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Archive for the ‘addiction’ Category

Today “The House of Lords science and technology committee said ministers seemed to be mistaken in their use of what is known as the nudge theory.”  ( http://www.bbc.co.uk/news/health-14187802 ) Nudge theory is the idea that changes are made to the social and physical environment without legislation that encourage (or discourage) specific behaviour. One example of this would be for fast food restaurants to have salad rather than chips as the default side order.

The committee made the point that a balance of approaches should be used rather than relying solely on ‘nudging’ people.  This seems a blindingly obvious ‘finding’ for anyone who has worked personally or professionally around changing problematic behaviours.  Perhaps this is more about where power and influence truly lies rather than personal perspectives on what is a sensible approach. 

My point here is there is already a very well balanced set of approaches to something like illicit drug use where the agenda is quite simple.  The problems with balanced approaches and the use of legislation become far more complicated when things like minimum prices for alcohol and supermarket food labelling are on the agenda.  The challenge with the use of legislation here is that some influential organisations and individuals might lose money; suddenly there is apprehension about moving forward.

It’s great to see all the ‘courageous’ stands by politicians about ‘the press’ in light of the News of the World scandal.  But it seems unlikely that the same courage is going to follow through into other areas.

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The Children’s Society yesterday reported on the numbers of pre-teen runaways increasing (link below) and the risks that these young people face once they have fled their home or care. The report noted that a child runs away from home every five minutes in the UK and one in three of these will go unreported.

As a society we seem easily able to understand the impact that this type of thing has on children and how unacceptable it is that they are left in such a vulnerable position. The report also said:

“Agencies are unaware of the scale and nature of the problem and often fail to see runaways as children in need. Yet the report reveals that a quarter of them are forced to leave, often fleeing violence, abuse and chaos at home.”

For us we know these young people who miss out on a good start in life and then slip through the net of services all too often end up as adults with some fairly challenging support needs. The tough bit for us to swallow is when these people aren’t children anymore ‘as a society’ we seem to think differently. But they are the same people with the same traumatic pasts, they simply can’t be seen as ‘helpless’ anymore even though they are officially vulnerable adults.

A few hundred years ago these people were known as ‘sturdy beggars’, and were punished for begging when they were physically able to work. Today society is still obsessed with people’s physical ability to work and blames ‘choices’ to become drug or alcohol dependent adults or their irrational and problematic behaviour as the reason for their situation. As the above shows we have to get away from the physical and have more capacity to work with the emotional and psychological state if people in this situation are to find a way to reach their own potential.

http://www.childrenssociety.org.uk/news-views/press-release/report-worrying-new-trends-increasing-pre-teen-and-male-runaways

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Jon, one of our support workers shares the experiences of a day ‘at the office’ in Huddersfield:

As I was walking down to the Mission to meet Tim I bumped in to Julie who I have been doing some short term work with regarding her abusive relationship and domestic violence. She had blood on her coat and clothes and what appeared to be a cut on the side of her head. I spent some time talking to her and tried to get her to either go to the doctors’ or to let me call her an ambulance due to the fact she had a head injury. She refused to go seek any medical help and insisted she was fine. While talking to her she informed me that she had been stabbed in the leg with a screwdriver repeatedly and had been attacked by her husband but she still refused to see a Dr or to have an ambulance called.

As I had an appointment to go to and I could not get anywhere with Julie and she insisted on staying in the park I went to meet Alan. I managed to book him an appointment at the Doctors’ in order to talk to the Dr about his mental health and the options available to him for treatment. While waiting for the appointment we managed to phone and restart a benefits claim for him and he is now just waiting for the statement to be posted ou.

I also called the addiction service for Alan to talk to his worker there about his community order. When I managed to talk to his worker there she told me that he had not been engaging, as we knew, and that all efforts on their part from home visits and outreach that they had been unable to re establish contact. His worker was keen to help me to help Alan re engage with herself, his
CPN and probation and gave me the names and contact details of his probation officer and his CPN. On contacting these I managed to establish that Alan has been discharged from the mental health team due to non engagement, however they are willing to re asses him if the need arises. I was also told by probation that if Alan re engages with either the addiction service or probation or both them he would not be in breach of his community order and they could work to sort things out for him. I made an appointment for Alan at Lifeline tomorrow at 10am, his worker agreed to contact me to let me know if he did or did not attend so that we can discuss ways to help him to engage.

At the doctor’s appointment Alan was told that he needed to start re engaging with the addiction service as his short to medium term problems were best addressed by them and that once engaging with them more medium and long term solutions could be considered for his mental health. Alan gave the doctors’ permission to share his information with me and to contact him through me. From this I learned that when Alan was discharged from hospital his assessment was that there were no mental or psychological needs and that he was not in need of any medication. I am not sure if this diagnosis/assessment is still accurate as Alan talks about hearing voices and has told me he is a paranoid schizophrenic. He does exhibit signs of increasing paranoia and has been very agitated since the passing of a friend of his.

