Hard edges event: 28 October 2019

• What improvements could be made to substance services and supports across Angus?
• How can we overcome the issues that arise as a result of the rural nature of Angus?
• How can we prevent the next generation being impacted by the five disadvantages and help break the cycle?
• What can we do differently?

Perspective

• Challenges around terminology ‘Treatment’ and ‘Recovery’. Treatment can include community and social interventions but is often assumed to only refer to medical intervention.
• Unkind language around drug and alcohol use does not help, this prevents us seeing the person that needs help and support
• What do those who are not in the world of substance use services see?
• Mixed group support where different people can share different experiences allows for perspective and empathy for others
• Sometimes the impact of substance use is contained within the home, so it may not be obvious to those out with the family/peer network – how do you spot the signs when they are well disguised?
• Fear of accessing services  Stigma and fear act as a barrier for families, concerns around having their children taken away if they access services – raise attention of support services
• Mixed messages around types of drug and alcohol use and the way society views different types of abuse
• We need to move away from believing that users are the architects of their current status and that they are the problem
• Decriminalisation, looking at Portugal as a positive example – reducing stigma and isolation.
• How do we categorise substance use? Is it a health or a crime issue? Could decriminalisation help us to focus on the health needs rather than the legal issues?

Actively caring communities        

• How do we break the cycle? How do we get our sense of community back, where all are welcome and cared for within their community
• Community Cafes are a great way of bringing people together, reducing isolation and loneliness.
• Recovery - How do we support ‘recovery movement’? once a person is ‘recovered’ how do we continue to support them to re-engage with their community after isolation?
• We need to involve local people and communities in our core research
• What works – individuals running peer group sessions, with information available to follow up and find out about services
• If we are going to do something about this it needs to be with the purpose of making people happy, to help them have a better life – active caring and happiness

Resources

• Are we getting the message out there about support services that are available in Angus?
• Early Intervention work requires more attention
• Can be challenging for small but ‘volunteer rich’ organisations to find the relatively small amount of funding needed to run these (£4-5K per year) – how can we help here?
• Efficiency is not about the money, it is about how we use our resources effectively
• Inconsistencies with named person process across agencies
• Collaboration - organisations need to work together a lot more
• Reconsider how we share information across agencies to find patterns
• We cannot look at all the issues highlighted in the report in isolation, we need a shared perspective to see the full picture
• There is a general lack of support options, finding that people are self-prescribing rather than using methadone treatment
• Informed networks   It is important for organisations to be aware of what other support is out there and who the right person is to speak to. With so many changes, restructures, staff movement it can be difficult to find the right person – especially if needed in a hurry!
• A quarterly update would be helpful, informing of any significant changes in organisations and providing a key contact update – an E-Booklet used to be circulated by Arlene at VAA which was very helpful
• *noted here that VAA’s locality locator is a helpful resource and can be used to find key agencies and contact information. The Drugs and alcohol partnership website also has a list of key contacts and is updated quarterly.
• Communication could be improved, shared discussions around organisational and staffing changes, training needs and opportunities – can we become better informed to offer a more holistic approach?
• How can we manage increased demand on service delivery while making time/making priority for non-service delivery activities such as networking and meeting with officers from other organisations?

Barriers to accessing services

• Services are good when you get to them, however there are barriers in the way people need to qualify to use them.
• Can clinics/support services be more flexible across the board to provide access to support – not just Mon-Fri 9-5?
• Services are too slow to engage, one organisation commented that from the time of presentation it can take an average of 2 weeks to start a programme of support
• Education in schools – the curriculum framework – would be good to see more joined up working here around social issues. Could we develop a family engagement strategy that is co-produced, a multi-agency approach.

Rural Areas

• City gangs are specifically targeting rural areas to sell drugs – small villages and towns are so well connected, there is generally awareness across the community of this activity but a lack of reporting – or action on reporting
• Some behaviour can be attributed to connectivity – rural isolated locations with limited public transport and social community activities, can be a catalyst for drug and alcohol use
• Stigma around recovering people and negative influences in small towns have an effect on mental health, some need to escape.
• A community driven approach is required for rural communities, we need to use small community networks in a positive way