Posts in ‘Substance misuse’

Holistic support

I’m not expert on the welfare system, I’d be the first to admit it. But having been here now for eight months or so, I’ve had the opportunity to listen to the experiences of plenty of benefit claimants.

Certainly I can see that some of the consequences of the welfare reforms – Atos, digital inclusion, bedroom tax – have had a fair amount of negative impact. Spending just half a day in this UCAN can tell you that.

There’s been plenty of talk amongst the staff lately about those that don’t fit easily into the new world of welfare and this morning – because it’s a Friday and the UCAN is closed to the public – I’ve brought Vanessa, Rosanne and Carl together to have a chat.

“Let’s start, if we can, by identifying who we’re talking about,” I say, once we’re settled around the upstairs meeting table.

All three have examples of those with ‘multiple needs’ who, despite their best efforts, are unable to do what the Jobcentre requires of them.

“They might have been on Incapacity Benefit and not worked for many years,” says Vanessa. “They may have drug or alcohol issues, little literacy and no IT skills and now find themselves on a job-seeking benefit.”

“So what’s the problem?” I ask.

“They’re just not receiving the holistic support they need from the Jobcentre to become independent jobseekers,” continues Vanessa. “They are not being assessed properly in the first instance and then the Jobcentre advisor passes them onto us.”

Rosanne chips in: “The advisors are supposed to be assessing literacy and numeracy skills and it just isn’t happening. I phoned the Jobcentre about one customer who they had referred to us who could barely use the computer and I asked how they expected us to support him looking for a job. After I’d been passed from pillar to post, they told me to put him on Universal Jobmatch!”

“Which was precisely the thing he couldn’t use,” I say.

“Exactly.”

“There are certain customers who have multiple issues and need lots of one-to-one,” says Carl, “but we have to hold out hands up and say this is something we can’t provide.”

“So, for many, the new regime of online job search is not working because these customers are so far behind?” I ask. “But, if they don’t keep up with it they could be sanctioned…”

“This is what we’re faced with daily,” continues Carl. “Sometimes it’s just a matter of keeping people out of crisis until they can job search. But even basic IT can takes weeks of practice before they can search for work independently.”

“Perhaps there should be a sanction amnesty, a period where they won’t lose any benefit,” I suggest.

“Yes,” says Rosanne, “an amnesty for sanctions but not for job-searching. They should still have to make the effort.”

“There’s a massive knock-on effect for someone who’s not treated appropriately,” says Carl. “If they are sanctioned unnecessarily and get into financial hardship…”

“Which they will,” I interrupt.

“…which they will. Then it brings up other issues around self-esteem and confidence and often anxiety and depression.”

“Our relationship with the Jobcentre is getting better,” says Vanessa positively, “but there still needs to be more understanding of what we as UCANs can realistically achieve for those with deep-rooted issues.”

“And, it seems, the initial assessment by the JobCentre needs to get more rigorous,” I suggest.

“You don’t have to be a counsellor to pick ups some of the important clues when a person is sitting in front of you,” says Vanessa.

Elsewhere on this blog I’ve written about how the UCANs are flexible enough to adapt the services they offer to their local clientele depending on need. It’s one of their selling points.  So it comes as no surprise that Vanessa tells me she has already put in place a pilot project aimed at just the group of people we are discussing.

“It’s for those who had been on Incapacity Benefit for some time and have now been moved over to Jobseeker’s Allowance,” she says. “Mike, our CV-writing expert, is running it over the next six weeks. We want to see how they are coping and what, if anything, needs to change for them.”

“That sounds really interesting,” I say, “I should have a chat with Mike.”

“Brilliant,” says Vanessa.

“Do you think you can work?”

continued from Fit for work?

At the hospital we eventually find the right place and are promptly ushered into a standard consulting room where a pleasant nurse – she tells us later she used to work on a drug and alcohol team – explains the procedure and starts asking questions.

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She works through each of Richard’s symptoms: ADHD, alcohol dependency, hearing loss, anxiety and depression, and asthma and asks the same questions for each, typing his responses. “What are the symptoms of your ADHD?”

Richard is nervous. “Lack of concentration, confusion,” I recall he says.

She asks who diagnosed the condition, when, what tests did they do? When was the last time he saw a medical professional about this condition? She asks about his medication and then a series of standard questions about his daily routine. Can he cook for himself? Can he use a microwave? Can he wash himself? How often does he use the toilet at night?

The questions are rigid and formulaic. When she asks if he can use a microwave to heat and cook food Richard replies he can’t cook but he does heat food. “I can’t differentiate,” she says, “I’ll put down, cook and heat.”

The inadequacies of these ATOS assessments are well documented elsewhere but the irony of Richard’s situation isn’t lost on me. His ‘headline’ symptoms are an inability to concentrate and a tendency to get confused and here he is, sitting on the edge of his chair, being expected to articulate expansive answers to these quick fire questions and build his own case for staying on a disability benefit.

