Deadline approaching for new RSA paid internship opportunities
There are only four days remaining until the application deadline for the latest set of RSA internships paid at the London Living Wage.
There are three opportunities available, all of which are based in West Kent supporting our new recovery programme. This programme aims to nurture a vibrant ‘recovery community’ across the area which can support those experiencing substance misuse. At the heart of the programme is a belief that recovery can only truly be made possible and sustainable when the efforts and assets of the wider community are brought to bear on the challenge.
Interns will have the chance to assist with the programme’s community engagement strategy, particularly the many and varied recovery focussed events throughout the region. Successful candidates will support the Recovery Community Organiser in taking forward the ‘Recovery Month’ programme, part of which will involve interviewing event participants and developing promotional materials including website content, posters and blogs.
We are looking for candidates who have a keen interest in community engagement and/or recovery. Above all, we are looking for interns that are enthusiastic, committed and willing to try new things.
The internship will span a period of two months, beginning late May / early June.
The deadline for applications is midnight Sunday 13th May.
For more details and to find out how to apply, visit our internship page here.
Internship opportunities: Whole Person Recovery
This is an exciting week. Not only did I become an aunty for the first time, but we also announced 3 full-time paid intern positions to support our Whole Person Recovery programme of work across West Kent.
While I would like to gush over my new nephew here, I won’t. Instead I will focus on the internship opportunities before us. Interns will be asked to support the RSA Recovery Community Organisers at each of the programme sites (Maidstone, Tonbridge and Gravesend) in taking forward a full programme of activities throughout Recovery Month in June.
The fun doesn’t end there. In addition to supporting Recovery Month activities, interns will also be helping to establish a befriending scheme, a local Recovery Alliance, and the RSA Recovery Bank.
These roles require dynamic individuals with a passion for bringing communities together, supporting individuals in recovery and capable of thinking on their feet. These are full-time positions between end of May/June – July 2012.
To find out more about the internships and how to apply visit the Internship pages here.
Getting to know you… in Tunbridge Wells
It’s Week 4 of the RSA’s most recent expedition into the world of recovery which sees us taking forward our vision of a Whole Person Recovery System across West Kent. The last few weeks have come with the usual ups and downs linked to changing providers, TUPE procedures and settling into new buildings, but the momentum is growing and it’s all starting to take shape.
Yesterday was the first get together of service users in Tunbridge Wells to discuss what they would like to see within the Everyday Activities Programme. This is one of the set pieces that the RSA’s Recovery Community Organisers will be taking forward around each of the three main hubs (Maidstone, Gravesend and Tonbridge).
The Everyday Activities Programme is everyday stuff done every day. It’s about opening up opportunities for people in recovery to fill their time, have a laugh, learn some news skills, share their skills and meet other people in their local community. There will be activities to join morning and afternoon and at those times that can be the most difficult: evenings and weekends. The activities will be run by people in recovery, local community members, and practitioners and will be out in the community, away from the treatment centres.
The ideas generated from the discussion yesterday were plentiful. They ranged from boxing to cooking to hair and nails. Paintballing got a mention too. But by the end of the fevered brainstorm the group decided that the thing they most wanted to do was get to know each other. Simply have a place to go for a few hours every week where they knew they could relax, have a cuppa, play some games and get to know the people that they have been bumping into for years in the treatment centre waiting rooms. With a solid foundation that this could generate, the group felt they could do anything.
So that’s what we’re going to do in Tunbridge Wells. For now. I’m meeting a group in Maidstone tomorrow… I wonder what they will want to get started?
If you live or work in West Kent and would like to know more about the Whole Person Recovery programme and how you can get involved please contact Rebecca.daddow@rsa.org.uk
National Recovery Walk 2012
If you do one thing today let it be this… visit www.recoverywalk2012.org.uk and find out about all of the treats that Brian Morgan FRSA and the Recovery Walk 2012 team have in store for you 29 September 2012 in Brighton.
And then do another thing… tell someone else about it; someone that has never heard of the Recovery Walk. Tell them about the reality of recovery and the hope and aspiration it invokes. Tell them about the thousands of people that come together to celebrate their recovery journeys every year and who support the journeys of thousands more. Tell them how cities and towns are brought to a standstill in wonder at the purple parade marching through making recovery visible to whole communities.
