Phoenix Chief Exec Karen Biggs addresses the myths and legends of residential rehab and highlights the tangible truth.
Myths and Legends and the Tangible Truth
Over the course of the last 30 years we have developed a robust set of treatment interventions in the UK, based on evidence, research and practice. Delivered by a range of professionals with expertise from different disciplines. They are summarised in Drug Misuse Clinical Guidance and referenced by the National Institute for Clinical Guidance. It isn’t an exaggeration to say they are the envy of many in our sector across the world.
So why are we finding, at a time when we need to rely on that expertise, on the tangible truth, we resort to myths and legends – stories once upon a time we believed to be true and were held so vividly in the minds of some, used to explain something beyond their comprehension.
‘’There are forces at play to get everyone who has a drug problem into rehab’’
As with any good legend this is often a cautionary tale used against arguments to increase access to rehab for anyone. ‘Not everyone can go to rehab’ is the cry. A response no one would disagree with. Many people could benefit from rehab but it is most appropriate for the 3-4% of people with the most complex of issues. In many areas of the UK rehab just isn’t an option. Funding is never ‘awarded’, pathways don’t exist.
"Rehab is expensive"
Possibly the tale that best exposes the discrimination against people in addiction. Residential rehab, or addiction care homes, are together with inpatient detoxification facilities the most intensive form of addiction treatment for people with high needs and at high risk.
Look to any other health care needs and we have accessibility to health care based on the science. NICE exist to make those decisions. And NICE say
The range of therapeutic approaches employed in residential treatment makes some programmes especially suitable for those with the most complex needs and for those who “have not benefited from previous community-based psychosocial treatment” (NICE 2007). However, there will be some people who desire to go directly into residential treatment and some may benefit from doing so. Such decisions will need to rely on a best clinical judgement.[1]
...but still local officials, civil servants and health care professional decide that someone with the most complex of needs isn’t worthy of the funding. Why do we allow stories that try to lure us into a reality where cheapness wins?
"There isn’t the demand for rehab"
The most fantastic and fanciful of all the tales.
At Phoenix and I am sure many other addiction care homes across the UK we meet people who have been trying to access this form of treatment for years. People in addiction and their families tell us they never knew rehab was an option. They didn’t know that form of treatment existed because no one had told them. Families that take out loans to pay for private treatment for their loved ones because they ran out of time jumping through the hoops and navigating the processes.
"Funding isn’t the answer"
The tale that elicits the loudest response for those of us who have seen funding reduce in some areas by 40%.
No you can’t JUST throw money at the need to improve healthcare but alongside planning and coordination and a clear strategy, it does require some money, but very little compared to the cost of not treating people with complex needs.
"We would need to build lots of rehabs to increase access"
A myth of the highest order.
Our analysis shows you could double the amount of people going to rehab overnight without having to lay a single brick or reprovision a single property. Many rehab beds lay empty every night in the UK because local government won’t pay for vulnerable people in crisis to sleep in them.
"People are vulnerable when they leave residential treatment"
The most dangerous and demoralising of tales for people in addiction to be told.
People are vulnerable after treatment of any and every health condition, that’s why we need and have, integrated care pathway including housing that enables connection to family, community and employment
The Tangible Truth is that Residential rehabs are care homes for people with the most complex of needs. They are supported by Nice Guidance, they are detailed in the Clinical Guidance.
People don’t get access to this form of treatment, not because of a clinical decision based on years of experience and professional judgement in line with the guidance, or because they don’t want to go, or they don’t have the motivation, or they wouldn’t benefit from it, or it would make their lives more risky.
People are excluded from this form of treatment because of discrimination born from stigmatising views about the causes of addiction and because we have for too long let the myths and legends be told unchecked.
[1] Drug Misuse UK Clinical Guidance https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/673978/clinical_guidelines_2017.pdf
