Phoenix Chief Exec Karen Biggs warns of the emerging needs of people who use drugs and alchol during the coronavirus lockdown.
Tsunami of Need
The Covid 19 pandemic has brought many people in society to a crisis point. People who were already struggling to access the health and social care they desperately need. When society opens its doors again it will reveal a tsunami of need which we should be ready to meet.
Many people use drugs and alcohol to try to numb pain and smother deeply traumatic experiences. Many more of us would too if faced with similar circumstances. People who use drugs have always been invisible; labelled as ‘hard to reach’ or ‘too complex’. They are not, the reality is that decision makers and funders haven’t spent the time and money required to reach out, understand and help. There are many reasons for that; poverty, entrenched stigma across society and the sense of some people are more deserving than others, But what is clear now that is that we don’t need to argue anymore about whether or not that is true. It is fact, proven, accepted and understood – no matter how hard it is to stomach.
"Funding reductions are exacerbating gaps in treatment provision. As funding pressures have increased some services have disappeared altogether( such as outreach service targeting newer users), whilst others have been rationed (such as inpatient detoxification for people with complex and multiple problems heroin assisted treatment and residential rehabilitation)."
Professor Dame Carol Black
So, what happens when people who are already struggling to stay alive lose the fragile links to the support they have? Lose the opportunity to be with others with the same shared experiences of life? When people lose their sense of belonging? The answer; negative thoughts, relapse, self-harm, overdose, suicide and death.
My staff are seeing the most heart wrenching experiences of people trying to cope through the lockdown. Isolation is the enemy of recovery. And we have done our best to support people in their homes, or their temporary accommodation, or where ever they find themselves. We, like others, have created new solutions to the impossible situation we have found. We are looking after basic needs - giving out food, distributing phones and use on-line approaches, to ‘air drop’ packages of hope and distraction to people’s homes.
For some that works but for many it isn’t enough.
Like John, who said he was okay but when we went to give him a mobile phone to help him stay in touch, we could see he wasn’t. He was picking up his script from his pharmacist, checking in as he was expected to. But when we called at his door it didn’t take long to work out he hadn’t eaten for days, he was self-harming and having suicidal thoughts. We stayed there on his path, sorted out a shopping delivery, supported him to get in touch with his mental health support worker. Arranged for a local charity to bring him a hot meal once a day and agreed to come back the next day to have a chat.
And whilst the advice for most of the treatment sector has been to find ways to support people without face to face contact, in our care homes and our homelessness services we have maintained that vital face to face contact.
Many (49) of the sector’s care homes, we call them Residential Rehabs, have stayed open throughout the crisis and many of those have continued to take referrals. That has meant filtering through the myriad of care home guidance to create protocols and processes to keep residents and staff safe. Phoenix is the largest charitable provider of residential rehab and we have the backroom to support that work, to negotiate local processes for testing residents and staff and to spend the time and money getting the best deals we can on PPE.
Residential Rehab services aren’t commissioned, income isn’t guaranteed, prices can’t be negotiated to cover additional costs, charities that provide them can’t and wouldn’t decide to close their service and divert staff to other work.
But the whole Residential Rehab sector has kept services running through the dedication and commitment of their staff who have gone to work everyday, like all care home workers, to provide the very best care they can to people who need their help.
Already conversations are turning to what happens next. What can we keep from the ‘lockdown’ approaches? How do we deliver services in line with social distancing?
I heard a colleague say this week – its too early to learn anything because we are 6 weeks in a very long journey. And she is right.
But we do know that
- Pain and trauma doesn’t go away because you shut the door on it
- Despite us doing our very best as a sector many people have fallen into crisis and will need more help now and as soon as we can give it
- An underfunded and heavily rationed sector of health and social care cannot bear any further cuts and we should make that plain and unequivocal
Phoenix and many other psychosocial and Residential Rehab specialists know we have a vital role to play when everyone else opens their doors, hotels are emptied and the tsunami of need is revealed.