Addiction Recession?: March 2011

Sunday 27 March 2011

UK Recovery Federation (UKRF) Update 17/3/11

UK Recovery Federation (UKRF) Update

As the UK Recovery Federation page is tucked away a little bit on Wiredin I thought I’d plonk it up here as well. If you’d like to get involved please get in touch. One little extra bit that didn’t make it into the update: We’ll be launching a bit of a new UKRF ‘look’ on April 1st along with the website, bit of a spring clean. The path takes us to some interesting places.
We’ve been meaning to put together a UKRF update blog for a while now but been very busy and the days have slipped by. There’s no time like the present though so here are the current UKRF headlines.

2011 Recovery Walk:

To assist in the promotion of the walk that will take place in Cardiff on the 10th of September we’ve hurried up a bit with our UKRF website plans and (fingers crossed) this will go up in two weeks time. You’ll be able to find us athttp://www.ukrf.org.uk as from the 1st of April. Hopefully we won’t look too foolish. Mike Ng who works with Carl Cundall at the Sheffield ARC is doing all the website building work for us and for this we will be eternally grateful. We will also be promoting the walk at a number of conferences that we are speaking at over the next few months and in a number of articles in the ‘trade’ press.

Events:

The UKRF is supporting the South East Recovery Network (an emerging collective) with its South-East Recovery Network Conference on the 7th of April. Alistair Sinclair is working with facilitators from the Recovery Community and Conference organisers to develop a number of workshops that will explore asset/strength based ways of working and community development. For more details see:

http://wiredin.org.uk/blogs/entry/10379/mapping-this-conference-is-led-by-you-and-for-you/

We will be attending a Social Work conference on ‘Alcohol & Drug Treatment’ in Birmingham on the 27th of April and presenting the work of the UKRF at anEATA event in Manchester on the 9th of May, a HIT conference in Edinburgh on the 10th of May and a HIT conference in Liverpool on the 11th of May. We will be presenting at the National RCGP conference which takes place on the 12th and 13th of May and will be doing another UKRF presentation at anEATA event in the South-West sometime in the summer.

The next National UKRF conference is provisionally planned (fingers crossed again) for the 9th of September in Cardiff the day before the Recovery Walk. This will be delivered in partnership with the SMMGP as part of our developing relationship with them. Keep your eyes peeled on our new website for more details on this.

Articles

We are in the process of finishing off an article on the UKRF which will go in the next SMMGP newsletter and we have plans for further articles in DrugLink and Drink & Drug News. All articles will be posted on the new website. We’ve had some pretty exciting interaction around articles with Bill White recently. More details to follow – again on the new website.

Recovery Networks

We are currently working with recovery activists on Merseyside to explore the establishment of a Merseyside Recovery Network. A planning meeting will be looking at this in a few weeks. We hope to support this network in establishing close links with other Networks and build on the work we have been doing with recovery activists, the NTA, DAAT’s and Services in the South-East and the Eastern Region of the UK. Early discussions have taken place in Lancashire and Cumbria around the establishment of local Recovery Networks and we hope to make some pretty concrete progress very soon. Again, check out our website for details as they emerge.
Remember Annemarie will be free after the 31st to help develop in Scotland and anywhere else so get in touch for a bit of support.

UKRF Advisory Group

This group has now been established and held its first meeting in Liverpool on the 31st of January. Whilst principally made up of people from the Recovery Community this group also has representatives from the National Users Network, the UK Harm Reduction Association and the International Harm Reduction Association sitting on it. All are committed to the development of diverse new Recovery Networks across the UK.

The new UKRF Website 1st April 2011 www.ukrf.org.uk

Promotion and celebration of the National Recovery Walks will sit at the core of this website and it will be the UKRF’s new ‘shop front’, enabling us to promote our Recovery Principles in an easily accessible and interactive way. This website will link to self-moderating Forums (not blogs) and provide links to a variety of blog sites. We will place a great deal of emphasis on providing information regarding the many recovery assets on the ground (broken up into regions/localities) facilitating networking across diverse areas and the supporting of Recovery Networks. We intend to build a diverse UKRFmembership at an individual level (those that subscribe to the UKRF Recovery Principles), group/network/Federation level, Services (once they have demonstrated they are recovery-oriented) and businesses (social enterprises and CIC’s that support recovery in the Community). That’s the plan anyway. Fingers crossed again. There will also be something of an international link on the website. Very exciting! We’ll keep you posted on this.