Once you’ve done that, do it all over again. Everything else can wait for today…
If, like me, you’re an avid Twitterer then follow @UKRW2012 for all up to date information about the walk.
Putting ‘full’ recovery first…
The Home Office’s Putting Full Recovery First document has created a hotbed of unrest across the recovery / addictions world with comments from as far afield as Australia. Closer to home, Twitter has been a-flutter with academics, practitioners, and recovery activists who seem predominantly apprehensive, anxious and confused by the departments latest offering.
I’ll be exploring some of the issues raised over the coming days through this blog, but in the meantime, here the Substance Misuse Management in General Practice (SMMGP) helpfully provide a brief overview of the document and explore some of the areas of unrest and discussion.
A brief overview: In this document, which appeared on the Home Office website at the end of March, the Inter Ministerial Group (IMG) on drugs sets out to provide a roadmap for a new treatment system based on the overarching principles of wellbeing, citizenship and freedom from dependence. It does this by putting into context the ambition for reforming the system via a ‘purposeful policy programme’ and improved outcomes in a locally led system.
There are some positives to note – it recognises the contribution made by the Substance Misuse Skills Consortium, Recovery Group UK and Drugscope, and the role of these organisations “as key drivers of change” in providing a voice and channel of communication to the IMG.
The document outlines the purpose of Public Health England (PHE) as a ‘recovery orientated body’, with a vision for an integrated substance misuse treatment sector that includes alcohol. It confirms the major transfer of responsibilities to local authorities who will commission treatment services. Broadening the policy scope to include the welfare of families and securing housing and employment for people in treatment, and an integrated system that includes alcohol treatment, is commendable and of course, necessary.
SMMGP comment: The Putting Full Recovery First paper is an important looking document, with an introduction by Lord Henley, Chair of the Inter-ministerial Group on Drugs, and endorsed by Department of Health, DWP, Ministry of Justice, HM Treasury, Department of Education, Cabinet Office, and appears at first impression to be aimed – at least in part – at fulfilling the promises of the ‘Building Recovery in Communities’ programme that was consulted on last year.
We therefore read it with care and anticipation. However, on scrutiny, and disappointingly, it is a confusing document that contains several anomalies, e.g. there are several references to 2010/11 – why publish a (seemingly rushed) document at the end of the business year? It describes PHE almost solely in terms of taking over the functions of the NTA (‘which will be abolished’), when there are more than 60 outcome indicators for PHE of which drug and alcohol treatment is just one.
The frequent use of the phrase ‘full recovery’ in the paper is also confusing and will probably alarm people in treatment who already fear the threat of time-limited sanctions. It isn’t quite clear what is meant by it – whether having full recovery refers to being in treatment plus having a job and a house, or whether it means abstinence is being advocated.
With no clear action points included, it doesn’t quite live up to the promise of providing a roadmap, if anything, it loses its way, and may have the effect of needing to stop and ask again for directions before ending up in a dead end, or causing a pile up.
No one would argue with an ambition to improve people’s lives by having them recover from dependence on drugs (or alcohol) plus having a job and being housed; that is an ambition shared by most of us who work in the field. This document undervalues the recovery gains that have been made in the current system, and sadly writes it off as having been ‘full of …waste’.
Recovery is seldom a single event contained within a set period of time. It is usually incremental, often over many years. It can even be spontaneous. What is almost impossible is to describe it in rigorous terms and attach a value to it upon which payments will be made, once people have achieved it ‘fully’. It would be dangerous if there was a rush to commission services based on the belief that this document sanctions time limited treatment or that the underlying goal is abstinence for all.
We agree that a static treatment system benefits no one, and in recent years there have been encouraging community initiatives and recovery networks gaining ground all over the country, which provide a welcome and important means of support for all. But we know that the evidence for drug treatment as it stands, implemented responsibly, backed by sound clinical governance, and working in partnership with the patient, delivers. It delivers on the prevention of death and disease and crime reduction, whilst improving people’s lives, health and wellbeing, thereby giving them the opportunity of to recover.
