(Extended version of a speech delivered at the Tackling Multiple Disadvantage summit on the 9th May in a session entitled
“What should frontline agencies, commissioners and people with lived experience be doing to ‘change the game’ for people with multiple needs?”
System failure is an all too common refrain when we talk about what prevents us meeting the needs of the most vulnerable and excluded in our communities.
Sadly it’s all too easy to talk about ‘linear funding mechanisms’ and ‘siloed provision’.
How when faced with financial constraint, commissioners and providers alike make decisions that don’t always allow for the needs of the most vulnerable to be met.
The solutions have been rehearsed and recited for eons
Genuine joint working
Getting rid of artificial barriers
Be less risk averse and paternalistic
Respond to presenting need but ensure your approach considers the whole person
Joint strategic commissioning that allows for innovation and collaboration
Create services using all we know from lived experience, research evidence and best practice
So surely, that list is the answer to what we should all be doing to change the game for people with multiple needs. Well the fact that we are still being asked the question suggests we aren’t getting the answer right.
I’ve spent the first 16 years of my career working within homelessness and the last 10 in substance misuse. I have known for a long time that without good friends, decent housing, high levels of health and wellbeing and a feeling of self-worth, no amount of treatment is going to lead to a successful recovery.
I believe we need a tsunami of change in the way society thinks about and treats people in addiction and in recovery.
I think that although we are seeing some great improvement in society’s attitude to mental health we are also seeing an increase in stigma for other groups. The recent reporting (see page 11) of the spice use amongst homeless and prison populations is the latest evidence of that.
And of course we need to provide support for people in a way that helps them live a better life rather than according to a category or a contract specification.
But to create a real game changer in my view will take us all to reflect on what we really think is possible and who deserves our help.
All of us need to be confident about the potential of people to recover from the seemingly most desperate of circumstances.
We need to show how it can be done. And there are many examples of it being done well.
We need to speak with confidence about the importance of treatment and the potential of people to recover.
It sounds trite I am sure but if we don’t have the confidence it can be done and do it ourselves, I don’t know how can we expect people to have faith it is possible. Have we become so disempowered that we need to rely on a contract specification to tell us what to do and how to do it?
If we continue to allow ourselves to be paralysed by the difficulties and constraints, how can we convince others that it is worth giving it a go?
We are all working and living with a huge level of uncertainty but I am sure many of our founders were inspired to create the organisations we now work in, to support people when no one else thought it necessary, possible or worthwhile.
Last week I launched our new corporate strategy within Phoenix which encourages us to reconnect with our charitable purpose. Phoenix has always had a strong connection with its history. It is embedded in our values.
We know there is less money being spent on our services but also that increasing numbers of people are finding themselves in the most desperate of circumstances.
We know more people are dying of drug related issues than ever recorded.
We know it’s harder to access funding which means some people don’t get access to the treatment they need, or they don’t get it for long enough, or they have to wait until the situation is even more desperate before they come into service.
We know that one of the main reasons for the increase in drug related deaths is the fact that people in treatment and active use are getting older. They have used opiates for a long time and the issues that causes are being amplified by the normal aging process or the impact of decades of low self-care.
We know too that there is a change of drug use amongst some populations. Young people’s drug use is different to 20 years ago. Spice is wreaking havoc within our prisons and our homeless populations.
It’s a hard fact that more people are trying to access help for the substance misuse whilst being homeless and 13% of opiate users in treatment report as being in acute housing need six months after entering treatment.
And of course all of these issues interrelate. Reduce spend across health and social care means people aren’t being supported at the right time by many agencies and when they do get the attention they need they are all too often in crisis.
So there is much to be despondent about.
But isn’t it times like this when charities prove their worth?
If we don’t continue to deliver hope in our new context of uncertainty – I’m not sure anyone else will.
We owe it to those who need our help to use our expertise and agility to deliver programmes that build recovery capital in individuals and communities.
If there is one truth we know at Phoenix it’s that it is hard to achieve confidence in your recovery but together we will use our individual and organisational resilience to help whoever wants to try.