Assessing Scotland's "Road to Recovery

Introduction

Scotland has been affected by a continuing drug problem which has been persisting for several years. To help combat this problem, the Scottish government has undertaken the initiative termed “Road to Recovery” which includes reform services for problem drug users (Becker, Bryman and Ferguson, 2012). The purpose of this study was to find out the experience the users who have taken this service and see the impact it is having on the problem population. This study was done using the method informal interviews to elicit accurate information based on the nature of participants and then the finding was analysed to uncover the effectiveness of this policy.

Policy Response

Social policy is the policies in play within a governmental or a political party, such as public welfare or social services. Such policies usually contain guideline, legislation, principle and action plan that affect the welfare of the society or community the governing body or political party resides in and improves the quality of life for the members (Wiman, 2009). Social policy can also be described as a practice of social intervention with a purpose and it is effective to secure social change in order to promote the wellbeing of its citizens (Becker, Bryan and Ferguson, 2012).

According to Bradshaw (2012), social welfare can be advanced by effective social policies and it helps to mitigate the social problems. Social policies should bring accomplished livelihood to the people, if it is well researched and implemented. Social policy is based upon a multitude of disciplines ranging from economics, sociology, psychology, political science etc. The Scottish Government’s social policy which is in line with the SNP’s policies is reflected in the welfare activities of the general Scottish public (Scott and Wright, 2012).

Since the SNP came to power in 2007, if there is one legacy the SNP wants to be remembered for, then it is to be the party than famously gained independence and freedom for the Scottish people. For this reason, they are deliberately trying to identify different welfare and social policies in Scotland because it serves its political purpose which is ultimately to gain independence. For this reason, they want to use policies like the ‘’road to recovery’’ to say look, we have this here in Scotland which the rest of the UK do not have. In their 2017, general election manifesto, it stated some of the achievement it has chopped in the mental health services in Scotland (SNP Manifesto, 2017). Firstly, being the first government to appoint the first ever Minister for Mental Health in the whole of the UK with spending at its record high (SNP Manifesto, 2017). Secondly, stating that even though there is still a lot to be done, it has significantly increased the workforce in adolescent and child mental health since 1 in 4 people experience mental health issues in their lifetime (SNP Manifesto, 2017, p17)

At the time of the project “Road to Recovery” undertaking, Scotland had around 52,000 problem drug users (Scottish Government, 2008). The project thus reflects the public welfare action plan of the Scottish Government’s policy and is governed by guidelines to ensure the overall quality of life for the Scottish people, particularly the problem drug users and their families, is enhanced(Keating, 2010).

In Donald Dewar, the party had a pioneer broadly seen as the father of devolution - the man who secured a Yes vote within the 1997 choice that cleared the way for Holyrood (Scottish parliament). All sorts of arrangement and advancement were guaranteed with devolution and are guaranteed by advocates of freedom. In this setting, it is healthy to reflect that the by and large record of the Scottish Government and the Scottish Parliament in these important arrangement ranges within the decade and a half of their present existence is, with a number of exemptions (Elcock and Keating, 2013).

Health consumption of around £11 billion constitutes almost one third of the entire Scottish budget and comes about in a ten per cent per capita higher spend north of the border compared to Britain. It has evident that, the Scottish NHS has been saved the scale of ceaseless showcase based rearrangement experienced within the south and restricted moves to clinic trusts that were revoked. In this context, relative execution does not appear to have progressed further. For instance, the Scottish people were saying that their wellbeing weren't satisfactory in both 2001 and 2011 census (McPhee, Brown and Martin, 2013). The rate of the populace with a long term activity-limiting wellbeing issue or incapacity was 20 per cent in both a long time. In Britain, the comparable last mentioned figure was 18 per cent in both a long time. In spite of the higher per capita, investing on the wellbeing in Scotland, there is no prove that, devolution in wellbeing approach has made any significant contrast in comparative levels of well-being or considerably disintegrated contrasts in wellbeing that has been resulted between Scotland and Britain. A consider for 2001-7 proposed, for occurrence, that Scotland still had one of the most noticeably awful wellbeing records in Europe which ‘excess mortality’, over that accounted for by hardship, was 20 per cent higher in Scotland than Britain. A couple of developments do, be that as it may, merits specify.

