Ring fencing and service provisions for complex service users

WDP | October 2019 | 8 minutes

Policy proposal: Provide and promote a 'ring-fenced' resource for alcohol treatment, early alcohol intervention provision and prevention services.


Policy proposal: Ensure local areas have adequate service provision for those with complex needs, especially those with both alcohol and mental health conditions. One way to achieve this is through assertive outreach and multi-agency partnerships.

The Alcohol Charter, produced jointly by the Drugs, Alcohol & Justice Cross-Party Parliamentary Group and the All-Party Parliamentary Group on Alcohol Harm, sets out effective and workable policies to reduce the damage to society caused by alcohol misuse. The proposals above are two of 16 evidence-based policy proposals laid out in the Charter.

WDP is one of more than 30 organisations that endorse the Alcohol Charter. Here, they outline their reasons for supporting these proposals.

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Prevention and early intervention

We deliver a service known as Square Mile Health within the City of London. A unique aspect of this contract involves delivering drug and alcohol awareness training to community and corporate businesses.

Training and workshops have included ‘Champagne and Cocaine in the City: Breaking the Trend’ and ‘Healthier Living: Smarter Choices with Alcohol and Tobacco’. Provisions such as this allow us to:

  • reach individuals who are at risk of or are already drinking at ‘at risk’ levels
  • support local businesses to recognise and address prevalent ‘drinking cultures’

This provision has been well received by both organisations and their employees:

I would personally like to thank Square Mile Health for coming and engaging with the event and strategy so positively. It is your support…that will bring the programme to life and ensure we make long-lasting and meaningful impacts.

The combination of positive stakeholder feedback and the fact our Community and Corporate Trainers often have long waiting lists shows that there is a demand for this. With 24% of men and 13% of women drinking at hazardous levels in England, we would also encourage other local authorities to ring fence resources for such provision.

Assertive outreach

Alex's case study

One of our outreach teams encountered ‘Alex’ drinking on the street. A victim of domestic violence, Alex was visibly beaten and had taken to sleeping rough as a result. Our outreach workers were able to find Alex temporary accommodation and are working to find long-term housing. Alex has also been referred to Violence Against Women and Girls, who offer support for domestic abuse victims. In fact, 39% of violent incidents in England and Wales are alcohol-related.

Many individuals can be isolated and withdrawn, so an assertive outreach effort becomes essential. Without the outreach team(s) making contact and working in partnership with other agencies, it is possible that Alex would have remained living on the street, begun using other substances and developed significant health issues.

The earlier individuals are engaged and supported in their recovery, the greater the chance they will become healthy and self-sustaining. Greater spending on outreach services may be more cost-efficient by reducing costly acute episodes of treatment with the NHS. Every year there are 1.2 million hospital admissions related to alcohol in England alone.

Mental health training in addiction

Case study 1

‘John’ presented to one of our services with alcohol dependency and significant mental health needs including depression, anxiety and dissociation due to early trauma. Due to his complex needs, John was allocated to one of our dual diagnosis practitioners to concurrently address his mental health and substance misuse needs by:

  • initially focusing on engagement
  • making referrals to in-house counselling services
  • providing strategies to manage anxiety and build self-esteem
  • working jointly with John’s GP

After six months, John stopped self-harming. Within two years, John had significantly reduced his drinking and successfully completed treatment with us.

This case study highlights the importance of ensuring that there are funds available in substance misuse budgets for specialist roles, such as dual diagnosis practitioners and counsellors. Their expertise means that services can effectively support complex service users over a longer than normal period of time. This can help the individual successfully reduce their substance misuse and improve their mental wellbeing.

Case study 2

36-year-old ‘Simon’ was referred to one of our services as part of his Alcohol Treatment Requirement. He started drinking problematically when he was 17 and by his twenties he reported that he had "completely lost control" of his alcohol use. At assessment, he had mild physical dependence, had lost contact with his children and was experiencing low moods associated with depression.

Simon’s key worker used a range of CBT tools which supported him to realistically appraise his current situation and manage his cravings. In addition, she worked in collaboration with probation and arranged for him to attend a Building Better Relationships Course and a six-week Alcohol Harm Reduction Course. Simon ended up successfully completing treatment with us and established fortnightly contact with his children.

Conclusion

Our service user case studies and stakeholder feedback highlight the need for specific and targeted service provisions for alcohol service users at every stage of the recovery journey. Prevention and early intervention provisions, assertive outreach and mental health-trained workers are all essential and services must be resourced accordingly.

WDP is a vibrant and innovative drug and alcohol charity committed to helping those who are affected by substance misuse. For over 25 years they have provided support to individuals, their families and the wider communities from centres across London, the North West, South East and East of England.

Find out more about WDP's Innovation and Research Unit and follow them on Twitter.

Take action

The policies laid out in the Alcohol Charter represent realistic, powerful ways to reduce the harm caused by alcohol. Help make them happen.

Sign up as an organisational supporter of the Charter and help the policies of the Charter become reality.

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