Drugs, Skills and Jobs: Why work should be a key component of recovery from addiction
A little over a year ago, Dame Carol Black called for evidence for her enquiry – commissioned by the then Prime Minister – into the effects of drug and alcohol addiction (and obesity for good measure) on employment outcomes. Although we know the report is completed, it still awaits publication, blown off course no doubt by Brexit’s political hurricane. As someone who has spent most of their working life in the fields of both addiction and employment services, and since The Work Company submitted evidence to the enquiry, I hope we shall not have much longer to wait.
When I cast my mind back to the 1990s, when I was first working in the drug and alcohol treatment field, work was an extremely peripheral concern. I wince when I recall case reviews in which customers’ jobs might be regarded as an inconvenience to methadone dispensing arrangements, or attendance at appointments. Of course these were the minority - because most customers (we would have called them clients or even patients then) were not in work and they were given very little encouragement to do so. The priorities of the time were HIV prevention and later of crime reduction; work had no obvious place in either paradigm. If employment was talked about at all, it was seen as a distant desired end state - something to be addressed at the end of the treatment journey.
A positive exception to this state of affairs was a growing trend to train and employ former customers as ‘indigenous workers’ or ‘experts by experience’. Despite the obvious pitfalls, this has undoubtedly improved the treatment sector’s workforce by providing a good leavening of customer experience. But the idea that former drug users might want or be able to work in “normal” jobs outside the treatment field had not taken hold.
The impact of the recovery movement on the treatment field – say since 2005 - has apparently been profound, with its revolutionary emphasis on self-activity and self-help. These days it is a brave treatment provider who does not at least pay lip service to the movement’s goals, and in many areas there is now a parallel universe of user-led recovery organisations alongside professionalised treatment services. And yet…recent contact with a number of treatment providers and commissioners suggests not as much has changed as might appear. Suggestions that mainstream jobs are a realistic goal for service users are still met with hoary old myths:
“There is no call for it”
“They only want traditional jobs” (usually ones that no longer exist)
“There are no jobs” (this at a time when employment rates are the highest since the mid ‘70s)
“Aren’t they better off on benefits anyway?”
When I hear this type of comment I feel angry. The treatment field has done much to prevent the spread of HIV and Hepatitis but it is still communicating an infectious poverty of aspiration to a group of people who all too often start with little of their own.
One of the reasons I can suspend this disbelief is because, since 2009, The Work Company has been running specific employment services, in partnership with one the UK’s leading treatment providers – Change, Grow, Live (formerly CRI). We now run these services across the North West and in Yorkshire. The model is a simple one, with employment workers embedded in the treatment services. We are able to establish the idea of work as a normality goal at the outset of the treatment journey and to offer a series of graduated responses that accelerate customer progress, rather than wait for a treatment journey destination that might never arrive. When customers reach the point of job readiness, we prep and promote them to mainstream employers on their strengths as candidates, rather than badge them as victims relying on employers’ philanthropy. This experience - and a conversion to job rate of 39% - demonstrates a fundamental truth: That recovery is a dynamic not a linear process. Changes in the lives of customers – new relationships, new skills and a job – are capable of making the recovery journey proceed in leaps and bounds, rather than a trudge to an elusive finish line.
I’m hopeful that Dame Carol’s report will support the idea that employment should be embedded as a treatment goal from the get-go; will recognise that our customers are entitled to easy access to employment services through their treatment service (and not only via the Job Centre); and will support the principles of Individual Placement & Support (IPS). At a time of unparalleled focus on health barriers to the labour market, the opportunity to make a decisive change in our approach to this customer group is surely overdue.