Training and Education

The UKRF has been working closely with Re-Up: Training & Consultancy Services, another CIC set up by UKRF members, which will be launching a new website sometime in April. Re-Up will be the first CIC to join the UKRFand any profits from this company will be used to support the general aims of the UKRF. We have also been working with people from a Recovery Community in Lancaster to develop recovery-oriented standards for a local rehab and hope to post some details on the new website in the early summer. Training has been delivered in Hertfordshire and further training is planned in Bedfordshire in either May or June. We met with Recovery activists from the North-East last week who are keen to assist the UKRF in the development of a Social Enterprise Development Strategy which will enable the UKRF to coherently support people from the Recovery Community who want to establish social enterprises/Community Interest Companies.

Lots of work to do but we’re getting there. In “Recovery Time” as Bill White would say.

If you’d like more details on this stuff you can contact us at:

alistair@ukrf.org.uk

annemarieward@ukrf.org.uk

We make the Path by walking it.

Take care all.

Sprinter or marathon runner?

I wrote this in response to Dave Healey’s blog The future is?.

Bear with me here folks, I have just spent the last few hours writing a response to this. And by the way my own contract is up on March 31st (it was a fixed term strategic role within the NHS).

I’m glad to say however their were about 40 addiction nurses, also on fixed term till the 31st, but their posts have been rolled over for another year whilst the workforce development and service redesign get underway.

Despite the many and varied initiatives taking place across the UK, and the national policies in England and Wales and Scotland’s emphasis on recovery, we know that the recovery reorientation has not been widely adopted and implemented.

There is a long way to go before a recovery orientation is standard practice for addiction and mental health services and there remain significant barriers to changes in service reorientation that will not simply be swept away just because some folks demand so. These barriers are not just about belief systems, inertia, vested interests or attitudes – to a certain extent these are the easy ones to tackle.

The more difficult barriers are cultural, systematic and structural. Consumers, clients, patients – whatever you want to call us – are still often unable to access mental health/addiction care as and when we need it. Service availability does not meet population needs in many places, particularly in rural and remote areas and for some demographic groups (such as older people).

The social and emotional well-being of many older people in services remains a source of national shame and I fear history will judge our field very harshly for the lack of care given to so many over such a long period of time.

A change in attitude among service providers is fundamental to working within a recovery orientation I agree. And we know many service providers, particularly of clinical services, still hold outdated beliefs that a diagnosis of mental illness/addiction is a life sentence to an incurable condition that invariably will have only negative consequences for a person’s life course.

Workforce training and development is fundamental to the roll-out of a recovery orientation. All sectors of the addiction/mental health workforce need to be trained to enable them to operate within a framework that supports the empowerment of consumers/clients and personal capacity building.

Also required is better understanding of the factors that impact on recovery, rehabilitation and relapse, along with coordinated provision of the support services that are essential to recovery. Equitable access to and better coordination of support services must be achieved, particularly for accommodation, disability, and employment services.

We all know that addiction services/mental health services will need to make significant changes to practice, services, structures and culture in order to be more supportive of recovery processes. And of course that means radical changes to the workforce. e.g. Whitely et al. (2009) studied implementation of Mueser’s ‘Illness management and recovery programmes’ across 12 community settings and found 4 important factors:

1. Quality of training
2. Quality of management (particularly supervision)
3. Local leadership
4. A culture of innovation

When all 4 of these are present together, acted synergistically it works. But training in itself is ineffective without good supervision, local leadership and a receptive culture.

So whilst we do see resistance to the recovery reorientation, we have to consider that probably most of that resistance is coming from expertise and concerns around the nature and speed of the shift . If not done throughly, comprehensively and with integrity we will be in a bigger mess than were we are now.

After all we are talking about massive change here. We are talking about changing the very nature of day-to-day interactions between consumers – I keep using that word consumers because I’m thinking of the changes in the English NHS. Thankfully in Scotland we are still patients/clients for the moment.