Free medicines were brought by the minority SNP organisations earlier to the 2011 Scottish Parliamentary races and it were £57 million, where the elderly people like cancer patients are profitable from such courses of action. In 2011, 70,000 individuals are profited from this benefit. Concurring to one ponder, this framework comes about in investing on social administrations in Scotland being 25 per cent higher per capita than somewhere else inthe UK. Say moreover should be made of the later blending of territorial police and fire administrations into centralised national associations’ maybe the foremost radical of the changes coming about from devolution(Scott and Wright, 2012). Free individual care, started by the moment Liberal Democrat organisation, was an effective development to serve the people with best quality treatment and care.

After the devolution in 1999, setting and negotiating budgets and agendas became very difficult as there were always confusions between the minority and coalition government.Again, when the SNP came to power with minority vote in 2007, there was a massive global economic crisis which consequently affected their budget planning (Cree and Smith, 2018:a) and some of the policies and projects they had intended to undertake. Gradually, there have been some autonomous powers given to the Scottish government from Westminster to control its finances and budgets. For example, the Scotland Act 2016 gave powers to set interest rates and income tax thresholds, which contributes in establishing new and different benefits in devolved areas (SNP, n.d.). However, due to the recent referendum in the UK, there are uncertainties in the Scottish parliament as the UK is still struggling to get a deal and a leave date with their partners from the European Union. Such uncertainties will play a major part in the Scottish government budget and expenditure (Cree and Smith, 2018:b) therefore affecting its social policy projects.

In Scotland, there has been less of a concern with a race to the bottom in terms of the recovery motivation, master arrangement for addiction and recuperation administrations remains firmly in the hands of NHS administrations –but or maybe there has been a sense of dissatisfaction around how little has changed since the distribution of “The road to recovery” procedure in 2008 (Scottish Government, 2008). There is a different political climate since the approach of the devolved government and the determination of the Scottish recovery arrangement has remained closer to paralleling the mental wellbeing recuperation which shows in a way that was not the case within the English policy which was predicated much more emphatically on the change and decentralisation of the treatment system. This has implied that, the core components of sedate and liquor treatment delivery in Scotland have been changed much less profoundly the abilities they ought to be portion of the work showcase and hence are fundamentally critical to moving forward our financial execution (Scottish Government, 2008).

The purpose of selecting “Road to Recovery” for the study is that it reflects the public services policies of the SNP government and ideal to measure the quality of service the government is being able to provide to its people. Central to the policy of “Road to Recovery” may be a modern approach through the concept of recuperation. Recuperation may be a handle through which an individual is empowered to move-on from their issue of drug problem towards a drug-free life and ended up being a dynamic and contributing part of society (Cunningham, 2012). Centre to usually the change of the way that medicates administrations are planned, commissioned and conveyed to put a more grounded accentuation on outcomes and on recuperation than in Britain.

The welcome by the First Minister to Chair a Commission into the longer term conveyance of open administrations in Scotland was one, I was pleased to acknowledge. Open administrations are critical to us all but are of specific significance in securing the vulnerable and socially excluded people in our society. They are central to achieving the reasonable and just society in which we live. The methodology sets to prepare a number of activities to turn recovery into a reality (Cunningham, 2012).

Reflective Account

I had selected this strategy to consult my service users as this has influenced their lives. Before starting the consultation, I discussed the strategy with the leader of the team. The discussion was to gain permission and attain other necessary information such as the process of gaining consent from the participants, how to select the consultees as well as what method of data collection to use. The team leader, who had just started working in the setting around the same time I started my placement, suggested to me to take advice from my senior colleagues on how to choose my consultees. This had helped me a lot as my senior colleges have been working with the service for well over a decade and had valuable insight into the processes to go about this study.

With the help of my senior colleagues, I had gathered a number of service users for a briefing in which I told them the purpose of my study, their involvement and other details relating to the research. After hearing the details, 6 people from the group of service users gave their consent to participate in this study. I selected the service users that I had built a relationship with because I thought to have a professional relationship with them would make them feel at ease to express their views and concerns. At the beginning of the discussion, the service users were not keen to be consulted as they expressed their concerns that nothing has ever been done on anything they have been previously consulted upon. I made my consulters feel comfortable with the process by telling them that it isn’t mandatory for them to cooperate and that they were allowed to leave or discontinue their part any time they wanted. I also helped them understand the implications of this research and how the information gathered from them can be used for public benefit. Furthermore, I reassured them their information would not be shared with anybody without their consent provided it was something that could put them at risk. This made them give me their consent that they would want me to share their concerns with their professionals such as CPN, nurses, advocacy workers, GPs and social workers. I enabled them to understand the purpose of the consultation which was to assess and understand their process of recovery and any feedback and findings would be shared with the staff to help to improve the services they provided to them.

