The Ley Community development update

We are very pleased that the Ley Board and Phoenix Group Board have agreed that the service should be a specialist women’s service. This complements the other specialist residential services the Phoenix Group deliver including New Oakwood Lodge an Enhanced Therapeutic Community (TC) offering combined mental health and substance use care, Harper House, Specialist Family Service Scotland and The Specialist Family Service England and Wales.

We know that people who come to residential treatment benefit from intensive interventions provided in our psychologically informed environments. We have a long tradition and high level of expertise in delivering specialist residential services and look forward to opening this much needed service this year. 

Here we explain what the service will provide and why it is so needed within our treatment system in England. 

The range of therapeutic approaches employed in residential treatment, and the ability to coordinate care around an individual’s specific needs, makes residential treatment especially suitable for people with more complex needs and for those who “have not benefited from previous community-based psychosocial treatment” (NICE 2007). Residential treatment can remove barriers to drug and alcohol treatment such as homelessness and childcare and matches people who need higher levels of multi-disciplinary care to co-located multi-disciplinary staff teams who have lower case loads than in community settings.  

Most residential treatment services are mixed gender with gender-specific features, whereby the majority of the treatment experience is shared (recognising shared treatment needs) and gender-specific sleeping areas and gender-sensitive treatment are provided. This mixed-gender approach recognises shared needs whilst enabling specific support for women with different patterns of substance use from men and that women are more likely to be involved in sex work, have more extensive histories of trauma and abuse, are more likely to have childcare responsibilities and experience intersectional societal stigma. This is a very successful approach for many and indeed Phoenix’s results show that women make huge progress in their recovery in these settings. 

However, for some women with certain characteristics and circumstances, the largely mixed nature of most residential treatment is a barrier to benefiting from the residential experience. There is not a definitive set of characteristics and circumstances but they typically involve low self-worth and difficulties maintaining supportive healthy relationships because of repeated past abuse and trauma by men. Women may also need more confidential and well-planned safe access to services to escape immediate risk from coercive relationships.

From Phoenix’s experience of providing Grace House, a women’s service based in London, we found that disordered eating and self-harm are also common support needs that are less well provided for in mixed-gender services, even those with effective gender-sensitive treatment. Grace House showed us that women-only services, characterised by both all-female residents and staff teams, can provide a specially designed environment and programme, delivered by an appropriately trained staff team, that can help women feel safe and empowered. This sense of safety enables honest and open discussions about shared women-specific issues creating an improved community of support between residents and a focus on building individualised and highly personal skills and resources to aid long-term recovery. 

Grace House also showed us there are challenges in providing women-only services. Environments need to be designed to meet very specific requirements, residents need more time with their support staff, activities need to be carefully planned, and staff need appropriate training, support and supervision to work with clients and keep themselves safe. Clients required safety to access the service and stability to build trusting relationships with staff and engage with the treatment. Services need to be integrated with wider health and social care  and a network of specialist support for women before, during and after treatment. Appropriate post-treatment housing and aftercare are essential. 

At Grace House, we showed that this is achievable and with the launch of the new drug strategy and funding, a renewed focus on health equality and new commissioning quality standards we believe now is the time to develop a new women-only residential treatment service. 

As we develop the service we’ll be calling on women with lived experience of the Ley Community and Phoenix’s residential services to help. We believe the rich life-changing legacy of the Ley Community will live on through this new service.