Later on when I went back to the mission I was told that an ambulance had been called for Julie as she was looking to be very sleepy and people were worried about her injuries. I talked with the paramedics and because she refused to be taken to hospital there was little they could do except to inform us of the signs to be aware of with head trauma. After this Julie wanted to go to a housing appointment we had booked previously and so we went up and presented at housing.

Initially they processed the application as a domestic violence application but after going through the interview and checking details the only places they could offer were in Keighley or Rotheram, neither of which Julie wanted to go to for differing reasons. As she had been sleeping rough for 2 nights we managed to go down the rough sleeper process rather than domestic violence. Once this was done they found her some temporary accommodation in until such a time as they can give her a temporary flat.   Julie was over the moon with this and was very thankful that I had managed to get her somewhere to stay and said that although she still felt scared she did feel safer. I called into the mission with her on the way back in order to make a referral for clothes as the only ones she had were the ones she was wearing and they were all covered in blood. Julie appeared to be ok when I left but I’m still worried and will catch up with her again as soon as I can.

 Jon, Support Worker

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Our support worker in Bradford, Mat, who is new to us and quite new to our service user group is asking some great questions!  For instance yesterday he spent a few hours trying to support a guy to get some housing who had just been evicted from a hostel.  As always with our service users things are never straight forward and there is probably more to learn, but the reason for his eviction (or at least a contributing factor) is to do with him either having alcohol or consuming alcohol on the premises.

The challenge for Mat is that the guy only moved into this hostel about a week ago.  He has a massive alcohol problem.  So Mat’s questions are why was this person referred to and housed by a hostel that has such strict rules about alcohol on the premises.  The job in hand today should have been done a week ago and without the challenge of a recent eviction making supported housing providers nervous about this guy’s behaviour.  We’re confident that he’s no angel, but if square pegs are forced into round holes something has to break and it’s usually the vulnerable that come off worse.

My worry is that we live in a society where it’s all too easy to point at people like our service users and say ‘it’s your own fault, you should behave properly’ but when you consider this not unfamiliar story of how someone was set up to fail maybe the fingers that are pointing need to take a u-turn!

Clive

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If you would like to help Simon on the Streets support homeless people in Leeds, Bradford, Huddersfield please check this link to make a donation or here if you would be interested in volunteering

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For Tom to be able to eventually go to residential Rehab there were some strict conditions; He must show willing by attending structured day care at least 3 times a week, attend all testing appointments with DRR (a court order) and hopefully get negative urine tests, and to attend Probation monthly.

Tom took the Bull by the horns and has been attending structured day care regularly. He has attended all probation and DRR appointments and has also been giving regular drug free urine samples.

I meet up with Tom regularly and his whole attitude has done a 180 degree turn. He has been up to the rehab with his DRR worker and thought it looked fantastic. He has another appointment in a couple of weeks to make his own way to the rehab to spend the day there and Tom’s revelling in the prospective challenge.

Every time I meet up with Tom he’s beaming from ear-to-ear and the support offered is more around psychosocial and cognitive behaviour. We mainly sit down and talk about life and the potential if not definite positive changes that have and are still happening with Tom.

We as an organisation are only too aware of the potential for relapse and have made sure that a structured safety net is in place so that we can pick up Tom if and when necessary.

Jamie

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I’ve worked with Terry for about 2 years now and for most of that time he’s been an entrenched rough sleeper. Terry was in care from an early age and soon resorted to crime – namely car theft and joy riding – to fill his time and stunt his boredom. The outcome of this was a trip to the local Young Offenders Institution where he started experimenting with drugs! After a few years of smoking weed and doing recreational drugs Terry’s mental health suffered and he tried to commit suicide by jumping off a railway bridge. He was hurt, but not dead and was then sectioned by the local authority and diagnosed as schizophrenic.

When Terry was discharged from the psychiatric ward he went into supported housing in Bradford, it was here he started using heroin. He turned up in Leeds and was brought to the attention of our organisation; this was about 4 years ago. Throughout this time Terry had been in and out of hostels, but mainly rough sleeping due to his drug addiction. We, as an organisation, never gave up on Terry. He was often incredibly difficult to engage with and refused to have anything to do with specialist support services. But we persevered and knew that if we maintained contact with him there was always an opportunity for positive change even if in the short term that was simply buying him a sandwich or just a chat. Consequently through long term planning and getting Terry to recognise the need for small steps towards his desired outcomes we managed to secure drug treatment for him which he’s doing fine with and is stable. He’s also just signed for his own tenancy with the local authority and we’re working with Terry to get him moved in and settled.

Jamie, Support Worker

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