I consulted the consulters based on their preferred day, time and location. One of them withdrew in the mid of the process because they lost interest remaining a female and 4 males. The chosen consultees had two things which were having mental health and drug issues. In choosing the method in which I would conduct the consultation, I choose to have an informal interview with them individually. As this was a qualitative study, the informal interview was the most appropriate to gather the required information. Interviews allowed me to talk to them and conduct the session in a way so that they were the most comfortable and willing to share information. The process and the setting had to be light-hearted and informal and it was important to stay away from structured processes or predetermined interview framework. This was due to the nature of their mental health state which had a structured formal interview would be too overwhelming and I believed it would enable them to feel comfortable without any interruption. In terms of location, I gave each of the consultee opportunity to choose their preferred place of which two of them chose to have it done in their rooms while other three preferred an environment outside the agency setting.

I chose to share my findings with some of the senior staffs and my fellow student colleagues who were at the setting through a focus group. This allowed me to gain multiple insights into the answers given by my consultees to accurately determine the required information. This was especially useful in the critical analysis section as informal interview transcripts tend to be to have nuanced answers which require multiple perspectives to accurately elicit (Cunningham, 2012).. Furthermore, the unique knowledge and expertise they had brought to the table made my analysis of the findings more fruitful and detailed, and so I am grateful to them for their contribution to this research. The aim of the focus group was to discuss my findings and to see how best we could improve the support providing to the service users. Some the colleagues agreed to the findings and expressed that they could see some of the service user’s recovery process challenging due to enough support that their professionals provided to them.

Methodology

The method selected for this study is qualitative research. Qualitative research technique is considered to be suitable when the analyst or the examiner either explores the modern field of pondering or serious to discover and theorize noticeable issues (Cunningham, 2012). Due to the nature of the consultees, the chosen method for collecting and analysing was conducting informal interviews and manually analysing the interview transcripts. An informal interview is an interview conducted in a casual setting such as over having lunch or coffee and is conducted without a predetermined structure. This enables the interviewee to feel more relaxed and allows more freedom of expression when answering the question due to the mental state of the service users that were interviewed, as well as the reluctance of some of them to give consent to the study, the most appropriate research method was determined to be informal interviews (Qu and Dumay, 2011). There are numerous subjective strategies which are created to have a broad understanding of the issues by applying their literary translation and the foremost common sorts for changing perception (Jamshed, 2014).

Data Collection

As the data required for this research is the subjective experience of the service users, interviews were determined to be the ideal method. Furthermore, the mental state of the interviewees required them to feel very comfortable sharing their information. It was also important to have their trust as previous studies such as this were done which produced unsatisfactory results for the service users (Cunningham, 2012). So it was decided that informal interviews in the time and location preferred by each interviewee will be done as the means for collecting data. Informal interviews are exceptionally distinctive to confront assembly between you and a selection representative. Researchers who conduct informal interviews do tend to discover that candidates are a parcel looser, which makes it less demanding to watch their identity, and whether they would fit into the culture of the organisation. Informal interviews may be utilised at the begin of the determination prepare, which is frequently the case on the off chance that an organisation is not effectively enlisting, but is continuously sharp to have discussions with exceptionally great candidates to develop critical arguments (Hofisi, Hofisi, and Mago, 2019).

Data Analysis

The interview transcripts will reflect the individual experiences of the 6 interviews about the service they received and their consultation process. The transcripts will then be summarized in finds from which the effectiveness and the overall experience of the service users as a whole will be determined. The dimensions that will be focused on are the understanding of the recovery for the problem drug users who are receiving this service, their re-entry to the community and the existing perceptions present about the road to the recovery policy. Recommendations are given based on this information to make the consultation process a better experience for the receivers. Finally, the findings will be critically analysed to provide reflective judgment regarding the policies, the consultation process as a whole and organizational change.

Findings

The service users at the agency seemed to be primarily sent to seek their service because of behavioural problems. What’s interesting is that the cause behind this problem of behaviours was different for different consultees. These causes range from mental health problems to substance abuse. Two of the participants said that they were referred to the agency by their CPN because of their mental health issues. One of them was diagnosed with schizophrenia while the other had the bipolar affective disorder. These had led them to lead difficult lives and so the reason for their referral. One of the consultees said that he was sent to the agency by his social worker as he had an alcoholic problem which leads him unable to perform daily tasks to live a healthy life along with issues with his mental health. The other two consultees had a history of drugs problems and that caused them to engage in certain criminal behaviours and was at one point homeless. So after they had served their sentence and were released from prison, they were referred to the agency by Criminal Justice so that they can fix their problematic behaviour and cope up with mental health issues in order to become capable of returning to the community.

