How do you make recovery visible and relevant to a diverse community? Ashley Gibson of the Unity Drug and Alcohol Recovery Service shares Cumbria’s experience.
In early 2012 Cumbria DAAT decided to go out to tender for a recovery-oriented, asset-based service with one lead provider. Those of us involved in Cumbria service provision felt it to be a forward thinking step – we really wanted more people to get well and we liked how the focus on recovery had impacted on other areas of the country, and the North West in particular. It was also clear from consultations with people accessing services that they wanted change too, and the tender specification accurately reflected the needs of those surveyed.
Back then Cumbria, like many other parts of the country, was struggling with the numbers in treatment. Having learned to bring people into treatment and minimise harm, we were finding it difficult to move people through the system, despite service provision that encouraged uptake of support programmes. We weren’t wholly unsuccessful – the Straight Ahead programme and Bridging the Gap were proving themselves as recovery building assets – but there were question marks over the necessary visibility of recovery in Cumbria.
Bridging the gaps
Obstacles to change included the geographical distances between local communities, Cumbria being pretty much the same size as the rest of the North West. It has a mixture of affluence and rural poverty, with pockets of high unemployment in areas like Barrow and the west of the county, and some significant housing challenges. Centralised approaches to working in the diverse communities of Cumbria were just not demonstrating enough relevance to local needs.
As a treatment system made up of different providers, we struggled to pay enough attention to what happened to people who were leaving treatment and we were not proactive enough regarding feedback that there was no aftercare available. We supported the set-up of Smart Recovery but at that time we didn’t have enough people at that level of recovery to sustain it. We had a lot to learn – and still do. Our contact with, and knowledge of, 12-step recovery was sporadic at best.
Cumbria had three main providers, covering prescribing and clinical, criminal justice, and structured day care services. This created some really positive joint working and some not so positive competition. Everyone recognised the importance of keeping people who access services at the heart of the process – but I am not sure that this always happened, however hard most of us tried.
Greater Manchester West Mental Health NHS Foundation Trust were successful in their bid to provide a recovery-focused asset-based service in Cumbria, with a contract beginning on 1 July last year. For those like myself, whose previous experience had always been with third sector organisations, it was an interesting prospect. GMW senior management were very clear with us all that recovery would be at the heart of the way forward and that we would be working with an asset-based approach. It sounded exciting; in my role as a third sector service manager in Cumbria I had already been involved with asset-sharing ideas, particularly in Barrow, and had previously attended a John McKnight asset-based community development seminar in Kendal. I am also in recovery and the prospect of what felt like going back to my own roots in my work was a really inviting one.
As the result of a consultation exercise, Unity, with a strapline of ‘recovery in your community’, became the new name for the ‘one provider’ service. The name reflected the need of people from the previously separate services to unify with people already in recovery and those accessing services. It also felt like a message to ourselves as we built the foundations of our co-productive approach within Cumbrian communities.
Taking an innovative approach, and recognising that recovery networks are key to people getting and staying well, Unity set up an asset building fund. This takes bids during each year of the contract from groups and organisations that wish to contribute to recovery and its further development in Cumbria. As well as this, a new role of community development lead (my role) was introduced into the Unity management structure. Its purpose was to support recovery development by letting us share assets through joined-up work between people and services in the community. We recognised – and it was also commented on in Cumbria DAAT’s modernisation consultation with service users – that both drug and alcohol services and recovery support needed to be relevant to local communities. One size definitely does not fit all in Cumbria.
Different recovery groups and organisations with local connections were already set up or were starting to develop their ideas. These groups were encouraged to apply for support from the Unity asset-building fund – a great opportunity for them and for Unity to start to build a co-productive approach. Those successfully shortlisted would be invited to participate in a ‘friendly Dragon’s Den’ – a nod to the popular TV programme.
Key to the accessibility of the asset-building fund was Unity’s recognition that the process needed to be very straightforward. Although bid-related goals were agreed, these would be flexible according to the specific local requirements of the group needing funding. Unity, through my role, and also the commitment of the local recovery service teams, support all groups, whether they are funded yet or not, to play their part in the local community.
What we try to do is listen and support as opposed to tell and regulate, in the belief that recovery is not owned but shared. We also try to help those who wish to design and develop recovery support networks to realise their aspirations. The growing mutual respect was highlighted by the contribution that different recovery groups from around the county made to our recent workforce development training. They played a major part in helping Unity staff teams develop their understanding of recovery and this co-working continues to bear fruit.
In practical terms, Unity work closely with local groups – Vulture Club in Whitehaven, New Beginning in Workington, Cumbria Gateway and Jigsaws in Carlisle, ReFocus in Penrith, and New Roots in Barrow – to develop their ideas further and make the groups more visible. These organisations are all inspired to support recovery in Cumbria and choose to work closely with Unity to develop strong and meaningful links with other organisations in their local communities.
In Barrow and Workington we have recently taken our next step in recovery asset building. Following an inspirational visit to friends at the Scottish Recovery Consortium and some practice at our workforce development days, we have joined the brave new world of ‘recovery conversation cafés’, inviting people who access local services, carers and people from the community to talk about what recovery means locally. This is a great way to have everyone who supports recovery get together, make use of the links we have, forge new ones and decide on actions that relate to recovery in the local communities of Cumbria.
The informal café atmosphere is designed to help everyone feel at ease and talk openly about real ideas that will support recovery networks and their development. It is ideally suited to the asset-based approach as it brings focus to the sharing of strengths and assets in a positive environment. So far the Barrow and Workington conversation cafés have been vibrant and full of ideas that have included such things as social media development, ways to challenge stigma and sharing of workspace.
We have also begun work to build relationships with 12-step and other mutual aid organisations. North West representatives from Narcotics Anonymous came out to Barrow-in-Furness to put on a ‘myth-busting’ event to support positive, reality-based links that ensure people accessing treatment services get a full range of recovery choices, and Unity are now working to support the set up of new NA meetings in Cumbria. In Carlisle the Unity team and partners linked with an Alcoholics Anonymous public meeting, building important relationships to facilitate more informed choice for people accessing services. This linkage has been further developed after Mark Gilman’s visit to the city to promote mutual aid facilitation, as AA will be hosting an open meeting to introduce the 12 steps at Unity’s Botchergate centre from September. In HMP Haverigg we will soon have Smart Recovery meetings taking place, with staff members currently in training.
To mix metaphors for us, recovery is not a bull at a gate but a rising tide, as it becomes more visible in Cumbria. What I love about it is its diversity – each locality doing its own thing, demonstrating, I think, that we were right not to centralise our ideas. The beauty of it is how, as the varied organisations and their members develop in their own local communities, there is increasing talk of wanting more contact with each other, and we hope to help everyone get together this month for our very own Cumbria recovery walk.
The next recovery conversation café is planned for 24 September in Carlisle.
Ashley Gibson is community development lead at Unity Drug and Alcohol Recovery Service, Cumbria.