/outputs are universally understood and aspired to. This may be achieved via more innovative commissioning and contracting arrangements, producing cross-sector outcomes which will ultimately lead to more people achieving a whole person recovery and increased levels of citizenship.
We all have the right as human beings to live an enriched quality of life with beautiful experiences. This can be hampered by numerous factors at varying times. It is the duty of each one of us to positively impact the journey of others who are disaffected by their circumstances. Individually and collectively, we have many opportunities to create social change – this is a responsibility that we all must embrace, at all levels.
Whole person recovery, a project that the RSA are running in collaboration with national treatment provider CRI, aims to unearth the mystery of how to fully meet the needs of drug and alcohol service users and will be releasing a report on their findings next week. The report will be available to download here.
Sunny Dhadley is the manager of Wolverhampton SUIT and director of The Recovery Foundation CIC. In 2014, the SUIT model was awarded the highest accolade in the UK for a community, or voluntary organisation namely The Queen’s Award for Voluntary Service (equivalent to MBE).
Recovery in terms of ‘health’ care, rather than ‘sick’ care, and a long term focus on wellbeing, instead of simply treating the symptoms, is at the core of our latest report.