The main purpose of the service users seeking the road to recovery service was so that they could recover from the behavioural and cognitive issues they were having and leading a normal healthy life. However, each of the participants of this study had described recovery differently which meant that the end goal of recovery would be different for each one of them. The consultee who was suffering from schizophrenia said that recovery was for him to be out of schizophrenia so that he can restore his physical health as well as recovering the health issues to lead a normal healthy life like others. Restoring his physical health would consist of reducing his weight in order to undergo an operation for his hernia. The female consultee who participated in the study had stated that recovery was for her to have her family back including her children which would be a result of being free from her bipolar disorder. While the end goal of recovery for these two service users was fairly unique in restoration of physical health and getting back to her family, the other four consultees stated that their version of recovery would be to become free of their drug or alcohol problem without any external support so that they become fit to return back to their communities.

The results of the consultation and progress in recovery had a common thread among all the participants. They recover through the treatment, but it is not at quality standard as they need more care and support to overcome the health issues properly. Moreover, all of them felt that the entire process was very challenging for them. According to the research consultees, the staffs at the agency have been doing their best but it is sometimes difficult for staff to understand the mental, emotional and psychological state of the service users. It is because the staffs usually do not have the knowledge and skills related to their mental health and the proper qualifications to deal with such service users. Although it agreed upon that the supported accommodation is their present home and they could go out anytime they wanted, the consultees felt that the experience was like being in prison or restricted since it is very different from their home environment and devoid of their family and friends.

The consultees also share the experience of being stigmatized by the community. Most people in the community make them feel like wasted or bad people despite love and encouragement being two very important factors in their recovery. Four of the participants of this research responded that they get emotional and practical support from the staffs which give them hope and help them in the recovery process. One consultee stated that the services rendered by the staff are not enough for his particular needs and therefore the service had in fact, a negative impact on that person’s process of recovery. Three of the consultees hoped to improve their lives and be back to the community to have a fulfilling life while two of them expressed that they could not see any massive change in their recovery in years to come. This was because they could imagine receiving less support from professionals due to cutting off of funds to support them.

Two of the consultees had said that staff should organise sessions and events outside the agency’s setting that would engage them more like outings, dinners, going for trips or cinema together. This would offer a greater feeling of being a part of the community for the service users and would be an enjoyable experience. The remaining two wished the staff would continue providing them emotional support and less physical support as they could cope with most of their daily activities now. Additionally, all of the consultees expressed that the strategy would be effective if there were enough support for staff and themselves. However, three admitted that they have seen some improvement in their lives while remaining two expressed that the strategy has not had any great impact on them.

Recommendations for Change

In light of the issues that were uncovered in the findings, the following recommendations are given to the service providers to ensure a better experience of service users and proper achievement of the goals of “Road to Recovery”.

Staff should increase one on one session and provide individualised services to the service users. As seen from the findings, different service users had different needs and so any uniform service procedure is not appropriate. To better implement this, increasing the number of staffs are also suggested.

Schedule periodic training for staff members in the treatment of mental health service users. Majority of the staffs did not have the necessary knowledge regarding mental health to provide high quality service despite their effort.

Appoint managers who are knowledgeable in mental illnesses and have experience dealing with mental health service users so that he or she can properly brief and guide the staff.

Include activities in the consultation program that will give the service users a feeling of belonging in the community and as if they are living a normal life. This includes more outdoor programs and fewer activities in an agency setting, as well as creating an opportunity to socialize with other people besides other users of the agency’s service.