We are also talking about developing and delivering mational “people in recovery and user-led” education and training programmes. I know some organisations are probably tackling some of this but usually in isolation from each other, so there has to be some sort of national centre involved in this to ensure quality over all the different geographical regions and perhaps even across the UK, to drive this forward.

Transforming the workforce is not a simple or straightforward task. We have to change the way we approach risk assessment and manage and support the staff in their own recovery journeys.

We must therefore ensure we have an ethical framework, acknowledging the various philosophies of care, and a service framework identifying the systemic elements and their interconnection. We have already seen the work of theSMMGP update and reorientation of their clinical and practice guidelines. Which are tremendous progress considering the time span.

We still have a data infrastructure measuring various aspects of performance outcomes and indicators based on the old goals and we have to ensure that these too are influenced by those in recovery and who have recovered. Otherwise it’s nonsense.

A peer influenced (or even peer led ) regulatory framework of necessary governance and standards covering systems, services and individuals is key to the success of the new strategies undoubtedly.

When I say peer led here, don’t forget many folks in long term recovery across the UK have experience not just working in services as addiction workers. I know policy makers, strategic co-ordinators, performance evaluators, clinical directors and many more skilled folks in long term recovery who (given half the chance) would jump to be involved.

We have made a noble start in building a unity between patients, workforce and the public to meet the challenge of integrating a variety of recovery approaches and beliefs into a coherent mainstream strategy. Whilst trying to being vigilant in remembering the critical and vulnerable state of some of the users of these systems and services.

Again given the weight of the responsibility and scope of the depth of change required to move towards a recovery orientation, resistance is enievitable but also conscientious.

Putting the principles of recovery into practice and ensuring that the real developmental opportunities afforded by the strategies are maximised requires cultural change. Which needs to be supported and developed at every level of our organisations.

Recovering people and health professionals will be key in bringing about cultural change, and individual professionals need to take responsibility for engaging with the process.

To make the principles work in practice, the capacity for values-based care needs to be supported and developed. Values-based practice recognises that decisions taken in mental health/ addiction (you know I wish I didn’t have to keep doing this ‘mental health/ addiction’ as I see addiction as a mental health issue) but for the sake of clarity I will continue to do (it).

Anyway what was I saying? Oh yes….

Values-based practice recognises that decisions taken that are based on values as well as evidence. And that practitioners, service providers, service users, families and carers may have differing and sometimes conflicting values.

It aims to support workers to provide care and services that reflect people’s rights and the underpinning principles of practice. And to achieve the space to reflect on their practice, understand different values, negotiate conflicts, make decisions based on strong value systems, reaffirm, shape and challenge roles and practices.

It’s the people at the most senior levels in organisations delivering mental health/addiction services who need to acknowledge this. Ensuring that values and principles are embedded in organisational policy, and facilitate the change necessary to translate values and principles into practice.

Training in values-based practice should be a central feature of all health/addiction workers. The exploration and development of values-based practice also needs to be embedded in individual practitioner’s personal development plans and clinical supervision.

We need to:

Develop a national framework for training in recovery-based practice to support the dissemination of recovery-focused models into practice.

Support all professionals involved to review and revise assessment and care planning frameworks and documentation in their organisations to ensure they reflect the key elements of a recovery orientated system of care.

Acknowledge and promote people’s central role in assessment of their own needs and in planning and evaluating their care, decreasing their need to rely on formal services and support.

Respect people, value their contributions and views and preserve their dignity.

Focus on people and maximise individual choice, enable people to take greater control of their lives and instill hope and belief that recovery is possible.

Encourage people to retain or regain social networks, work, education and community connections as early as possible.

Build on people’s strengths and aspirations, emphasising strengths rather than deficits or dysfunction.

Foster authentic partnerships between people who need support and people who support them, acknowledge the key role played by families and carers in the person’s recovery.

Shift the emphasis of interventions and services from managing organisational risk towards therapeutic management of the individual.

In summary, at a national level, the UK has explicitly adopted recovery as a basic principle for mental health/addiction services.

I think the whole field would agree that change can be frustratingly slow, however, we need to get this right, we have a real window of opportunity.

Most folks in a variety of fields don’t get the chance in their lifetime to shape or shift their field. We have the chance!

