"Our clients are often marginalized, stigmatized and face serious inequalities in day-to-day life"
Alcohol & Drugs Action provide a range of services from Direct Access (low threshold; needle exchange, blood borne virus testing, helpline for information, advice), short-term support for both alcohol and drug users, their families and concerned professionals. Recovery Services are in place linked with statutory partners to provide wraparound multiagency support for individuals entering and exiting treatment with recovery focused key-working throughout. In total, a range of services cover Aberdeen City, and South/Central Aberdeenshire.
At ADA we prize our values of always being there for our clients. We open 7 days per week, with evenings also available for a number of our services. So, this pandemic forced us to quickly re-evaluate what we could do (whilst properly adopting the full guidance measures) safely, and of course concentrate on still providing essential services.
All our traditional face-to-face and group work was paused at the onset of the COVID restrictions. Helpline, and online support (email and web chat) was put into place and reinforced with additional staffing. We then quickly worked to establish a self-serve needle exchange from our base, and our ‘Sharp Response’ (a delivery service for injecting equipment, emergency food supplies, mobile phones, utilities, naloxone kits and self-test dried blood-spot testing) was launched in April 2020 and been developing positively ever since.
All recovery groups moved into the online format of Zoom meetings and WhatsApp also being used for daily check-ins for those requiring additional recovery supports. We also had to change our volunteering roles – so our peer volunteers (those with lived experience) helped to establish a telephone befriending service for those clients feeling lonely and isolated without direct group and peer contact. Staff were identifying issues early on during their regular calls with clients. This has been a fantastic addition to supporting clients and equally allowing volunteers to continue with their valuable contribution and stay busy at a time which could also cause problems for them too. Our Recovery Services staff further supported NHS and Pharmacy colleagues with the personal delivery of medication to the homes of a number of clients either shielding or self-isolating. We also put in place a series of measures such as multi-agency socially distanced meetings, outdoor meetings, ‘door-step reviews’ and in some emergency situations partnership home visits to ensure safety and continuity of care for individuals deemed high risk.
Our biggest challenge has been in relation to navigating the ‘health gap’ which will be in place as we have not been able to reach as many people as we would normally do all due to the effect of restrictions being in place. This gap is gradually narrowing, but the health of our service users is critical as there is of course a high prevalence for drug and alcohol-related harms and deaths, across Scotland. Our clients are often marginalized, stigmatized and face serious inequalities in day-to-day life, so the restrictions have had negative impacts on mental wellbeing too.
We anticipate a further challenge may eventually arise from increased alcohol consumption in the population, as well as additional harms to those who will have been struggling with an alcohol dependency. This may result in additional strain on service capacity in the general ability to meet demand and individual needs. We are working closely with our commissioners and other partners to try and make sure that we are ready for these further challenges when they may arise. To that end we have contributed to local campaigns utilizing social media outlets in order to try and reach people earlier who may be struggling with their alcohol consumption.
With the restrictions affecting client’s travel and communication, we have learned that some of our assertive outreach and support will continue to be delivered in a post-COVID environment as an example of good practice arising from the necessity of enforced innovation. Traditional methods of engagement will return but we envisage a mixed approach and supporting clients to have access to Wi-Fi and more ability to be able to contact their support workers, families and friends when they need to.
It would be helpful for us to see the third sector being more recognized alongside their NHS colleagues in providing direct support and care to clients during the COVID restrictions. Some discussions have focused only on the most obvious areas, but other services and their workers have been equally active and at the front line of supporting vulnerable individuals. Being more openly recognized and valued will also help lessen stigma for these groups in time.