When your at work, you like to be all you can be and excel in whatever it is you do, and I’m sure managers out there would be in agreement with this as best asset to services you provide. But…..what if you were in a job that made you feel like you had to be two different people? One where your heart and your head tell you two different things.
If you were a doctor and you had to do an important operation that could mean life or death with a patient, and you went into the operating theatre all prepared for the op, then someone stood leaning over you all the way through telling you to do it a different way, when you knew it could put your patient at risk, how would you feel and what would you do?
My head tells me that I need to focus and do whatever it takes to support myself by meeting my targets, keeping my employment, and taking direction from someone that supposedly knows best in order to survive and live comfortably without any risks of losing it all. My heart tells me to do whatever it takes to support others to meet their targets, working towards gainful employment, (as well as any other surrounding assets being fully supported) and to share direction with someone who does know best, to help them survive and to live? At a pace that promotes stability and positivity with every step, no matter how small with no deadline, No rush as long as we are moving forward safely and securely. Policy dictates a different approach…..
….can you see the dilemma, This has a knock on effect on whoever I’m supporting in number of ways. If I try and meet on middle ground, (within myself), my message becomes diluted and I may come across as being slightly confused around what it is I’m actually advocating for, or worse still fake, because in truth that is exactly what I am. My heart bringing empathy, my head allowing it to do what it’s best at, knowing that it is all working towards closing the deal with a stat! If I, go with my head and follow the policies that ‘govern’ those who I work alongside and the management that oversee, then the empathy has no place and it’s straight for the jugular…..get the stat! And lastly, if I follow my heart and allow the client to lead the way at their own pace and at their own discretion, I don’t meet targets, and run the risk of losing my job!! I never envisioned myself as a business man, still don’t. I saw myself as someone fortunate enough to be in a position to combine personal experience with qualified training in order to provide a service to another individual who was going through the same stuff I had, or indeed still was. Getting paid for it was a bonus. Admittedly I need to get by, but it was never about the funds. It was always about the people. Now I feel like I’m becoming a cog in a corporate machine that is big business, not unlike a production line, using medication and false promises to bargain with peoples futures.
This machine may feel like it’s working and well oiled by those who would have us believe they have our concerns at heart but everyone with any insight and heart can see that it’s far from seemless, not oiled at all, screaching quite loudly with audible clarity,and has no heart!
A little while back there was a new burst of energy in the field, a new breath of fresh air that some were fooled into thinking was a lifeline to normality and a new direction that would lead to huge rises in positive outcomes for all and a more solid foundation for equality and diversity in our communities. It had come from our guiding lights, those who were concerned for their constituents and wanted to give them a real chance at becoming part of their communities…..via work programs, with no money, no real prospects and only if they jumped through a number of irrational hoops. Groups and federations, CIC’s and Social Enterprises popped up all over the country to provide support, fellowship and unity at the other end of the treatment, recovery became a buzz word and a movement was predicted to sweep those trapped in addiction towards freedom and a new way of life. Momentum gathered at a rapid rate and nearly every town you went to had a growing recovery movement of likeminded people outside of the treatment system. Individuals came together and put themselves forward for the big society dream that was being sold. The Emperors new clothes looked like stylish Armani threads, and there was a strut in the step of those who were involved, however, the more we were fooled into thinking that the future was looking bright, and, as the cracks in the walls that the light shone through began to get bigger, we began to see the nighmare behind the dream, the truth…..
….nothing was any different, except….the way services were being commissioned and the way treatment was being delivered. Toxic relationships produced toxic partnerships and things got messy. Tenders were written to match the new agenda,, which despite a number of negative reactions, and very loud and vocal debates, went through anyway, with nothing changed after the consultations or numerous debating arena’s, except the wording, because we are all thick as shit and couldn’t see through that. The cracks in the wall were showing a different result on the other side, the federations, CIC’s and mutual aid groups began to gain too much momentum and despite the 2010 agenda advocating an emphasis on mutual aid, the nationals saw this as a threat rather than a positive alliance. Partnerships or coalitions became non existent unless terms were met and ‘recovery’ was highjacked by establishment driven by ideological policy and passive ignorance. So, now we have old school realists, still providing services in the communities with a pragmatist approach, making sure that individuals are kept safe while they prepare for the next step on their journey, and, at the other end of the scale we have survivors forming groups to support other survivors who come out the other end. But….in the middle we have a moral dilemma!! The treatment itself. A veritable breeding ground for contempt, confusion, failure and conflict.
So those with a heart for harm reduction are promoting safety and minimising the risks to those who are living with addiction in our communities, and indeed the community on the whole, and making sure they move forward with their health intact, and still breathing, then there is a ‘seemless’ hand over, for those that want it, to the recovery community, whose principles still lay firmly in the harm reduction of their community members, and their communities, ready and waiting to pick individuals up and integrate them into the community by promoting their assets and supporting them to maintain. A common thread throughout. Mutual aid from start to finish and at minimal cost, which is just as well because, more cuts are looming. And treatment….well. The treatment phase seems to be where all the money is being spent, yet it seems to be really struggling with continued confusion and pressure, and by all accounts is struggling to breath. PbR is creating a drive for success that is in fact promoting failure. Individuals are choosing to turn to mutual aid and not present to services because there are too many ‘requirements’ to adhere to, and too much pressure to stay on top of your own recovery, with strict terms and conditions. Accountability is one thing but being pushed into an arena that rushes you through without accountability is another. Scripts are becoming bargaining tools, GP’s are now starting to refuse benzo scripts and those who have been on the books for any length of time are being pushed into treatment or having their scripts stopped. Treatment services are only accepting those individuals with an agreement that a reduction plan be set, in stone, prior to accepting them into the treatment arena. Those on OST, MMS, are being pushed towards abstinence at a scary pace, set by those who hold the scripts rather than at their own comfort, creating discomfort. Those who are not registered with GP’s in the community for whatever reason are now being told their scripts will be stopped unless they register with a GP. Professionals are being asked to single out specific clients and push them towards exit if they are on low dose, and managers are having to enforce this despite what they feel or how much they are against it. So…the number of drop outs from treatment is reflecting in the recovery movement, and also the numbers of individuals who are not accessing treatment is reflecting the harsh environment they are faced with to make change. And the enforced cattle market regime they have to go through to make the transition. Hence the recovery movement is getting no new blood to thrive and grow.
The MAR model, which clearly states that there is a need for medication assisted recovery has been adapted and changed to meet the drive for results. And although it has been accepted that medically assisted recovery is essential alongside psycho-social interventions, this has been twisted and turned into a manipulative program that see’s prescriptions as a carrot and those that need prescribing as statistics. The system is becoming an inhumane mess of bullshit policy and promotion that is building walls to high to climb with no way around. So where do we go from here?
But then again this is just my opinion and it may well be me that’s chatting out of my arse and not the policy makers!!!!