Critical Analysis

One key aspect of the findings is the fact that the difference in the definition of recovery for different service user. The road to recovery campaign defines recovery as the process of moving from a drug-dependent state to a drug free state and being able to fully function as a member of society. Where that is a good place to start is in fact in line with what most consultees viewed what their recovery to be, it leaves out the damage repair of the mental illnesses the service users are suffering from as a by-product of drug abuse. Especially service users who suffer from severe diseases such as the bipolar disorder or schizophrenia, it is important to tend to their mental health and make way for their cognitive functions to be in sync with community living (Choi and Twamley, 2013). Furthermore, the recovery policy of the campaign leaves out any external damage caused to the service user as a result of their drug dependent lifestyle which puts the service users in a negative situation, if the substance misuse is high and it become harmful for the patients. So despite being able to free of their drug dependence, they don’t experience full recovery as they are then faced with a new challenge of overcoming the persisting crisis. This is evident for mental health service users once more (Drake and Whitley, 2014). The consultee suffering from schizophrenia had the requirements of physical treatment for recovery which would not be covered in the services of the agency. And the female consultee who was suffering from bipolar disorder had to deal with being away from her family and required arrangements for being in touch with them again. These scenarios indicate that “Road to Recovery” cannot achieve its goals as a stand-alone campaign and needs to co-operate with other care providers such as clinics, psychotherapy clinics and rehabilitation centres to be able to provide a comprehensive service to their users.

A lot of the policies in place are appropriate for the campaign; however, there seems to be a gap in implementation. The consultees reported that they were seeing improvements which were good news since that implied that the policies were on the right track. However, they also reported that experience was very challenging for them. This indicates that the policies resulted in centric and did not take the process into account. A big reason for this issue is that while the staff is dedicated and giving their full efforts, the lack of knowledge, skills, and training of the service providers is the main issues for which they fail to deal with people who are suffering from mental health problems (BRENER, VON HIPPEL, VON HIPPEL, RESNICK and TRELOAR, 2010). The lack of knowledge despite the effort is leading to serious inefficiency in the strategy and is making the bad experience for the service users. Hence, the policies need to be incorporated in more process oriented points and are required to lay out stricter qualifications for successful hiring of the staff. Alternatively, the management can keep the existing stack body and issue periodic training as mentioned in the recommendation section.

The service also requires individualised care and consultation sessions. Treating people witha drug problem is a complicated process and requires very acute behavioural elements in the staff’s part as well as drug treatment specific knowledge. Especially considering the fact the staff will be working with users who suffer from serious mental illnesses such as schizophrenia and bipolar disorder. Drug treatment maintenance and completionhave consistently been related with positive results, including improved mental and physical wellbeing, positive changes in medicate utilize, diminishes in criminal action and increased work (Geddes and Miklowitz, 2013). Understanding the factors that may contribute to treatment completion is particularly important in light of the tall dropout rates among clients in sedate treatment. Staffs attitudes can impact the quality of care provided to individuals in treatment and will therefore, play a part in treatment maintenance. Previous research with respect to staff-related factors in medicating treatment has centered on staff aptitudes as well as similarities in staff and client convictions around treatment processes and results. For better quality of services, there need proper cooperation and communication between the service providers and the users (Perry and Pescosolido, 2015). Essentially, helpful alliance during sedate treatment has been found to predict retention. Seeing staff as non-threatening and steady shows up to be imperative for ongoing engagement of service users in treatment and continuing after-care. Treatment of bipolar disorder expectedly centres on intense adjustment, in which the objective is to bring a service user with symptomatic recovery; and on maintenance, in which the objectives are backslid prevention, reduction of sub threshold indications, and enhanced social and word relatedworks. Treatment of both phases of the sickness can be complex, since the same treatments that lighten sadness can cause mania, hypomania, or quick cycling, and the medications that reduce mania might cause bounce back depressive scenes (Grande, Berk, Birmaher and Vieta, 2016).

Finally, there needs to be some organizational change as the setting of the agency often has a negative feeling on the service users. They had reported that the agency setting often installed the idea of being restricted or being a prison for them and had created the perception of being away from the community (Perry and Pescosolido, 2015). This is a dangerous precedent since the majority of service users are suffering from mental health problems and this will only create further negative complications in their cognitive landscape. As suggested by one of the consultees, shifting the organizational setting at times with induction of outdoor activities such as picnics or going to the cinema can restore the feeling of leading a normal life among the service users.

Conclusion

Scotland’s drug problem has been a long standing one and the “Road to Recovery” initiative is a step ahead in rehabilitating the problem drug users. A key part of this recovery is tending to mental health needs as that are a prevalent issue for the users of this service. While the campaign has had somewhat success, there seem to be gaps in the communication between the management and the service users which lead to unsatisfactory service in some cases. Hopefully, the findings of this research can lessen that gap and allow agencies such as where I did my placement to make more appropriate measures sothat the service users get a more comprehensive service based on their individual needs and meet the criteria of their individual definitions of recovery.

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