Whole person recovery – the RSA’s new drugs report

November 24, 2010 by
Filed under: The RSA 

Today saw the publication of the RSA report on whole person recovery.

It is a great piece of work and also timely. I see it as a signpost to the Big Society public services of the future. It takes the idea of personalisation to a new level. Based on deliberation involving 200 problem users, the report argues that capacity of individuals with drug and alcohol issues to cope with addiction, to enter treatment and to recover reflects their own social resources comprising individual, social and community capital. Services need to focus on the key factors which enable people to take control of their lives. One interesting finding, for example, is that service users can be significantly helped by being involved in civic life and feeling that they are valued as citizens.

Equally important is the way the report encourages us to define public services not simply in terms of those things provided by the state but also wider social attitudes and support. As austerity bites it is important that we reconceptualise public services by including the vital networks of family, friends and the wider community. By blurring the boundary between the state and civil society we can not only understand services more fully but also see the ways in which well designed public services encourage and support, rather than crowd out, the efforts of families and communities to help vulnerable people.               
  
The report offers a new way of thinking but also continuity with our past:

- The focus is on invention, not simply policy making. The next stage of the project will seek to implement and test the ideas developed in the first phase.

- The emphasis on understanding human capability and how to enhance it: made even more powerful by considering this from the perspective of a vulnerable and stigmatised group

- The project itself emerged from the excellent work of our 2007 Commission on Illegal Drugs, Communities and Public Policy.

The report makes concrete the concept at the heart of our recent 2020 Public Services Commission – that we should judge public services by their social productivity: the extent to which they help people help themselves, and each other.

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3 Comments on Whole person recovery – the RSA’s new drugs report

  1. Jane Duke on Wed, 24th Nov 2010 8:07 pm

    2. Hi Matthew,

    Speaking as an NHS Practice Manager and longstanding recovering alcoholic, I feel that the encouraging of families and communities to ‘support’ addicts and alcoholics can be counterproductive in some sense. It’s really the family or friends of an active addict or alcoholic who primarily need support, because of the addict or alcoholic in their midst. The addict needs to reach a realisation of their condition, a ‘eureka moment’, or support and well meant help is wasted, or worse, taken advantage of. This realisation is absolutely key, a breaking through of denial. It happens most effectively when the addict encounters real difficulties, a disintegration of their life and to a certain extent, a refusal by their friends and family to collude in patching up their problems for them. Nothing is so effective as this, I know from my own and others’ experiences. It takes huge courage to demonstrate this tough love and is why it’s those surrounding the addict that need help, at least in the first instance.
    It’s not new but is a radical way of thinking, it’s been clumsily expressed in some Alcoholics Anonymous literature, but is the only effective remedy I know of as a trigger for addicts to actually comply with their treatment and recovery. There has to be a motive for them, and helping their friends and family is no motive, sadly.

    I feel the NHS has a flawed approach of ‘managing’ such patients, as I have discussed with my GP colleagues. Mollifying, cajoling and endlessly negotiating over their treatment/usage can lock an addict/alcoholic in an endless cycle of using, arguably unnecessarily in my view. A GP encouraging for example an addict to ‘cut down’ has an opposite result from that which is looked for, a fact which is not taught at medical school as far as I am aware. Because of the emotional response to a request like this, usage is likely to increase. It’s counterintuitive to medical teaching to express cynicism and mistrust of the patient to their face, and most likely would make the addict angry, putting them at risk of dangerous behaviour, but as a tool for bringing matters to a head, it works. Remember, although vulnerable, actively using addicts and alcoholics form a group in society unparallelled in their propensity to lie, cheat and manipulate family, friends, doctors, anyone who can benefit them. Ultimately this isn’t a moral failing but a primary symptom of their disease. It’s that symptom that needs challenging first and foremost.

    I would be interested to know your thoughts on this.

    Cheers

    Jane

  2. Dr David Johnson on Thu, 25th Nov 2010 9:22 am

    3. I agree in principle with the conclusions of the report. However, in many ways I believe the sentiments cascade further than the target group and I wholeheartedly believe that the solutions lie in the resources and capability of individuals. This is an interesting one for me as I am a psychologist, and there is always the temptation to drift towards explanations focused upon the individual, but I appreciate that individuals live in a social world and that world provides encouragement and barriers in unequal supply.

    If we look at the world of enterprise education – whilst the entrepreneurial argument focuses upon individual agency and aspiration, the core capacity of a school or college student to create a successful business is equally influenced by their own motivation and skill, but also by their access to resources including social support and encouragement and indeed a bit of cash!

    Providing people with awareness of opportunity to instil aspiration is always a useful intervention, but if this os supported by the development of a facilitative infrastructure we add greatly to the probablity that people will be able to take active control of their lives.

    Clearly the case of drug and alcohol use is not the same as enterprise education, but the lessons indicate clearly that we need to support individuals and at the same time work to create cultures that foster the emergence of real positive human expression.

  3. RADAR – 26.11.10 | Vanilla Freelance on Fri, 26th Nov 2010 11:25 am

    4. [...] RSA Chief Exec Matthew Taylor introduced the report in a blogpost with an interesting thought; he said (excuse the long quote) that the report was part of a drive [...]

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