Probably only one chance!

Right here! Right now!

Our emphasis must be on making that shift the very best it can be, not only because of the opportunity, but as a duty to the people we serve now and in the future.

Are “all” pathways to recovery to be celebrated?

One of the central ideas in the recovery advocacy movement in the U.S. is that there are many (religious, spiritual, secular) pathways to long-term recovery and that all are cause for celebration. Is this idea also a key tenet of the UK recovery movement?

Commodification, Recovery and Advocacy

I just wanted to add to the recent discussions around commercialisation, or the commodification of recovery. I think it’s important that we remember to be sensitive to institutional interests.

For me in my own advocacy efforts, just like my own recovery, I have to have periods of sustained reflection. Particularly, at the moment, on the sociopolitical and economic influences that influence alcohol and other drug problems.

Of course we have to be mindful of the existence of predatory industries that promote and profit from addictive products. Yes, products. Let’s not kid ourselves here. And we do have to ask openly and confront the ways in which public health can be sacrificed for corporate gain.

As advocates we are also calling upon today’s treatment organisations to become more accountable to the needs of the individuals, families, and communities they serve. And why shouldn’t they? After all addiction rarely happens in isolation.

I’m sure this movement is not about lobbying for an infinite number of ever-expanding addiction treatment centers. It is about nurturing the development of indigenous recovery-support resources that diminish the need for professionally directed treatment. It is about using the raw materials of addiction and healing to rebuild and revitalise families,and communities.

It is about recognising the healing power of a community of shared experience embraced by larger communities of hope and encouragement. Well it is for me anyway.

I love how Bill White puts it in his paper Toward a new recovery movement

“The leadership of the recovery movement must come from the recovery community and the movement’s agenda must be those of recovering people and their families. Great care must be taken in avoiding the problem of double agentry – individuals speaking openly as recovering people while their voices actually represent hidden professional or institutional interests.

The movement must guard against those who will seek to colonise this movement to further their own personal, professional, and proprietary interests.

Federal/state alcohol and drug authorities, treatment institutions, and treatment professionals may be supporters, members, and partners within this movement, but the leadership must come from within the indigenous recovery community.

Where few indigenous resources exist, local treatment agencies/professionals can play a role in nurturing the development of such resources, but it is the recovery community itself that must eventually assume the central role in recovery advocacy and in the design, delivery and evaluation of key recovery support services.

The recovery movement is greater than its leaders, and it is that higher value which compels these leaders to honorably represent the movement and to not wound the movement through personal excesses or indiscretions. What advocacy movements demand of their most visible leaders is not perfection but continual vigilance and a reasonable congruence between the life lived and the implicit and explicit values of the movement. The weight of this mantle of leadership can be a considerable one.”

Wise words for us all, eh folks.

On a slightly different note I want to make what I feel is a very important point. Let me say this loud and clear please, “Recovery advocacy is a philosophy of social action; it is not a programme of personal recovery”.

My experience of being in recovery, and undoubtedly in the history of the recovery advocacy movement, has shown that the grave yard, pubs and shooting galleries are full of folks who thought that they could get and stay sober by trying to change the world.

Do not make the mistake that advocacy equals recovery. Advocacy is not a means of achieving or sustaining personal recovery it is only one of many possible fruits of recovery.

I remind myself, and you, that participation in social change must not obscure the primacy of personal recovery as a foundation for larger service to the community. It must not become a diversion from those daily activities that sustain and enrich my own personal recovery. And for me one of those activities is practicing some principles in all my affairs.

Seize the day service user conference Birmingham

We certainly know how to Seize the Day!

Wow guys. Just to let you all know about my experience at the National Service User conference yesterday in Birmingham – ‘Seize the Day’.

Alistair Sinclair and I were asked to speak about the UK Recovery Federation (UKRF). As you know speaking at a conference in front of lots of people (over 400 I think) is never easy. I usually don’t feel too apprehensive but yesterday I felt really really nervous.

I’m used to speaking to ‘professionals’ but this was different. A room full of recovering people and people in recovery and people from the harm reduction world. It felt really important to get our message out and really do it justice. I think the apprehension was because of the gravity of the occasion.

