TOPIC: When the tail wags the dog do we lose sight of what constitutes a successful outcome?
When the tail wags the dog do we lose sight of what constitutes a successful outcome?
9 months, 1 week ago #1
Jane was really pleased about leaving treatment drug free but she worried about the long term “I have had loads of help from this service and I’ve been volunteering for 6 months. But in 2 weeks my treatment ends. What will happen then? There aren’t many support groups still running round here and the Job Centre said that as soon as my treatment ends I will be on JSA. I’d love to go on volunteering but I might loose my benefits. Its crazy - my volunteering is the best shot I have for getting a paid job but they just don’t seem to understand how important it is to my recovery.”
As a service user representative and in my work at Patient Opinion I meet people like Jane every week. These are the people that Drug Strategy and Healthy Lives, Healthy People are meant to help. But making it a reality in every place is the real challenge. As Dave another ex-user said: “I am stable, I haven’t used for years and I have had a fulltime job for 3 years. But all I am hearing at the moment is abstinence this, and abstinence that. I’m really worried that sooner or later I am going to come under pressure to start reducing my script which is a risk I am not willing to take. I feel I have made massive progress and I just want to get on with my life. It makes no sense at all to me that I should do anything that would threaten my position. It all seems to be about saving money and getting people out of treatment these days.”
In the new vision of a locally-led, recovery oriented system, most drugs and alcohol services will be commissioned by local authorities through Directors of Public Health. With the focus now upon outcomes and increased treatment exits, local relevance and understanding of need will be essential to an ambitious and balanced treatment system.
In many ways Dave's story is a success but because he is not abstinent the new system perversely may see it as a failure. Jane by contrast is abstinent and therefore a current success but is still at risk of lapsing back without further support. Either way the commendable scale and ambition of the changes doesn’t do away with the need to really listen and act on the concerns of users.
What we need is a nuanced vision that inspires, includes and supports the many pathways to recovery. Wellbeing, citizenship and freedom from dependence might be the aims but in the difficult transition away from their dependence, Dave and Jane are the essential partners in describing the vision, outcome and success of the new recovery oriented system.