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News | FDAP conference – no more excuses
Service to ‘difficult’ clients
blocked by blame culture
Young people a ‘priority’
Young people are a priority for the
government, home office minister
Caroline Flint told delegates: ‘It was
right to reclassify cannabis. It’s now
important to focus on heroin, cocaine
and crack.’
There was a real difference
between those who try cannabis as
a rite of passage, and those children
for whom substance misuse becom-
es something to blot out their lives,
she said. ‘We need to bear this in
mind when producing services and
materials.’
The National Drug Strategy must
meet the needs of the whole comm-
unity, Ms Flint emphasised. Having an
equal opportunities policy did not
necessarily represent engagement.
Organisations on the ground must
‘change to practical actions that
work,’ she said.
Many of the government’s prior-
ities had been targeted on deprived
areas – ‘but are we getting the out-
comes we need to see?’ she asked.
Mental illness, particularly among
Afro Caribbean communities, was
overlooked. ‘How do we make sure
that people who present themselves
with depression or illness are being
reached?’ Ms Flint challenged.
Women could be similarly hard to
reach, particularly is they were involv-
ed in prostitution, or worried about
their children being taken off them.
A useful guide to promoting
services was to think about what
currently keeps different groups away
and find better ways of commun-
ication, she suggested.
Partnership working and user
groups were a practical way of
targeting services. ‘We cannot take
academic tomes and fine words and
say we’ve cracked it,’ she said.
‘Delivery is in many of your hands – in
making it work, making it a reality.’
‘It was
right to
reclassify
cannabis.
It’s now
important
to focus
on
heroin,
cocaine
and
crack.’
Responsiveness crucial to next stages of reform
More responsiveness is crucial to reshaping
services – which is the crucial next stage of
public service reform, according to Peter Martin,
Chief Executive of Addaction.
‘Getting it wrong in our field costs lives. We
have to become more responsive,’ he said.
Flourishing communities were the holy grail –
but many people weren’t part of communities,
he pointed out.
‘The state must make sure the least
powerful and most in need get help.’
Hard to reach communities required great
commitment to conquer the experiences of
stigma of which many users complained.
‘I have come across outrageous arrogance…
sometimes it doesn’t take much to make the
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atmosphere more welcoming,’ said Mr Martin.
Agencies had a duty to make services more
accessible – by having flexible opening hours,
smarter commissioning and working with other
agencies.
One-stop shops and mobile needle
exchanges were ‘reflections of a can-do
approach’, giving practical help where they were
needed.
Hard to reach groups had notoriously low
expectations, as they were used to looking
down, not up, Mr Martin said. It was up to
everyone involved in treatment to provide a
welcoming service, he urged.
‘We do need to get our own house in order.
We have a moral duty of access to all.’
Getting services to hard to reach
groups will be much more effec-
tive if we address the blame
culture that exists, according to
Darren Garrett, development
manager at the Alliance.
‘We tend to talk in terms
of a “difficult client” and
complain that we just can’t
get them to come to us,’ he
said. This led to a cycle of
‘chaotic bureaucracy’, as
clients became ‘hard to reach,
hear, attract – and please.’
The key to reaching
diverse groups was to ensure
that you are accepted by the
client and work on their terms.
Notions of shame and
stigma often got in the way of
people accessing the services
they needed and it was vital to
educate communities to
ensure knee-jerk reactions
didn’t prosper.
‘One-size fits all services
are not appropriate. If clients
are not given what they need,
they come away with even
bigger habits,’ he warned. There
was no panacea, but treatment
options were essential. ‘Most
users think that services won’t
be sympathetic to their needs,’
said Mr Garrett. The challenge
was ensuring you had the abil-
ity and wherewithal to retain
users, and this meant being
flexible to people’s different
circumstances and working
hours. ‘How inclusive are
chemist schemes if they are not
open to suit?’ he pointed out.
Building trusting relation-
ships was essential to getting
people involved with drug
services. There was often anx-
iety about working with young
people, relating to child protec-
tion issues. Women users with
children were often punished
by society, for deviating from
their role as carer. It was
important to understand the
prejudices these groups faced,
to communicate effectively.
Above all, it was vital to
make sure services were
something users wanted to
be involved in, he said.
No such thing as ‘hard
to reach’ groups
‘There’s no such thing as hard
to reach groups – only hard to
reach services,’ Victor
Adebowale, Chief Executive at
Turning Point, told Conference.
Hard to reach was ‘one of
things that people invent as
an excuse’, he said.
Substance misuse masked
a range of complex needs.
Often there were mental
health problems – the
challenge for substance
misuse was to find its place
alongside other services.
Concentration on services
for opiate users often meant
lack of targeted provision for
other drug users – including
black and minority ethnic
(BME) communities. Particular
patterns of drug use (such as
khat) in these communities
was very poorly understood,
said Mr Adebowale. This was
out of synch with a growing
black population in many
parts of the country.
Research from Turning
Point showed that people from
these communities were not
presenting for treatment.
Services tended to focus on
single problems, instead of
looking at the whole picture of
unemployment, family
demands and immigration
status. One-stop advice should
include training and education.
‘The cost of not reaching
hard to reach groups will come
back on us tenfold,’ Mr
Adebowale warned. Those
with greatest need were likely
to cost the taxpayer more in
the long run.
1 November 2004 | drinkanddrugsnews | 5