During this time of ‘business as unusual’, we will continue to work hard to champion high standards and ensure quality treatment for all. As reflected on our forums and in other communications, we are encouraged by the resolve of the members of SMMGP and others in the field who work to uphold the gains made in treatment in recent years.
The views expressed in this post are those of the SMMGP. If you would like to discuss any of the content with SMMGP please contact Elsa Browne at elsa.browne@nta-nhs.org.uk
Managing the transition of public health
Do you know what ward you live in? Do you know the name of the elected member of council who represents your ward? Did you vote for them? Do you know how to get in contact with them?
If I am completely honest, until recently, I could only answer the last question and that was only because I vaguely know that council websites have the direct contact details for elected council members! I blame my transient London lifestyle and the fact I never stay in one ward area long enough to vote.
Why am I bleating on about this you wonder? Well, I listened live to the NICE webinar yesterday looking at the transition of public health to local authorities. It focussed particularly on:
- Commissioning in local authorities
- Using evidence in public health
- Commissioning good value public health programmes
- Moving public health into local authorities: how NICE can help
It was hugely informative but I came away with sense of urgency to get out there and win the hearts and minds of every elected member in the country in support of the recovery agenda.
What was starkly clear from the discussion yesterday – if we didn’t already know – was the potential for some issues to be de-prioritised at the local level, especially those that are complex, stigmatised, hidden or difficult to address. Elected members have a duty to represent the concerns of their constituency. But what if they don’t know of, fail to engage or simply ignore parts of their constituency? Look at who votes in local elections and you might get a sense of the views that are being represented and those that are missing. It’s not new news that those who are socially excluded ’are less likely to turn out to vote and less likely to participate in non-electoral ways.’
Add to that the advice being passed down to Health and Wellbeing Boards that they limit their strategy to focus on just 3-4 issues. Where do you think drug and alcohol issues will feature on the priority list alongside obesity, smoking, cancer, and the aging population? During the NICE event, a poll asking listeners to vote for what the priorities in their community suggested it might come second (to obesity) but this might be expected given the likely profession of most listeners. I’m a little more sceptical about it coming second amongst the wider voting public.
I’m in danger of being overly pessimistic here. Localism brings a number of advantages to the recovery field especially in those areas that have a healthy evidence base, well-informed local experts (in the right place), strong partnerships and the pro-active engagement of more than the just the usual voting public. We suggest that a good starting point for this is to create broad Recovery Alliances but more on this another time.
The transition to public health in local authorities is going to be an interesting journey – one of the speakers even suggested that the first phase will be a transition to the transition, so I’m not even sure whether the road is ready yet! So if you’re pioneering the recovery revolution, as I know many of you are, my suggestion would be to get a head start in making the path by walking it so that when the sat-navs get switched on across local government, the route is lined with a visible and integrated presence of recovery.
Seriously, why do we drink alcohol?
Alastair Campbell’s Panorama documentary on Britain’s Hidden Alcoholics was a refreshing attempt to draw attention to the complexity of our alcohol problem. The programme revealed the full range of alcohol consumption patterns, from ritualistic social drinking in working class pubs to professionals quaffing wine like it was water, often alone at home. Campbell also shared the story of his own battles with drink, and made passing references to some of the policies that influence the supply of alcohol.
But what about demand? Throughout the documentary, not once was there any penetrating attempt to make sense of exactly why people drink. It’s not just about unwinding after work, socialising, or having a good time. To quote the man himself, these explanations are bog-standard.
With a national audience looking for insight, this was a missed opportunity to deepen the discussion. Campbell could have called upon at least four useful perspectives that we should be more widely aware of.
First, neuroscience tells us that we drink to reduce associations in our mind. Ethanol, the psychoactive ingredient of alcohol, impairs communication between neurons by weakening the molecules in the walls that separate them, such that electrical signals are not sent as normal and associations between ideas do not emerge as readily. That might sound like a bad thing, but such associations are the basis for our continuous and strenuous efforts to make sense of the world, a burden we could do without. Alcohol typically elevates mood because with fewer associations to bother us, we start living less in our heads, and more in the here and now.
