opinion
Why are we sending people
miles away to rehab instead
of supporting them to survive
in their own community, asks
Mark Gilman
Adios
RecoveRy RivieRA?
n his 2017 book Poverty Safari, Darren McGarvey
explains how stress is often the engine room
that fuels addictions and mental health issues:
‘For those living in poor social conditions, stress
is all consuming; it’s the soup everyone is
swimming in all the time.’ 1
So, why is it a bad thing to be sent 300 miles away
from home for a mental health issue, but a good thing
for someone with a substance use disorder? 2
People with a substance use disorder (addiction)
are still sent out of area to residential rehabilitation. I
had never heard about residential rehabilitation until
1984 when I was interviewing young heroin users in
the North of England. I knew a lot about drugs and
had been using them myself since my first encounter
with benzodiazepines in 1969 at the age of 12. Until
1995, I had known many people who had died from
drugs (barbiturates and opioids) but I had never seen
anyone ‘recover’ from ‘addiction’.
In September 1985, I was employed by Lifeline as
the manager of one of the first community drugs
teams in Trafford, Greater Manchester. I never
understood the fixation on sending people away to
residential rehabilitation. Some of the rationale
included getting the ‘client’ away from ‘triggers’ in the
places where their problems had originated. I didn’t
get this because by then I had started to develop my
own alcohol problem. As I sat watching TV during one
of my countless DIY detoxes, I had to sit through
alcohol adverts.
I had to walk past pubs, shivering and knowing
that I had the money to go in and order a large brandy
and port and a pint of stout (my favourite morning
tipple). I could never understand why ‘addicts’ had to
be sent away, out of area, to residential rehabilitation
while ‘alcoholics’ like me (I never admitted this till
1995) were sent to the local psychiatric hospital for a
detox and then sent home.
I
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My perspective has been tainted by the fact that I
have always lived in Bury (apart from a brief exile in
Bradford and now in Burnley) and mix with people I
grew up with on an almost daily basis. When I first
sought help for my own alcohol problem it never
even occurred to me to go anywhere other than 12-
step mutual aid. I knew some real alcoholics (who I
had drunk with) who had stopped drinking by going
to Alcoholics Anonymous (AA). Residential
rehabilitation, if discussed at all, was dismissed as a
bizarre joke, but AA was treated with a degree of
respect because people had seen the change in
people like ‘Terry from Bury’.
‘Residential
rehabilitation,
if discussed at all,
was dismissed as
a bizarre joke, but
AA was treated
with a degree
of respect.’
ast forward to 7 September 2018 and I am
sat in the audience at the recovery
conference and I hear David Best talking
about building recovery communities by
connecting people to hope. He seems to say,
or I choose to hear him say, that sending people out of
area to residential treatment is harmful because it
doesn’t add to the local therapeutic landscape. I get
excited and start to tweet. In my haste to tell the
world that one of our leading, bone fide academics on
recovery is presenting evidence that says ‘keep it local’
I fear I may have over egged the pudding. If I have, I
want to publicly apologise to David Best for
misquoting him.
However, I do want to state, for the record, that I
certainly think that if people do need residential
detoxification and residential rehabilitation they
should stay as near to home as they can. We do
recover and we can get well where we got sick. When
we are ‘recovered’ or ‘in recovery’ and walk through
our local shopping centres, people who know us, who
drank and used with us but are stuck in the madness
see us and they can connect to hope. They can’t do
this if they are recovering 300 miles away on the
Recovery Riviera.
Finally, I want to dedicate this rant to ‘Terry from
Bury’ who planted a seed of hope in me that grew
roots and 23 years later sprouted, and gave me a life
beyond my wildest dreams.
F
Mark Gilman is managing director of Discovering
Health, www.discoveringhealth.co.uk
1 Darren McGarvey, Poverty Safari: Understanding the Anger
of Britain’s Underclass. Picador 2018. Page 61.
2 https://www.theguardian.com/society/2018/sep/17/mental-
health-patients-sent-300-miles-from-home-due-to-lack-of-
beds?CMP=share_btn_fb
October 2018 | drinkanddrugsnews | 15