Amongst the broader population of dependent drinkers is a smaller group of drinkers whose alcohol dependency is particularly entrenched and chronic.
8 September 2021
This guide aims to help practitioners to improve the well-being and safety of adults who are highly vulnerable, chronic, dependent drinkers.
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Executive summary
This group can have a significant negative impact on their community and on public services, as well as on their own quality of life. The good news is that these people can be helped by Alcohol Change UK’s Blue Light initiative, including interventions such as assertive outreach, harm reduction and multi-agency management.
However, an even smaller sub-group is particularly vulnerable and faces significant safeguarding risks, to themselves and others.
Without action, these people and those around them can experience serious dangers, including neglect, abuse, and untimely deaths. This group of people often requires more robust support, by using legal powers.
Practitioners (police officers, social workers, substance use workers, health professionals, probation officers, and others) have consistently reported that they are aware that certain legal frameworks, such as the Care Act 2014, Mental Capacity Act 2005 and Mental Health Act 2007, could be used to help these people, but that they are unsure how to properly, proportionately and confidently use those powers.
This guide provides an accessible introduction to three pieces of legislation that can be applied to chronic, highly vulnerable, dependent drinkers so as to improve outcomes for them, their families and their communities.
The guide also outlines the limits of these legal frameworks and when they should not be used.
The Care Act does apply to people with alcohol problems and in particular the inclusion of self-neglect as a form of neglect will encompass many in this client group.
The Mental Capacity Act can be used with people impaired by the effects of alcohol. There are challenges of applying this Act to chronic dependent drinkers because of a lack of specific guidance. However, the concept of executive capacity can be useful.
The Mental Health Act should be used as a last resort. It specifically excludes people who are solely dependent on alcohol, but there are circumstances in which the Act may be used with people who have other mental or behavioural disorders arising from alcohol dependency.
Other legal frameworks can also be useful for practitioners who work with chronic, vulnerable drinkers, such as the Human Rights Act 1998, the Anti-social Behaviour, Crime and Policing Act 2014, the Criminal Justice Act 2003 and various pieces of environmental health legislation. So these are briefly covered too.
This guide considers the governance of the use of these legal powers and recommends using a robust management framework such as multi-agency management. It provides advice on how such frameworks can be implemented.
Finally, this guide explains how certain ‘myths’ can hamper practitioners’ work with highly vulnerable, chronic, dependent drinkers.
In particular, it encourages practitioners to challenge the assumption that these people 'choose' or 'like' an abusive or self-neglecting lifestyle; and outlines alternative ways of thinking about these people and the reasons for the challenges they face.
By combining the power of positive interventions (assertive relationship building, harm reduction and motivational interventions) with the effective and careful use of legal powers, practitioners can help vulnerable, chronic, dependent drinkers to be safer, healthier, and stand a better chance of achieving positive longer-term outcomes. We hope this guide provides both practical advice and inspiration.