Secondly, and relatedly, psychology suggests we drink to escape the self. When we succeed in this venture we feel great, with less narcissistic chattering and relatively unmediated connection to the people and world around us. But of course alcohol can also make us think only of our selves, leaving us heavy, lost in thought, and disconnected from the world. The reason one of these two things happen, rather than both, is that alcohol causes cognitive narrowing, making us less nimble with our attention. With less flexibility, we tend to focus our reduced cognitive resources on whatever is most salient to us at the time, and ignore almost everything else.
Third, anthropology suggests we drink to allow ourselves to break taboos. However, we should be clear about what is caused by ethanol and what is caused by culture. Anthropologist Kate Fox, supported by a huge body of cross-cultural evidence, argues that while the physiological effects mentioned above are undeniable, the assumptions we make about the impact of such effects should be contested.
Drinking does not make you outspoken, promiscuous, aggressive or rude, and nor need it make you lose control of your behaviour more generally. Such things happen in the UK, but they are self-fulfilling, and happen because of what we collectively expect alcohol to do to us. As Fox puts it: “When people think they are drinking alcohol, they behave according to their cultural beliefs about the behavioural effects of alcohol.” The problems of drinking-related anti-social behaviour in Britain are therefore about cultural conceptions of what drunkenness means, not what alcohol does.
What this means is a bit shocking. Not only do we drink to get drunk, but we get drunk to justify behaviour that is not actually caused by drink at all! And we do this because we have an ‘ambivalent drinking culture’ where we view alcohol as morally significant, rather than an ‘integrated drinking culture’, where alcohol is morally neutral.
Fourthly, spirituality tells us that we drink to glimpse unity and transcendence. Whatever you think of the the Alcoholics Anonymous process it places spirituality at the heart because it recognises that the compulsion to drink is a perverted spiritual need. By weakening self-consciousness and relaxing the central nervous system, drinking gives a glimpse of transcendence and serves as a kind of secular spiritual experience. The centrality of this link was indicated by William James over a century ago in his classic text On the Varieties of Religious Experience:
“The sway of alcohol over mankind is unquestionably due to its power to stimulate the mystical faculties of human nature, usually crushed to earth by the cold facts and dry criticisms of the sober hour. Sobriety diminishes, discriminates, and says no; drunkenness expands, unites, and says yes. It is in fact the great exciter of the YES function in man…”
For anybody who enjoys a drink, I imagine that much is plausible, but as always James saw deeper:
“It is part of the deeper mystery and tragedy of life that whiffs and gleams of something that we immediately recognise as excellent should be vouchsafed to so many of us only in the fleeting earlier phases of what in its totality is so degrading a poisoning. The drunken consciousness is one bit of the mystic consciousness, and our total opinion of it must find its place in our opinion of the larger whole.”
In modern language I think he means something like this: It’s such a pity that we draw the wrong conclusions from the pleasures of being slightly drunk.
The tragedy James alludes to is that when we get this periodic glimpse of being present, at ease with the world, and available for other people, we wrongly think that drinking more will heighten the sensation. Instead, we should ask ourselves more fundamental questions about how we might live our lives, in order to experience such bliss all the time.
Recovery on the RSA website
Today we launch a new section on the RSA website dedicated to our Recovery work.
On these pages you will find information on all our projects, their reports and the range of local initiatives taken forward in collaboration with local partners.
This includes ‘The role of GPs in the recovery process’, a film developed with members of the local independent recovery group, EXACT, and with the support of the NTA and SMMGP. The film is designed to raise awareness amongst GPs (and wider primary care) workers, of the enormous impact they can have on a persons recovery journey.
Watch this space for information about how this film is being used in different areas of the UK. And if you would like to use the film for training or other purposes then just drop me an email at rebecca.daddow@rsa.org.uk.
Promoting recovery in Peterborough
Talk about ‘recovery groups’ can often lead to a discussion of 12 step based groups, SMART groups, service-user groups and so on. These types of groups are fairly easy to understand from the ‘outside’ and thanks to the media portrayal of some recovery groups, there can sometimes be a narrow view of them. They can follow particular formats, they can have certain traditions or rules and they can aim for specific outcomes that may be measurable.
