Knocked Back: A tragic loss of human potential
Our Knocked Back report revealed that at least 12,000 people who are homeless are missing out on potentially life-saving drug and alcohol treatment. Oliver Standing, Director of Collective Voice, reflects on the report’s findings.
Collective Voice is the national alliance of drug and alcohol treatment charities, whose members collectively support 200,000 people every year. A substantial proportion of these people will not only be dealing with a substance misuse problem but with other areas of severe and multiple disadvantage, including homelessness.
For this reason, we welcome the publication of St Mungo’s latest report, Knocked Back, highlighting the growing prevalence of drug and alcohol use by people sleeping rough, and its increasingly tragic consequences.
It will be sadly unsurprising to many in our sector to read that drugs and alcohol caused the deaths of 380 people sleeping rough in 2018 (over half the total number of people who died). But we must remain shocked and appalled at this growing public health crisis, and stay resolute in our ambition to reach the huge numbers sleeping rough who desperately need treatment but at present are not getting it – 12,000 people according to the St Mungo’s report.
Every year people in the substance misuse treatment sector anticipate with sickening dread the latest drug death statistics. And with every year in recent times bringing more bad news, the dread only increases. In 2018, we know that hundreds of people sleeping rough died as a result of drugs or alcohol. The total number of drug related deaths are even higher, at 4,359. That’s the largest amount since we started counting in 1993 and a 16% leap from 2017’s figures. Those statistics alone make for disturbing reading.
But what’s really disturbing are the human stories behind the statistics. Our communities have lost fathers, mothers, brothers, sisters, sons and daughters, who will no longer fulfil the promise their parents saw in their bright eyes as children, will no longer laugh or love. These are not just numbers, but a tragic loss of human potential.
It can sometimes seem hard to determine the real-world impact of public policy making. But surely the seemingly unstoppable increase of this particular type of death marks a clear and significant failure of the public policy and political leadership necessary to protect a very vulnerable group of people.
When it comes to people who use drugs and sleep rough we can’t ignore stigma as a factor. When people are dying on our streets from conditions we know how to treat we must ask ourselves the question — what is different about this group of people that allows this to happen well into 21st century Britain?
The most frustrating aspect of this? That the evidence on what works is so very clear. We have a world class compendium of evidence in our “Orange Book” and multiple NICE guidelines. We have a substance use workforce not short of ambition, compassion and expertise.
It’s welcome to see St Mungo’s Knocked Back report make clear the link between homelessness and drug related deaths. It demonstrates how some substance use outreach services, so vital in reaching people sleeping rough, have been lost in the blizzard of local authority cuts.
While in 2013, local government was handed the responsibility for commissioning life-saving substance misuse treatment services, but it was asked to do so with one hand tied behind its back. In the eight years to 2020 local government has lost 60 pence in every pound it received from national government.
It’s welcome to see the report stress the importance of close partnership work across the domains of severe and multiple disadvantage. People’s challenges simply do not resolve into the neat concepts such as ‘substance use’ or ‘mental ill health’ we use to think about the delivery of public services.
On the frontline, practitioners have of course always known that partnership working across those boundaries is essential. The same can be said for service-managers, commissioners and Chief Executives. National programmes such as Fulfilling Lives and MEAM are making robust coordinated attempts to bring together these services at the local level. These are all to be welcomed.
In the sector, we have the compassion, ambition and expertise to meet the needs of a great proportion of the people we support — we just lack the resource.
The government’s new addictions strategy and monitoring unit should both be unveiled this year and will provide important opportunities to drive much needed change.
I implore the government to set out an ambitious plan for preventing further deaths through the delivery of adequately funded evidence-based services — and I know that effective partnership between the substance use and homeless sectors will be essential in supporting the delivery of such a plan.
Read our Knocked Back research.
Find out more about Collective Voice.