A step ahead

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Brian DudleyChief executive of the award-winning Broadway Lodge, Brian Dudley, talks to DDN about the importance of providing specialist care and dispelling preconceptions about the 12 steps.

‘For drug and alcohol services to actually get some recognition for the work we do was incredible, because we never get any praise,’ says Broadway Lodge chief executive Brian Dudley. His organisation was named ‘independent specialised care provider of the year’ last year and, in this sector, ‘hitting the headlines for the right reasons is an absolute boost’, he says.

Established 40 years ago, Broadway Lodge was the first UK service to provide treatment via the abstinence-based Minnesota Model, and now employs more than 100 people. As well as a 33-bed residential centre in Weston-super-Mare there are an additional 22 places in adjacent houses, with primary care addressing steps one to five of the 12 steps and the remainder dealt with in secondary, with its focus on social and life skills. The organisation also has two third-stage houses for reintegration and its own detox unit.

‘That means we can just do a detox, or it can then lead into primary care, secondary care and then the third-stage, move-on houses,’ he says. ‘We’re fully medical so our primary is quite intense, then the secondary is a step down where they’ll start to look more at what’s happening after treatment. We’ve got our own recovery centre now as well.’

Broadway Lodge feel so strongly about the need to dispel what they see as the myths around the 12 steps that they’ve now produced a series of short DVDs on the subject. ‘The only similar work is 1970s American stuff, so we’re putting it into a 2013 English context,’ he says. ‘We’ve really addressed the cult issue and the God issue, so it’s not this frightening cult thing that people think of. The feedback we’ve had has been amazing.’

The DVDs have been bought by other treatment centres, here and overseas, and Public Health England were also impressed, he says. ‘It’s really useful for commissioning groups as well as people who don’t know anything about the 12 steps. People are telling us that their clients are getting a lot out of it.’

It’s specialist care that the organisation is most committed to, however. The service has established a new 12-step women-only project, Ashcroft House in Cardiff, after acquiring the unit earlier this year, and it’s on course to be around 90 per cent full by the end of this month. ‘It’s about having somewhere where women can deal with not just the addiction issues,’ he says. ‘There might be abuse issues, self-harm issues, domestic violence issues as well. It’s a sort of place of safety where they can deal with more than just the addiction.’

Several of the speakers at the recent Brighton Oasis Project conference pointed out that, despite making up around a quarter of the service user population, women remain essentially invisible when it comes to the design of services. Do he feel that’s fair comment? ‘I think so,’ he says. ‘I only know maybe three or four other women-only units in the whole of the country. There’s hardly anything – probably under a hundred beds – and there’s a massive need.’

Broadway Lodge’s specialist provision extends further than most, however, offering services for eating disorders, gaming and gambling addiction. Is gambling something that’s overlooked by services generally? ‘We’re contracted by [industry-funded support service] Gamcare to provide residential treatment facilities for gambling,’ he states. ‘It’s funded by the gambling industry because there’s no other funding. Your local DAAT commissioner or your local council won’t provide any funding for gambling, but the gambling industry’s put money into treatment – the Gordon Moody Association in the Midlands and ourselves are the two residential places that they fund.’

Are there many referrals? ‘No, we probably get about half a dozen a year,’ he says. ‘I think the need is there but the money doesn’t follow it. What we’re paid doesn’t even cover our costs for people to come into treatment, but obviously there’s a lot of comorbidity. Someone will come in with a drug or alcohol problem but when we actually start working with them we might well find their primary addiction is gambling, but they’d never have got funded. So we do come across it an awful lot in treatment, but not with people coming through from being funded. Because there’s no funding there.’

The organisation is also unusual in that it provides services around co-depend­ency, something he feels can be a neglected issue. ‘Within the field what we do know is that you’ll find mothers or fathers actually going out and buying drugs for their child, because they think that’s safer. Their own health becomes totally depend­ent on that of their children or siblings. We don’t get many, but again we get a few.’

Although Broadway Lodge addresses this more in its family programmes than residential, some people have been in residential treatment for co-dependency ‘when their life’s become totally dependent on someone else’s – it’s frightening,’ he says. ‘We’ve been running a three-day residential family programme now for about 30 years, and we tend to do a lot of work in that. A lot of the time the child or the family friend will come into treatment and the family’s only known chaos, so you’re putting someone who’s been through treatment back into that environment and they haven’t got a clue what to do. So it’s educating them as much as the actual person in treatment.’


 

Dudley has been at Broadway Lodge for seven years now, before which he worked in social housing, and although he’d done a lot of work in the charitable sector he admits to having some ‘very pre-conceived’ ideas about the field before taking up the post. ‘I was just totally blown away very quickly in getting that understanding, going from quite a stigmatised approach,’ he says. ‘I thought an alcoholic was someone on the park bench swigging White Lightning and drug addicts were 18-year-olds going around mugging everyone and shooting up in alleyways. But it changed remarkably quickly. Once you come into this place you buy into it really, really quickly because you’re involved from day one, seeing clients, meeting clients, learning their stories. The transformation was incredibly quick and now I’m just absolutely passionate about it.’

Broadway Lodge has also joined with up with RAPt (Rehabilitation for Addicted Prisoners Trust) for a project in one prison that it hopes will become a blueprint to be applied elsewhere. ‘Again, it’s sort of new within the field – a residential provider partnering up with a specialist prison service,’ he says. ‘We’re doing all the clinical work but are also involved in the therapeutic. It’s about what more we can offer when people come out of prison, joining up treatment.’

Initial feedback has been exceptionally good, he says, and the commissioners are happy. ‘They’ve gone away from the old model of an NHS provider providing the service towards specialists. They can see the benefits – both RAPt and ourselves have been around for a long time. We’ve got a contract with Turning Point in Gloucester and we’ve just had our six-monthly review and were just staggered because everyone who completed treatment at Broadway Lodge and went on to the Turning Point programme is still clean after six months. What a change of investment, from an NHS mental health ward to a totally joined-up way of working.’

Other plans for joined-up work include partnering with a housing organisation to provide longer-term accommodation, as all but five of the 27 people to pass through the organisation’s third stage are now in education or employment. ‘We know that long-term investment works, but there’s a lack of it,’ he states. ‘We know only 2 per cent of people in the UK are offered rehab and we know funding’s getting cut.’

Against that backdrop, his ambitions are for the organisation to remain a specialist provider, focusing on the south-west and the services ‘that aren’t really available at the moment’, such as the women’s unit. ‘We’d like to set something up for young people as well, because there’s no residential rehab for young people in the UK. It’s about being a specialist provider because I think that’s where the funding will be, but also hopefully taking over some of the services the NHS run at the moment. Because we’re half the price, and we can join it up – we can provide the whole front end.

‘We’ve got the skills, the quality, the pricing to save money but we’re in the same boat as all other rehabs. If you don’t use us you lose us.’ DDN

12-step DVDs available at broadwaylodge.org.uk/dvds