But there are also those recovery groups that are simply individuals that come together on a regular basis to a venue with no particular objective other than to have something fun or different to do and meet like-minded people.
The FREE group in Peterborough is a good example of this. The group, which developed out of a series of activities for the Recovery Capital project, has doubled in size since forming just 8 weeks ago, they now have a new permanent home and are beginning to meet more frequently. As one member put it at our co-design event in mid-January: “we get together and have a giggle!”
The group are already having a big impact on each other’s recovery and lives and want to do more to help others in the city. But they have found – as we did in our Recovery Capital project research – that people are reluctant to get involved in activities like this; they have preconceived ideas of people sitting around in a circle and talking about their addiction generated by years of myths, few opportunities available in the past and the media representation of recovery support groups.
So together we made a short film to tell people about FREE – which stands for Free Recovery for Everyone Everywhere – and what to expect if you attend and the impact it has had on their recovery.
I hope you’ll agree they’ve done a great job!
You can find out about when and where the group meets by visiting www.citizenpower.co.uk or contacting recovery.intern@rsa.org.uk
Supporting Service User Group clout
I was invited to spend the morning with an incredible group of people in West Kent (the location of the next part of the RSA’s recovery journey) to be part of a discussion about the future of service user groups across the region.
It never ceases to amaze me how remarkable people are in giving so much of themselves, their time and commitment in supporting their peers and their wider communities.
Some of the concerns and hot topics of discussion focussed on some of the most deeply entrenched and difficult issues of power, stigma, relationships, accountability, and volunteer turnover. We have talked about some of these in the past in our Whole Person Recovery report, and I’m sure we will touch on the others more in the future. It’s interesting – and not wholly unsurprising – how they keep cropping up, especially in areas where systems haven’t changed for a while but are now moving towards more recovery-focussed systems.
Whatever the issues, the discussion was ultimately about service user involvement, what prevents service user groups from having more clout, and what can help.
It’s a truth universally acknowledged… ok, nearly… that meaningful service user involvement in the design, development and delivery of services makes for more efficient and effective provision that better meets the personal needs of the individuals seeking support. But for a variety of reasons this can be difficult to put into practice (and I point you in the direction of Section 2 of the report to see what some of these are). These can act as enormous barriers to engagement and to the potential impact of the groups on provision.
And these are often added to by questions around funding. Who should pay for premises for service user groups? Who pays for the training? How independent can service user groups truly be in setting their remit and aims when they accept money from the contracted provider or commissioner? How much influence do the groups have as unpaid and arguably ‘non-professional’ volunteers?
It got me thinking [again] about the potential of having a national independent body like the Independent Monitoring Boards (IMB) for prisons, but for drug and alcohol services. IMBs run on volunteer-power. They have clout. They hold prisons to account. They publish their independent findings. They have consistent training across the country. They have support. They directly inform policy and practice. They have keys to the prison and they “have unrestricted access to their local prison or immigration detention centre at any time and can talk to any prisoner or detainee they wish to, out of sight and hearing of a members of staff if necessary.”
Or, given that there are so many service user groups already in existence doing such brilliant stuff, then is the need more for something akin to the Association of Members of IMBs (AMIMB): “AMIMB is a nationally recognized body representing those who monitor the treatment and rehabilitation of adults and young people in prison, immigration removal centres, and other secure establishments. The expertise and independence of the AMIMB are respected by the public, the government and the press, and by other public and voluntary bodies. We are routinely consulted by government and other organisations when charges are proposed to the prison system, or when problems arise. The AMIMB, through its members, provides independent, objective, concerned, evidence-based information views and proposal.”
I may be flogging a dead horse here or over thinking things… But in any case, I’d be really interested in your thoughts.
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Rebecca Daddow is Senior Researcher at the RSA with a particular interest in criminal justice matters and recovery from substance misuse. Her current research focuses on network approaches to recovery and access to recovery capital in Peterborough. Follow @rjdaddow
Amie Powell is a Recovery Intern at the RSA. She has a particular interest in engaging those in recovery from substance misuse in creative activities to inspire them to continue on their journeys. She is also interested in raising awareness of recovery in communities as something to celebrate rather than stigmatize.