The Big Conversation

Through a highly interactive online event, the College of Lived Experience Recovery Organisations (CLERO) identified challenges, opportunities – and a call to action that involves us all. DDN reports.

Dame Carol Black’s review had given us an ‘amazing opportunity’ said the government’s recovery champion, Ed Day. We were at a pivotal moment, where ‘all the things we wanted’ had been identified in the report – more funding, a boost to workforce skills, better commissioning, and the will to reinvigorate all the different elements that should make up a treatment system.

Furthermore, the invitation was there to fully involve the true experts – the people with lived experience whose peer support could do more to connect people with treatment than any learned method.

So if it was indeed the ‘tipping point’ he described, how should we grasp the opportunity to help deliver the next stage? How do we achieve the aspiration of a recovery orientated system of care that, in Day’s words, meant ‘high quality clinical services with harm reduction at the front door’ alongside ‘high quality recovery support services’? Furthermore, he asked, ‘What could each part do to make the other parts thrive?’

‘Many things unite us, not least that we all want to make a difference,’ said Danny Hames, who as chair of NHS APA represented 16 NHS trusts. But he was realistic that it would take courage and honesty to ‘maintain balance’ without turning inwards and fighting each other. ‘Everybody is going to have to give away a little bit of power to come together,’ he said.

Chris Lee, chair of the National Commissioners Network, agreed with this and called for greater parity in making sure all voices were heard. Commissioners were ‘public servants like many of us and work in systems’, he said. They needed to work closely with lived experience communities to ‘shape policy and direction of the sector in a coherent manner’.

Honesty and Unity

With these aspirations for honesty and unity in mind, Cormac Russell – an ‘itinerant storyteller’ with an interest in social movements – opened up the discussion. People were coming to this forum with open hearts, ready for some of the risk-taking that was needed to get in the right relationships, he said. So what were the challenges?

First and foremost, we needed to be honest about what had gone before, suggested Michaela Jones of the Scottish Recovery Consortium. ‘Part of moving forward is recognising that hurt we’ve experienced from being locked out, even from our own recovery,’ she said – a sentiment that many others identified with.

‘If we want the community to buy into this, we have to acknowledge that they’ve been hurt and that they also have a voice,’ agreed David L. We needed to be all-inclusive from the beginning.

The other important part of the equation was acknowledging the devastating effect of the COVID pandemic, said Michelle from Calderdale. ‘We’re in the middle of a terrible time, with loneliness, isolation and trauma at the centre of it… We’ve got a lot of sorting to do.’

Tina from Talk Change Grow added to this: ‘Staff are traumatised. They don’t know if they’ll still have a job.’

The future is ‘we’

So there was appetite for an alternative future and agreement that to move forward would require honesty, unity – and the courage to take risks. What then, might this future look like?

‘We would like to see addiction reframed as part of the human condition,’ said Michaela. ‘Everybody is on a spectrum of addiction, everybody is using something to make themselves feel better. It’s not just about drugs and alcohol – it’s about all of us trying to cope with a very complex and challenging society.’

Ray Jenkins called for a holistic approach – not just dealing with the problem of addiction but about the rest of you, your family, where you’re living. He saw these elements in the Dame Carol Black report, ‘because she put those pieces around the individual. Substance misuse and the treatment of it was only one part.’

‘The future has to be a “we” project and not a “me” project,’ said Clare Kennedy. We needed to be asking ‘how can we help you flourish?’ and introducing people to treatment systems that worked for them.

Many solutions already lay within the community, said Glyn Butcher. ‘When services close at 5pm it’s the communities that are picking people up. People come with drug and alcohol problems but it’s trauma, it’s poverty.’ We needed to ‘invert the pyramid’ and invest in communities. ‘It’s about shifting some of the resources to people who are miracle workers,’ he said. ‘Take positive risks with people in your communities and allow them a chance.’

‘It’s great to be with so many passionate people, but I’ve realised over time that passion is not enough,’ added Ray. ‘You need confidence, and it’s about allowing those community-led, passionate organisations to be supported to gain that confidence so they can stand on their own feet.’

For providers, one of the challenges was to ‘hear the unheard voice’, said Andrew Carr, meaning ‘those people who appear to be functioning but who may well not be’. What could we do to help people to engage more effectively in services? We needed to be genuine about inviting criticism and open to people saying that a service is not functioning as well as it could, he said.

Stories not numbers

These conversations had been going on for ten years – ‘so what additional courage needs to be found to step into that preferred future?’ asked Cormac.

It was about being ‘vulnerable in sharing’, suggested Graham Clucas, and looking at how we could empower people to take what they need. Furthermore, the vision of what a service should look like needed to come from the community itself, said Mike Hardy, whose commissioning role was informed by his own lived experience. He was dismissive of KPIs, focusing instead on budgets spent where they needed to be and results shown in the difference made to the individual, their friends, family and community. ‘I don’t want numbers, I want stories – and that’s how we do the monitoring,’ he said.

Moving forward

‘You’re facing an organising challenge,’ Cormac told participants. What was everyone prepared to put on the table to move forward?

‘We are the experts in getting our communities better,’ said Becky, representing her recovery community. ‘We need to be respectful but firm about that, and lead our leaders. If things aren’t working, we are the people who know what to do about it.’

For Dot Smith of Recovery Connections it was about creating ‘a culture that allows us to be kind and compassionate, to create that space where everybody’s welcome, and we use language like people, person and citizen, and not service user and client.’ And a big part of this culture was to ‘get honest when we don’t get things right, to meet people where they’re at and to try to the best of our ability to coproduce everything we do.’

‘These values were why we got into the field in the first place, because we have a passion, enabling people to change their lives,’ said Dave Higham of The Well Communities. ‘We need to go back to that. It’s about unity and togetherness and everyone having an equal voice as stakeholders.’

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