“I almost have to pinch myself and ask is this real”: how alcohol services have transformed themselves during the lockdown

Ruth Spencer | November 2020 | 9 minutes

Ruth Spencer, Adult Treatment Service Manager at Aquarius in the West Midlands, looks at the ways alcohol services have adapted to COVID-19 and the lockdown, and warns about the dangers of burn-out from pushing services to do too much.

Our alcohol services support such a variety of people: older people drinking more since they retired, professionals learning to manage the drinking culture associated with their line of business, the homeless clients who drink to forget about why they are living on the street, and the young people experimenting, pushing boundaries and learning about how they fit into the world. We get to know them all. And since the origins of counselling with Freud and his couch, we’ve always relied on providing support face-to-face, to see what’s really going on.

Continuing to provide vital services

Changing the delivery of services is no walk in the park! At the start of lockdown, I sent most of my staff home to work, as did so many others in the country. However, I stayed in the office with a few colleagues, providing outreach to the homeless, trying to convince people living on the streets to come indoors; picking up those who had become homeless due to relationship breakdown, loss of job or eviction; visiting hotels with narrow corridors to deliver food, clothes and support; and making sure that those in withdrawal got medical support. It all sounds very daunting, but the reality was it motivated me, made me realise how thankful I am. On a BBC Radio 4 Listening Project conversation I took part in, the same theme came up: “I’m thankful for my door, thankful for my food and so much more”.

Our services have changed so much during lockdown that sometimes I almost have to pinch myself and ask is this real. Have I really gone from occasionally turning up to work in jeans to now needing to wear a wipeable coat, with a car boot full of aprons, plastic gloves, masks and hand gel? And that’s not just me. It’s been the case for all my colleagues. To rightly blow our own trumpet, the pandemic has really shown the grit, determination and hard work of all key workers, but especially the creative and innovative abilities of the voluntary sector.

Adapting to online

Lockdown thrust so much of this into a virtual world. Thankfully, due to GDPR and an already paperless workplace, our staff were used to working online and all client records were electronic and encrypted.

That said, the workforce has had to quickly upskill in how to respond, manage and communicate online, recognising that social media operates 24/7 and expectations on response rates no longer operate 9-5! At the same time we can’t assume that everyone we support is able to access online forums, chat rooms and social media. Our client group can also view technology (phones, computers) as a tradable asset to be able to pay off debts, buy the alcohol they need and get their next fix. How do we maintain contact if there’s no way of getting hold of them?

With all that in mind, it was never such a relief to look at data in the first weeks of lockdown and see that engagement rates were still strong, client contact was still taking place and staff were reporting less missed appointments than normal. Could this be true? Might some of our clients actually prefer phone and video contact? A realisation that perhaps we have been approaching the accessibility of services from the wrong angle dawned on us. Why do we insist that every appointment is face to face? Perhaps we could be a more open service if we maintained the option for video call appointments, even after the pandemic and lockdown has eased.

Stories of hope

Lockdown has given us so many stories of hope, stories of change and recovery. Many entrenched homeless now housed and engaging in treatment because it doesn’t feel like there were strings attached or that it was a forced change. Clients having cut down as without the work-related stress they feel they can breathe and without the ease of access to the pub the appeal isn’t the same.

What now?

Many challenges lie ahead as we find ourselves back in a second England-wide lockdown. Services had just seen referrals start to increase as people felt a sense of normality. We now need to review our messages to the communities we work with and promote health messages – encouraging people to ask for help, taking an education approach and supporting people to become more resilient. We need to explore how we expand our offers further - reaching people who have switched off from social media or are actively choosing to have technology free time after months of being glued to screens. Ultimately at a time when people are facing more hardships and isolation, our priority must be to clearly communicate that we still care and want to support people.

There has been a lot of praise for keyworkers, however there is still an expectation that the voluntary sector do more for less, with reduced budgets and cuts to services being the norm. We’ve seen responsibilities such as home visits, safeguarding and wellbeing checks delegated especially to our sector. Yet staff have been pushed to their limits during lockdown balancing full time work, childcare challenges and a fear of putting their loved ones at risk. Is it therefore enough to just clap? There needs to be more funding to ensure that voluntary sector organisations are able to pay a competitive wage, and a genuine recognition scheme acknowledging the hard work and dedication of the workforce. If we continue to push services to their limits, we will lose expertise, empathy and potentially risk a mass burn-out of the very people that we could not survive without during the pandemic.