The Health sector still lacks a clear and encompassing definition of what the term ‘recovery’ means. The shift to a ‘recovery focus’ over the last eight years or so has seen a welcome understanding of recovery being about lasting changes to an individual that seems to make things better for not only the individual, but also their families and communities. Recovery in terms of ‘health’ care, rather than ‘sick’ care, and a long term focus on wellbeing, instead of simply treating the symptoms, is at the core of our latest report.
Following the publication of the seminal report Drugs: Facing Facts (2007), the RSA has been undertaking a programme of work to develop a model for commissioning and supporting lasting recovery from drug and alcohol misuse. Today we launch ‘Whole Community Recovery: The Value of Person, Place and Community’, summarising our learning from the last three and a half years of delivering our Whole Person Recovery model within a Payment by Results system in partnership with national treatment provider CRI.
The need for recovery approaches involving whole communities is often underestimated. This month I was privileged to be at an impromptu celebration for one of our peer mentors (a volunteer who is in recovery) who had achieved a two year period of sobriety, following a time in his life where alcohol had had a devastating effect on himself and his family. Over 300,000 people entered treatment for alcohol or drug problems last year. This statistic, we know, in no way reflects the number of people who develop problems with drugs or alcohol. Many people find ways to address their problems through informal family, community or peer support, and of course some people continue to struggle, feeling that it is impossible or too late for them to make changes.
However, progress has been made in terms of the support offered to those with substance misuse issues. I remember my first forays as a frontline worker in the sector, spent generally charging about from custody to court to the probation service. I was working with a young man who was using cannabis, and said that he was thinking about trying heroin. Why wouldn’t he? All of his friends had tried it, and life didn’t seem to offer him much else by way of excitement. I introduced him to another man I worked with who had been using heroin for decades. The exchange shared was a powerful message; ‘don’t try heroin, unless you want to end up like me’. I don’t know what happened to that young man, but I do know that these sorts of powerful exchanges are now happening more often, in West Kent, and around the country. But our report argues that there is now a much more positive message; ‘you too, can recover, have a better life. If I can do it, so can you’.
The aim of our ‘Whole Person Recovery’ model in West Kent has been to tap into and strengthen assets that can support recovery in the longer term, both on an individual and community wide basis.
Our programme of work is based around three core principles:
- Co-production is key for service users to own, and feel a valued part of, their personal recovery process;
- Holistic, whole person approaches enable services to encompass multiple dimensions of a person’s recovery, increasing the likelihood of success in the short and longer term; and
- Social connectedness – within the recovery community and wider local community – creates a network of support and opportunities for individuals, enhancing the sustainability of recovery.
It is from this that we have worked with our recovery communities to develop initiatives that foster recovery capital (all the things that help to support recovery).
Our report explains our learning from our service delivery pilot and our wider conversations; how working with local people and communities to support them in building place based connections, co-produce initiatives and taking an approach that focusses on whole person wellbeing can help build an environment that not only fosters recovery, but allows it to flourish.
The report makes the following recommendations:
- The Department of Health should engage with Public Health England, NHS England and the professionals that deliver health and wellbeing services and the recovery community to develop a shared and consistent understanding of recovery.
- To improve outcomes at a local level we recommend Public Health England drive the development of a Creative Commissioning for Recovery approach that would meet commissioners' aspiration for more creative and flexible procurement.
- Recovery service providers need to further build capacity to support community focussed skills and activities within services.
The greatest source of pride for people who have been part of this project is to be able to say that this methodology is no longer unique. The Whole Person approach has been embraced, adopted and developed in many guises and despite challenges from stigma, fragmented public services and austerity cuts, the sector is rightfully proud of its achievements.
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We (RIJ - supporting refugee programmes) fund a project addressing addiction on the Thai-Burma border. One of the reasons for their high success rate is that they address the social aspects of addiction as well as the physical problems, as you make clear in your report. That people who are recovering from addiction can educate their peers and serve as role models. In the case of the refugee community drugs have been used to control communities.
Is there truly such a THING as a whole person or a whole community...or is it the treatment of people and communities as if they were whole objects that is at the root of the distress that leads into addiction?