This wasn’t a case of ‘preaching to the converted’. Many of the people in the room hadn’t even heard of the UKRF and I think many have received very mixed messages as to what recovery is. I felt a similar responsibility at the first service user conference in Scotland (see earlier blog). There’s never been a second much to my disappointment.

Anyway as I say, I was really nervous because there was, for me, a need for acceptance with this audience that I don’t feel with a general professional audience. I had all that, “I hope they don’t think I think I am someone”, business and, “Please God, let me do them justice”, going through my head. As if I could possibly control what other people think of me huh!

But this audience’s approval meant so much to me that I was physically trembling when I approached the podium. I needn’t have worried of course as the vibe back from everyone was really accepting and supportive and they even very graciously laughed at my very bad jokes.

My piece was on how the UK Recovery Federation came about and I think I did it justice. But I can tell you I was so relieved to hand over to Alistair who went on to speak about how we’ve developed and where we are now which was the really important bit. Again everyone was very supportive to Alistair; whooping and clapping as he talked about the UKRF aims and Recovery Principles. So overall I think we did a good job and I hope served the audience well.

I wanted to let you know something very powerful that struck me at the conference yesterday. Now I don’t know if this has always happened, as it was my first time, but when people from the audience were getting up to speak, or challenge the speakers, many identified themselves as in recovery. Many stating the time they had in abstinent recovery. Which really blew me away, as there was an atmosphere of celebration and achievement. Especially as we all reacted to this with great applause and pride.

I don’t know if this is significant but it really did feel wonderful to be part of the day.

So many thanks for all the hard work from the organisers who looked after us wonderfully and if you think we were rubbish and I am totally deluded let me know quick. The UKRF has been booked to speak at five different conferences over the next few months which will give us some practice and any feedback you have will be very gratefully received.

We make the path by walking it.

Maintaining legitimacy and authenticity when the money comes in

You know I think it’s great that various funders have came forward for wiredin and also throughout the UK I hear that more and more organisations claiming to be Recovery community organisations or recovery community projects, recovery cafés, etc are growing rapidly.

I also think it’s wonderful that there appears to be pockets of growth in national and local government offering foundation support for various recovery advocacy and peer support activities to organisations but I think it’s worth pointing out that they may or may not have strong ties to local communities of recovery and if they don’t this raises the question of the legitimacy or authenticity of organisations providing peer support services and how such legitimacy and authenticity can be maintained.

There are no rules from on high cast in stone to define such characteristics, but there is an extensive body of historical experience (for more than two centuries) that offers some wisdom on this issue.

This historical legacy and current sentiments within grassroots recovery community organistions (RCOs) would suggest 10 characteristics that define authentic RCOs and that can help RCOs manage threats to their authenticity. Authentic RCOs are organized by and for individuals and families in recovery. Toward that end, they :

1. Assure recovery representation (maintain recovery representation greater than 50% at membership, board, and staff levels)

2. Assure recovery leadership (leaders are drawn from individuals and family members in recovery or allies vetted by communities of recovery; RCO is committed to peer leadership development activities)

3. Maintain singularity of purpose (focus is on addiction recovery as evidenced by their mission, core values, plans and activities)

4. Minimize problems of “double agentry” (people in key leadership roles do not also represent other institutional—ideological, political, financial— interests that could undermine the mission of the RCO)

5. Seek diversification of funding (efforts are made to minimize the risk of colonization or corruption of organizational values by external authorities;
funding is rejected that comes with requirements that would compromise service relationships and relationships with communities of recovery)

6. Focus on long-term recovery at personal, family and community levels (recovery viewed as a process of intrapersonal, interpersonal and environmental transformation)

7. Distinguish their roles (from recovery mutual aid fellowships, professional treatment agencies and other agencies within the alcohol and other drug problems arena)

8. Respect multiple pathways of long-term recovery (recognise the legitimacy of multiple pathways of recovery and the rights of individuals/families to choose those pathways that best fit their needs and values)

9. Cautiously collaborate with kindred organisations (while resisting affiliations that would compromise their autonomy, integrity and mission)

10. Are responsible stewards (places recovery-focused services over personal or institutional aggrandizement and profit)

Worth a ponder or three, Can anyone think of anything else ?

