Not consultation – partnership: lessons from alcohol services’ work with Punjabi communities

Sarah Galvani | October 2020 | 7 minutes

In this blog, Professor Sarah Galvani discusses the lessons we can learn from guidance on alcohol services' work with Punjabi communities, published in June this year.

When our guidance on Supporting Punjabi People with Alcohol Problems was press released it attracted national and international interest. While I’d like to think this was solely about the originality and quality of our work, I was also aware this came amid intense media interest in the Black Lives Matter movement. The challenge for all sectors of society, including alcohol service providers, is to ensure a far deeper understanding of the role of alcohol in our diverse communities and to ensure that understanding is translated to practice.

I have been in and around alcohol services for more than 30 years, but carrying out the research that predated this guidance was a steep learning curve for me. My contact with people from the Punjabi community was previously limited to friends and colleagues. I had a fair understanding of racism and marginalisation, had witnessed it and railed against it. I had given relatively little thought, however, to how this would really manifest in relation to alcohol service provision.

Alcohol and Punjabi people

Supporting Punjabi People with Alcohol Problems is an attempt to convey some of that learning. Commissioned by alcohol, drugs and gambling charity, Aquarius, the guidance draws on the original research, the experience of Aquarius in setting up and running the Shanti project (2016-2019) in Birmingham and an end of project consultation. The driver for the original research was Aquarius’ reflections on the high number of Punjabi men its staff encountered in an accident and emergency hospital department. The men had serious liver conditions and the challenge Aquarius recognised was to try to intervene far earlier to prevent such late, and potentially life changing, presentations to hospital.

One of the more obvious cultural differences in this particular context is the tension between the religious prohibition of alcohol in Sikhism and the male Punjabi drinking culture. I lost count of the times that I was told that ‘real Sikhs don’t drink’ and came to understand that baptised Sikhs are abstinent and other Sikhs, as in other faith groups, are not, despite their religious teachings. I heard repeatedly about the amount of alcohol (spirits in particular) consumed at Sikh weddings and how the quality and quantity of this alcohol reflects a perceived status and wealth. Being aware of this tension, the denial of alcohol problems it brings, and the resistance of some temples to engage with the topic of alcohol is a helpful starting point in building relationships.

The gender differences in alcohol consumption in the Punjabi community are clear. Women’s drinking in Punjabi communities is frowned upon and younger women’s drinking has become a cause for concern within the community. Older women or ‘aunties’ are presumed not to drink. Providing access to alcohol services for all these women requires innovation and sensitivity but it is possible.

What can we learn?

What Aquarius found was that partnership with a community, whichever community that may be, has to be at the core of service response. Not consultation, partnership. Building those partnerships and gaining the trust required for genuine partnership work takes time – and more time than usual where there are obstacles of trust and cultural misunderstandings to hurdle. This can be a challenge for often time-limited service funding, so it needs to happen as part of normal alcohol service practice. But it needs to happen and sooner the better.

Finally, existing and established service models may need to change. During the original research, I was told by Punjabi community leaders that it was not acceptable to have “white services parachuted in” with “brown faces” in front of existing models of practice. A genuine openness to different ways of working and delivering alcohol provision is needed despite the lack of an evidence base. We have to start somewhere. Recognising the different needs of diverse communities and how to respond to them is vital.