Dear Ed…
Roger Howard pens an open letter to the new recovery champion Ed Day, in response to our interview with him last month.
All of those working in the treatment and indeed the wider peer-support field must have read your DDN interview last month (June, page 8) and silently wished you ‘good luck’. I remember when the idea of a national recovery champion was first mooted thinking, ‘what’s the added value the role will bring?’
Then I saw the role detailed in September 2017 and it said, ‘The champion will be responsible for driving and supporting collaboration between local authorities, public employment services, housing providers and criminal justice partners… provide national leadership, advising government on where improvements can be made to the existing system of drug treatment… encourage greater partnership working at a national level, as well as facilitating multi-agency collaboration locally…’ And I thought, phew, that’s some ‘ask’ for a volunteer!
Don’t get me wrong. We’ve had drug czars, drug action teams, ACMD, National Treatment Agency and assorted others including think tanks seeking to address the systemic challenges of improving policy, practice and collaboration. However, let’s not ignore some of the lessons from these. The drug czar got the heave-ho when he fell out with ministers over cannabis rescheduling and how to tackle drug policy. Professor David Nutt was dismissed as chair of ACMD over his comments about the relative risks of ecstasy. Paul Hayes ‘took a bullet’ for the rest of the NTA team to smooth its transition into the new PHE.
Speaking ‘truth to power’ is like walking a tight-rope. Another lesson is that initial patronage by an enthusiastic and supportive minister can rapidly change once events and personnel change – or if they don’t like your advice. So, for all of us willing you to succeed, what can we realistically expect?
My advice would be threefold:
First, ditch any idea that you can make any significant impact on local collaboration. There’s some great collaborative work going on locally, but financial resources are the lubricant to keep the wheels oiled. We know the dire financial situation for local councils, mental health services, police commissioners, criminal justice and social housing. So, unless you want to be sent to The Tower for heresy, no doubt you will be advised by the civil servants to tread carefully when giving advice to the Ministerial Drug Strategy Board about the very real impact of cuts and changes like universal credit on recovery prospects.
Second, yes you can (and must) champion evidence-based practice, including peer-led services. You have ACMD and PHE efforts to back you up. When John Strang, Eric Appleby (Alcohol Concern) and myself (DrugScope) helped Mike Ashton to set up Drug and Alcohol Findings some years ago (still going strong) it was with the explicit aim of underpinning treatment, criminal justice and prevention practice through a one-stop easy access portal to the evidence base. But let’s be realistic. It’s a mammoth and ongoing task, akin to painting the Forth Bridge.
Which takes me to my third piece of advice and one you have already identified as a critical challenge.
The barriers to the process of sustainable recovery are considerable. So perhaps side-stepping the obvious ones of collaboration and good practice and addressing the largely unchallenged issue of stigma is a pragmatic way forward. However, you will need to tread carefully with some ministers and practitioners. When I discussed ‘stigma’ with them, and ways to tackle it, I recall one minister saying that ‘stigma was a good thing’ as it sent a message.
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The research and policy development the UK Drug Policy Commission undertook on the challenge of tackling stigma remains highly relevant (see: www.ukdpc.org.uk). The mountain to climb, among professionals, media and those using social media is considerable. UKDPC worked with the Society of Editors to facilitate their 2012 joint-publication, Dealing with the stigma of drugs: a guide for journalists. I’m sure this could be built on to take account of new media platforms.
You could do worse that cast your eye over the anti-stigma initiatives championed in the mental health field. The Time to Change campaign and subsequent off-shoots have gradually help shift public perceptions about mental ill-health. Enlisting high profile public figures’ support has been invaluable. It has also engaged thousands of local people and organisations, building on social-contact theory and evidence to chip away at damaging perceptions and portrayals, including in the helping and caring professions. But I have to say this has been achieved over two decades and with substantial financial backing running in to tens of millions of pounds from the DoH and bodies like the former Big Lottery Fund.
A real achievement for the national (drug) recovery champion would be to persuade ministers and especially the Treasury to hand over some of the proceeds from drug-related crime and unexplained wealth orders to kick-start a new recovery anti-stigma programme. That might stimulate the National Community Lottery Fund to come on board.
Then we’d know after three years that the recovery champion has made a real impact. Good luck Ed!