Exploring communities of belonging around drink

This research is one of four projects funded by Alcohol Change UK as part of the New Horizons programme, which seeks to achieve a greater understanding of Groups, Communities and Alcohol Harm. It is a joint project between Sheffield Hallam University, ARC Research, and Leeds, Hull, Doncaster, North Lincolnshire local authorities along with delivery organisations in Doncaster and Kirklees.

The research explores the complex role that communities play in alcohol harm and recovery by focussing on communities in each area that reflected national and locally identified need and knowledge gaps.

Our Research Questions:

1. Does membership of a community of belonging impact on drinking behaviour and if so, how?
2. Is it possible to reduce drinking and maintain your links with your original community of belonging? What is the impact of marginalisation on the possibility of change?
3. Are some communities of belonging more flexible and more adaptable than others to changes in drinking behaviour? Or is a new community of belonging required?
4. How does being a member of a community of belonging impact on engagement with services? Can services usefully help communities adapt and develop to support new drinking behaviour?

We look at the notion of ‘a community of belonging’ around drinking further and draw out the stories of local communities in Yorkshire and the Humber. We specifically explore stories around belonging with members of marginalised groups where alcohol may play a part in the group identity, either as social glue or source of stigma. Our research focuses on ethnically diverse communities namely Polish and South Asian alongside LGBTQ+ communities across Yorkshire and the Humber in both rural and urban settings, communities chosen in conjunction with local partner agencies as identified priority areas.

Data collection

In each of the areas we recruited and trained local community researchers from the communities involved, geographical and belonging. Data collection had three parts, an interview exploring a participant’s drinking career, a walk about or go along interview exploring the place of drinking and a contextual interview with participant identified friends, family or other community members known to the participant.

In total 23 interviews with participants were undertaken, as well as 14 walking interviews and 2 participant identified interviews.

Interview analysis

Following transcription, the interviews were subject to Framework analysis by the research team. Framework Analysis is a systematic and flexible approach to analysing qualitative data which is particularly useful for multi-disciplinary research teams (Gale et al 2013).

The findings were shared with the Professional and Community Advisory groups, along with community researchers, at differing stages of the analysis to test validation and to inform the final data interpretation. The research process was subject to a COREQ check list (Tong et al 2007).

Findings

• The identification of a community to which they belonged was common to all participants, and this could encompass multiple communities both between and within groupings and be a source of strength.
• Community identification is informed by transition points into and out of communities; from straight to gay, joining a student community or moving to a new country.
• This movement into and out of a community of belonging is shaped by an individual drinking career alongside new and past community norms.
• The transition points challenge community belonging and can be traumatic with associated dangerous drinking behaviour to manage or at times enjoy that transition.
• Community identification and belonging is not a static moment in time but rather a fluid and active process.

To help understand the interaction of community belonging and alcohol the above model has been developed iteratively from the data. The model is a cycle which can be travelled both ways, with for example alcohol shaping the experience of belonging whilst at the same time belonging shaping the experience of alcohol.

Implications for practice

Our research highlights something of a dilemma for alcohol services. Findings indicate that belonging to a community is often more important than the alcohol consumption that is required to belong. Belonging to the community can promote mental and physical wellbeing but may lead to dangerous drinking particularly at times of transition. This in turn can lead to physical and mental health problems which addiction studies indicate can best be addressed with success by moving away from social groupings where alcohol use is the norm (Best 2015). Yet social identity research indicates that people going through transitions do better if they maintain membership of pre-existing and new groups which are compatible with social identities. (Dunbar et al 2017).

Certainly, for the Polish and LGBTQ+ communities in our research moving away from the community of belonging to seek help with alcohol related problems was not an option, rather the aim was to consolidate and embed belonging. The individuals in our research were very loath to seek help from services with self or peer identified problem drinking behaviour. All the communities we talked to baulked at the idea of accessing services regarding them as not for them, either due to perceived or actual prejudice within the services, within the wider community or within themselves and with some reflecting poor previous experience of mental health services. Individuals would seek help from friends and members of the community.

• In the South Asian community people talked about seeking help from family and the mosque. The common cultural and religious background was most important in seeking this help albeit tempered by the ever-present fear of being adversely judged.
• For the LGBTQ+ community, support was sought from friends within the community, accepting that this might mean going to the pubs and clubs which were partly the source of their alcohol problem.
• For the Polish community participants thought friends would be supportive to someone reducing drinking but overall, the normality of drinking in the culture meant approaching outside services was almost unthinkable unless faced with a catastrophic life experience.

This leaves alcohol services with a ‘wicked’ problem of acknowledging the importance of social network support for long term recovery (Longabaugh et al 2010) alongside the potential adverse impact of drinking norms within that community and great reluctance by those community members to access support from outside the community.

In tackling this problem our research leads us to the view that alcohol strong services might target help more towards those communities and members who are supporting people with problematic drinking behaviour and less towards providing support to the individual with the problem. Community based interventions may be more effective than individual therapeutic interventions. Consequently, outcome measures, such as those used by Office for Health Improvement and Disparities (OHID), on increased or decreased numbers in therapy may not be the best way to measure success.

Recommendations

In making recommendations to practitioners in an established field we need to be wary of the response that we already know that we do it anyway. Our recommendations acknowledge what is done and in no way wish to imply that the work we indicate is not taking place but suggest that doing a bit less of one and a bit more of another might be helpful.

• Services for communities of belonging around alcohol might refocus and target help more towards those communities and members who are supporting people with problematic drinking behaviour and less towards providing support to the individual with the problem.
• Supporting a friend or family member with alcohol problems is emotionally and physically draining and intellectually taxing. Services could provide increased knowledge and emotional support to facilitate and consolidate the care provided by community members.
• Community based interventions may be more effective than individual therapeutic interventions.
• Outcome measures, such as those used by Office for Health Improvement and Disparities (OHID), on increased or decreased numbers in therapy may not be the best way to measure success. Other measures may be more useful. These may look at interventions delivered in communities, and community level engagement.
• Transition points are important in promoting drinking amongst all communities. These transition points offer clear opportunities to present counter routes to belonging. British drinking behaviours of socialising in pubs, clubs and bars impacts on those in more marginalised groups when they seek to belong. Transition points into and out of this mainstream drinking culture are key points where support might impact. For example:
  • Bonding opportunities for students that are not alcohol dependent.
  • Safe social spaces for LGBTQ+ people that are not alcohol dependent.
  • Routes into British social and cultural spaces for immigrant groups that are not alcohol dependent.
• Despite providing the above examples, in identifying what community-based interventions may look like we need to be wary of external ‘expert’ opinion, but rather further research needs to be done with communities in specific localities alongside service providers to identify and shape interventions that would best meet community need.

Conclusions

In this report we have shown how belonging impacts on drinking behaviour for each of the groups in the study. This interplay between being a member of a community and drinking suggests that being a member of a community of belonging does impact on drinking behaviour. That whilst it is possible to reduce drinking and maintain links with your original community of belonging for some groups this is made difficult by the embeddedness of drinking within those groups.

This mobility in terms of belonging suggests that belonging can be flexible when necessary. Whether this flexibility is open to all is not known, amount drunk, behaviour and family response may all be relevant here. For all our communities, transition points were important with the formation of new communities of belonging often being helped by drinking. There are clear opportunities here to create new routes to belonging at those transition points for all the communities. This would change the role of services to a model that supported communities rather than individuals. A model that recognised the reluctance individuals have to engage with services and instead encourages the community to capitalise on the feelings of belonging that are present and nurture them.