Liverpool. The city with the UK’s fastest growing recovery movement?

Just thought I would highlight the Uks only magazine produced by service users (as far as I know). The magazine covers all areas of addiction and recovery, and anyone can contribute to it. So get in touch. It free by clicking on the link or you can become a friend. And for £20 you can have it delivered to your own door all year

Recovery Rising (formerly “The Word”) is produced and published by Genie in the Gutter. They are a not for profit company and all income raised is used to further recovery.

It produced in Liverpool and they are claiming to be the fast growing recovery city in the UK. Worth getting in touch just to challenge that methinks, haha!

Seriously though the back issues are all there on the site and theres some great reading to be had.

Enjoy x

UKRF Update 16/03/2011

UKRF Update

We’ve been meaning to put together a UKRF update blog for a while now but been very busy and the days have slipped by. There’s no time like the present though so here are the current UKRF headlines.

2011 Recovery Walk:

Events:

http://wiredin.org.uk/blogs/entry/10379/mapping-this-conference-is-led-by-you-and-for-you/

Articles

Recovery Networks

We are currently working with recovery activists on Merseyside to explore the establishment of a Merseyside Recovery Network. A planning meeting will be looking at this in a few weeks. We hope to support this network in establishing close links with other Networks and build on the work we have been doing with recovery activists, the NTA, DAAT’s and Services in the South-East and the Eastern Region of the UK. Early discussions have taken place in Lancashire and Cumbria around the establishment of local Recovery Networks and we hope to make some pretty concrete progress very soon. Again, check out our website for details as they emerge. Annemarie finishes up in her NHS post on the 31st March so for you Scots out there wanting to hook up, get in touch and she will get over and support you all.

UKRF Advisory Group

The new UKRF Website

We will place a great deal of emphasis on providing information regarding the many recovery assets on the ground (broken up into regions/localities) facilitating networking across diverse areas and the supporting of Recovery Networks. We intend to build a diverse UKRF membership at an individual level (those that subscribe to the UKRF Recovery Principles), group/network/Federation level, Services (once they have demonstrated they are recovery-oriented) and businesses (social enterprises and CIC’s that support recovery in the Community).

That’s the plan anyway.

Fingers crossed again.

There will also be something of an international link on the website. Very exciting! We’ll keep you posted on this.

Training and Education

Lots of work to do but we’re getting there. In “Recovery Time” as Bill White would say.

If you’d like more details on this stuff you can contact us at:

alistair@ukrf.org.uk

annemarieward@ukrf.org.uk

We make the Path by walking it.

Take care all.

The 3rd UK Recovery Walk!!! Cardiff, Wales 10th September 2011

The first ever Welsh National Recovery Walk will take place in Cardiff on Saturday, 10th September, 2011 supported by the UK Recovery Federation, the UK Recovery Academy, Cardiff County Council and the Lord Mayor Elect of Cardiff.
The date of the walk coincides with the successful Recovery Month in theUSA which has inspired the Welsh walk organisers, and which promotes the benefits to society of effective treatment for substance use disorders and mental health problems
Wynford Ellis Owen, who chairs the event committee, said:
“We want this Recovery Walk, the first in Wales, to be an event to remember! The US Recovery Month model which I admire lauds the contributions of good treatment providers, and spreads the positive message that prevention works, treatment is effective and people can and do recover. This is precisely what the Welsh National Recovery Walk embodies.
Through this walk we hope to engage with the UK Recovery community, and reach out and generate greater support amongst family members, friends and supporters of those in recovery.
The Recovery Walk is, in essence, a civil rights issue and will go a long way towards countering the considerable amount of prejudice, discrimination and stigmatisation of people with addiction and mental health problems that still exists in society.
We hope as many people as possible will join us on September 10th in Cardiff, putting positive faces and voices to recovery, and be effective and attractive advocates for the ‘hope of recovery’.
There’s one thing we can promise, there’ll be a welcome second to none in the hillsides, in the valleys, and throughout Wales for all those attending this first ever Welsh National Recovery Walk. It’s going to be an once-in-a-lifetime experience!”
To register for the walk and to receive further information, send an email towelshrecoverywalk@gmail.com or gobaithatgerdded@gmail.com.