What does it mean for me and my service, and for us in Tameside?

My professional background and training is as a social worker, and I was first exposed to the concept of recovery and its key elements when working as a community mental health social worker in east Manchester in the late 80s.  For me, the key elements of recovery practice are valuing the strengths that people bring to their own personal recovery; respecting peoples’ self-directedness; and having a focus on quality of life outcomes.  So for me, the essence of recovery is quality of life, and quality of life outcomes are the best measure of recovery.

But how are we to gauge quality of life, indeed the quality of our own lives?

How much, for example, do we enjoy life? How often do we experience anxiety or depression?  How satisfied are we with our personal relationships? Our sex lives?  The place where we live? How satisfied are we with our health?  Do we have enough energy to get through the day?  And last but not least, how much do we depend on medication to function in our daily lives?

This last question, how much we depend on medication to function in our daily lives, is obviously an important one.  But it is only one question in a wider quality-of-life assessment.

How important the issue of medication is to any one person, (compared to any of those other questions for example) is going to vary from individual to individual.  And the extent to which medication is a help or hindrance can only defined by that person.  No one else can do that for them.

If I had to say in one word how a drug and alcohol service could promote recovery I would say it could be through helping its clients exercise choice. Drug services in particular have sometimes neglected the importance of the detoxification and abstinence option, and clients have expressed the view that their ability to choose this intervention has been restricted.  I am pleased to say that over the last few years my service has dramatically increased the numbers of service users undertaking drug and alcohol detoxifications, and undertaking residential rehabilitation placements.  As important as volume, however, is the quality of the work itself, which means that we need to help clients prepare well for these treatments, offer good support to them and their families during the process, and provide meaningful aftercare.  Currently the completion rate for detoxifications (which itself is a good indicator of future and sustained abstinence from drugs and/or alcohol) is 94%.  And that is an impressive figure.

It’s usually difficult to define something important in one word, so I will add two others to how I think services can best promote recovery, and those two words are social inclusion.  For me, this means making the most of the ‘wraparound’ services that exist (such as employment, training and education services, housing support agencies, and money problem/debt advice agencies) in order to maximise opportunities for promoting social reintegration. I also understand social inclusion to be about the involvement and participation of service users in the planning of their own care and treatment, and in making decisions related to how the service that they use operates.  And finally, for me, it is about offering aspirational roles for service users (through volunteering opportunities, for example) so that services can better represent our service user constituency.

Aligning our work wherever we can with the general social and economic inclusion initiatives in Tameside will pay dividends.  The establishment of credit unions; multi-agency working to tackle loan sharks; and the piloting of individualised budgets are all examples of some of the work beginning to happen locally and further afield. The local treatment system is making some advances in moving towards becoming a recovery-oriented system but, as always, there is much more to do.