Throughout the half hour assessment the nurse makes it clear that she is not the one who will make the final decision. That will be left to a Department of Work and Pensions case manager who will read the report having never met Richard.

“I was expecting to be able to go into more detail about my own personal circumstances,” he says on our way back. “There should have been more on the emotional side, how ADHD affects me.”

“Although I barely know you Richard, I think I found out more about you in our thirty-minute journey there than she did in that formal interview.”

“You’re right. You did. I was much more relaxed.”

“Do you think you can work?” I ask.

“My concentration levels only allow me to do things in small quantities. It would need to be something I enjoy, something I can focus on. Anything boring or mundane, then I just wouldn’t be able to stick with it.”

“And as it stands now, you’re an alcoholic. Do you think you could actually hold a job down? Could you leave the house at eight and come back at six without having a drink?”

“No. No, I couldn’t.”

Fit for work?

His appointment is at 9am at the Royal Blackburn Hospital, two buses and a train away or half and hour in the car.

Richard can’t manage public transport on his own. He gets panicky. He’d asked his social worker and his alcohol team worker. Both were unavailable to take him which is where I stepped in. He gets a much-needed lift, I get another story for this blog.

So now, having met in a Morrison’s car park, we’re driving through the East Lancashire countryside in the rain, discussing his ADHD (Attention Deficit Hyperactivity Disorder).

“How does it affect you on a daily basis?” I ask.

“My concentration levels are really, really low,” he says. “I’m always thinking of 100 things at once and I can’t stop it. It’s very frustrating. I can’t organise myself.”

“So what are you thinking about now, as we’re talking?”

“I’m thinking about this wonderful scenery, about the detox and about the questions they are likely to ask me this morning.”

Because of his ADHD, his alcohol dependency and his depression and anxiety, Richard currently receives Employment Support Allowance, a benefit which means he’s unfit for work. However, he does volunteer at the UCAN on a Monday afternoon, helping IT freelancer, Charlotte get people online.

As part of the welfare reforms, he has a controversial ATOS interview this morning to assess whether he should be put on a different benefit.

In 300 yards turn left.

“I’ll give you another example,” he says. “I can completely zone out. I might start crossing a road and not realise it. It’s a miracle I haven’t been knocked over by now.”

Richard is 34 and he tells me he’s been drinking and using drugs since he was 14. “The last 10 years have been full-on addiction but I’ve only admitted it these past five years.”

He’s waiting to be admitted on a three-week hospital detox, although it’s not the first time he’s tried to stop.

“I’ve come off in the past, just to prove a point, but that’s not the same, is it? This one is for me. Because I want to change.”

As well as the detox, his psychiatrist has changed his ADHD medication and booked him on Cognitive Behavioural Therapy sessions – talking therapy – for the next couple of years.

“You’ve got quite a journey ahead of you, haven’t you?”

After 300 yards turn right and then bear right.

“I’m scared though. Because alcohol is all I know. It’s going to be hard.”

Richard’s two-hour volunteering session at the UCAN is a lifeline at the moment, the highlight of his week. “I went to do an IT course there and was shocked when Charlotte asked me to volunteer. I can manage it for a couple of hours and, because it’s something I’m passionate about, I can focus on it for that short time. Now I’m buzzing.”

In 300 yards, you have reached your destination.

Continued in “Do you think you can work?”

“There’ll be a rainbow soon”

continued from Eating less to pay the extra ‘tax’

I’ve taken enough of Hayley’s time and decide to check out the bulb planting that I can hear is underway. A table from one of the small offices has been dragged outside into the bright sunshine. Carl and Alan – from Dave’s support group for substance misusers – are giving advice to a small group of enthusiastic residents.

“What are we doing with these then?” one woman asks, with a handful of tulip bulbs.

“Put a few in a pot,” says Alan, “and cover them over with the soil. Give them a drink of water when you get home.”

“I’ll give them a drink of sherry!” laughs the woman.

Another woman, coming out of the mini-mart next door, calls out to someone she knows: “What are you all doing?”

“We’re planting bulbs!” her friend shouts back. “Come and have a go.” And she does.

Karen is here too. She’s from a construction company working with Bolton at Home on the refurbishment of some houses on the estate. Apparently, they have donated all the necessary for today’s activity.

“So, you’re like a fairy godmother,” I suggest, “You can make these things happen?”

“Oh yes, I suppose I am,” she says, passing a bag of Iris Harmony down the table.

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The UCAN is buzzing now, inside and out. Once they’ve planted a few bulbs in their tubs, the customers – almost exclusively women – gather inside where Rosanne is making brews and keeping the banter up. It’s billed as bulb planting but really it’s an opportunity to get to know customers better and continue building relationships.

