Complex services, straightforward needs
Friday/16/Nov 2007 Filed in:
Drug Treatment
So why can't they? In theory if someone is in treatment they have achieved or are moving towards stability - so services that people in treatment needs to access - like housing - shouldn't find a client in treatment particularly challenging to work with. So is it 'complex' because people in drug treatment need different kinds of support ? For instance, do they need different kinds of housing? Do they need to do different training and get different jobs? Not as far as I'm aware. Though they may require healthcare responses to different conditions, they don't require a different kind of healthcare provision.
It appears to me that the main things that prevent a stable service user in treatment from accessing housing and employment and healthcare are general structural barriers - such as opening times, access points, lack of childcare facilities (i.e. the very same things that stop other people accessing services) and structural barriers that are the result of institutional or individual discrimination - often based on fear - either of the drug users themselves or of the "complexity" of the work ("I'm not working with him - send him to the drug service - they know how to deal with him", "We don't provide social housing to people with convictions for drug offences"). A further inducement to complicate access to services for drug and alcohol users is the belief by commissioners of other services that they do not have a responsibility to provide support. Just last week I was told by a community nurse that mental health services in their area had been specifically told by their commissioners NOT to work with anyone with drug or alcohol problems as the budget for that work went to the Drug Action Team. In discussion with others since its become apparent that this was by no means a unique issue
What we need is greater clarity about the role of mainstream services with our client group. accompanied by a commitment on behalf of Government to monitor and measure the impact community services have on drug use and drug users. We also need to challenge the fear many people feel about working with drug and alcohol users. We can do this with some real efforts by the drug and alcohol treatment field to share their skills and knowledge with those in mainstream services - and de mystify drug and alcohol treatment. Additionally we need to be reminding people that while the Pooled Treatment Budget is there to provide funding for drug treatment, its not there to provide funding for everything to do with drug users - this is one of the downsides of having a ringfenced budget.
The more we define the need for basic community services by drug users as a complex need the more inclined the providers - and commissioners - of mainstream services will be to exclude drug users. After all, maybe the need for housing isn't actually all that complex - its just the jumping through hoops to get there that makes it so. So maybe we'd do better to talk about complex responses. That is, after all, the primary problem.