Once all the pots are filled and the table is cleared away I ask Alan if he can show me the UCAN allotment. Over the last couple of months I’ve heard quite a bit about it and it’s seems appropriate after the bulb planting.

“Is it far?” I ask

“Only round the corner,” he says.

The allotment is pretty much on the next street. We’re down a path of sorts between two houses and then Alan unlocks a gate onto a piece of land bounded by about a dozen back gardens. At first glance it’s clear this allotment has seen better days.

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“No one knows it’s here, says Alan, sitting on the side of a cleared bed planting some tulip bulbs he’s brought. “I never knew myself until someone showed me… and I’ve lived round here for years. It’s hidden.”

“And what are you hoping to do with it?”

“I’ve been doing my plot for about eight months now, just keeping on top of it, keeping it going. But I want more from the community to get involved. I’ve tried to get other people interested but it’s hard.”

“You watch, though, as more of them see what you’ve done, then they’ll get interested. You’ll inspire them.”

“Maybe.”

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I know Alan is a regular with the support group for alcoholics and drug users and so, as fine rain starts to fall over the allotment, I tentatively ask about his involvement.

“My problem was alcohol,” he says, “but I’m fully recovered now. This sort of project is good for me. It keeps you going, keeps you ticking. Oh, I could to tell you loads of things. But I don’t want to get into that.” I don’t push it.

“So doing this and the UCAN,” – Alan also tends to the space at the back of the offices – “has been good for you?”

“It’s been fantastic for me. They’ve given me support, they’ve given me responsibilities. They’ve put their trust in me.”

The sun’s out again but the drizzle has yet to stop. “There’ll be a rainbow soon,” I say, scanning the sky above the neighbouring rooftops. “And what have you grown on here so far?”

“I’m doing flowers down this end,” says Alan, “and veg done there. I’ve already had some running beans and tried sweetcorn but that died off.”

“You can spend a lot of time regretting”

Dave’s come early so we can talk.

He runs the Discovery Group, a weekly support session for substance misusers – recovering alcoholics and drug addicts – and he’s well qualified. “I’ve drunk heavily all my adult life and for 25 years I was dependent on alcohol,” he says, candidly. “I know the pain – I can’t over-emphasise that – and I know the mental processes an addict has to put in place to change the way they think.”

I ask Dave about the circumstances that led him to become an alcoholic. “By 16,” he says, “I had a reputation that was built around being able to drink more than anyone else and I embraced that quite happily.”

He tells me his father was in the trade and drink was readily available, part of everyday life. Yes there were family problems: his parents split and reunited, twice. Dave’s first marriage, to his childhood sweetheart, failed after seven years and his second after 13 years, “There were other issues in both relationships, but fundamentally you can put it down to alcohol,” he says.

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Now retired, he’s still amazed he managed to hold down a job throughout a lifetime of drink. “I would have sacked me, I really would. I wouldn’t have tolerated it.”

Dave’s group grew out of an NHS initiative that was axed due to the cuts. He could see the benefit it was providing to, he concedes, a relatively small number of addicts and he wanted to keep it going as a volunteer.

“It had become part of the routine,” he says, “and routine is vital to recovery. The UCAN offered this room for free and have never asked us for any payment, even for teas and coffees.”

“And why is this different from other groups like NA [Narcotics Anonymous] or AA [Alcoholics Anonymous]?”

“People have to try whatever’s out there. Some support suits some people and not others. Alcoholics Anonymous wasn’t right for me…”

“Why not?” I interrupt.

Dave pauses. “They were asking too much of me,” he says eventually. “Not of anyone else… of me.”

I leave it there. “So do you follow a particular programme with your course?”

“Yes. I’ve written a 12-week programme pulled together from different sources and so one week we might cover self harm, the next we could be discussing putting in place a recovery network of people who can help.”

“And, as a volunteer Dave, you must get something out of this as well? It’s got to be a two-way thing, right?”

“There is no doubt that doing this is good for me. I’d be a liar if I said any different. I’m someone who knows and cares, and yes, there’s a feel-good factor to it.

“I am so proud of being well thought of by all of them here at this UCAN. It’s probably one of the things I’m most proud of. I see them going the extra mile every day. I’ve got a great respect for them and they respect and value what I do too.”

Dave’s attendees have arrived downstairs for the start of this week’s two hour session. “I’ll just grab something to eat and then, if it’s okay, I’ll pop in to be a fly on the wall.”

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Later I take my camera and recorder into the meeting. Dave is here with Alan, a friendly man I’ve met at the UCAN a few times before and another man I’ll call George. It’s a smaller turnout than usual but that’s the nature of this client group.

They’re talking about children. Forty-year-old George says he’s been having regrets about not starting a family.

“I never had kids,” says Dave, “and I put that down to the drink. Alcohol affects every part of your body. But I don’t regret it. It’s best not to regret. You can spend a lot of time regretting…”