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Article
Publication date: 16 September 2011

Stephen Moore

This paper seeks to explore the views and experiences of female offenders with problem drug/alcohol use living in rural areas and to provide their perspectives on…

Abstract

Purpose

This paper seeks to explore the views and experiences of female offenders with problem drug/alcohol use living in rural areas and to provide their perspectives on shortcomings in support services.

Design/methodology/approach

The research used in‐depth interviews with (ex) female offenders with problem drug/alcohol use living in rural areas in the East of England.

Findings

The research indicates that the barriers to adequate provision of services for women in rural areas have distinct, but overlapping, gender and geographical elements. Gender issues centre on the failure to see the female offenders in the context of their roles as mothers and partners. The geographical element includes a significant and under‐reported lack of public transport and childcare support.

Research limitations/implications

Given the localised and opportunistic nature of the study, no attempt is made to claim that one can necessarily generalise from these results to all rural areas.

Practical implications

Increased recognition of women attending drug/alcohol support services as mothers with children, faced with problems of organising childcare, or accessing public transport. This is exacerbated by inadequate, public transport provision.

Originality/value

The importance of service providers recognizing the insight which clients could provide through their own lived experiences as users of services. In a rural situation with thinly spread provision, the importance of women‐only provision should not take precedence over quality of service provision.

Details

Drugs and Alcohol Today, vol. 11 no. 3
Type: Research Article
ISSN: 1745-9265

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Article
Publication date: 4 December 2018

Jeppe Oute and Bagga Bjerge

The purpose of this paper is twofold: to explore how gatekeepers’ ways of regulating the researchers’ access to knowledge in/about care services reflect the systemic and…

Abstract

Purpose

The purpose of this paper is twofold: to explore how gatekeepers’ ways of regulating the researchers’ access to knowledge in/about care services reflect the systemic and interpersonal values that inform Danish welfare systems’ daily workings at the street level; and also explore how the authors’ methodological experiences mirror the value-informed regulatory strategies that professionals and users themselves experience in their daily encounters in the same local practices that the authors have studied.

Design/methodology/approach

The paper takes its empirical point of departure in a multisited ethnographic field study of the management of citizens with complex problems in Danish welfare systems.

Findings

By means of Michael Lipsky’s outline of access regulation, the authors will analyze the following regulatory strategies that are identified during the fieldwork: “Gatekeepers’ sympathy and creaming,” “Queuing and delay,” and ‘Withdrawal of consent and “no resources.” The paper suggests that trust, shared goals and sympathy seem to be key to the process of getting access.

Originality/value

Despite principles of neutrality, equal rights and access to services in welfare systems, the authors’ experiences thus tend to support other research within bureaucratic and care organizations, which has found that interpersonal relations, sympathy, dislikes, norms and values, etc., can heavily influence timely access to services, tailored information and support.

Details

Journal of Organizational Ethnography, vol. 8 no. 3
Type: Research Article
ISSN: 2046-6749

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Article
Publication date: 11 November 2014

Richard Bell

The purpose of this paper is to demonstrate the learning from the multi-agency evaluation of the Leeds Dual Diagnosis Care co-ordination protocol undertaken by the Leeds…

Abstract

Purpose

The purpose of this paper is to demonstrate the learning from the multi-agency evaluation of the Leeds Dual Diagnosis Care co-ordination protocol undertaken by the Leeds Dual Diagnosis (DD) Project in 2013. The evaluation aimed to identify the prevalence of people with DD accessing network member services, and to identify the standard of care network members provided for people with DD in relation to the Leeds Care Co-ordination Protocol.

Design/methodology/approach

The evaluation adopted a service evaluation methodology and included features of real world research. Two standardised self-completion questionnaires were administered using Survey Monkey™ software.

Findings

The majority of service could provide prevalence data however the quality of data provided was significantly impacted by the limitations of client management systems. Completion of specific DD training beyond basic awareness was generally low and many participants were confused about the different levels of training available. Standards of care varied, a substantial amount of joint working was taking place via informal pathways which relied on established relationships and trust between practitioners and services. Jointing working was often informal when people were not under the Care Programme Approach.

Research limitations/implications

Due of the methodological choices the evaluation cannot be considered impartial. The prevalence data gathered lacks robustness and does not reflect the number of people who meet clinical threshold for DD as valid screening tools were not used by all services. The standards of care identified only reflect practitioner's personal views and do not provide a definitive answer to the standard of care being delivered. The response rate in relation to standards of care was low with large amounts of missing data negatively impacting the external validity of data gathered.

Practical implications

The completion of this evaluation demonstrates that it is extremely challenging to undertake a multi-agency evaluation with limited resources. It has highlighted key challenges and areas for future development locally in relation to DD. The themes explored are likely to be of interest to commissioners, service managers, DD consultant nurses and anyone involved in the strategic development of DD.

Originality/value

The evaluation has generated information which is of practical significance to local commissioners and Leeds DD Network Members. The knowledge and learning from this evaluation has subsequently been used by the Leeds DD Strategy Group to inform the new action plan for the DD Project, the re-commissioning of substance misuse services and the new mental health framework being developed for Leeds.

Details

Advances in Dual Diagnosis, vol. 7 no. 4
Type: Research Article
ISSN: 1757-0972

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Article
Publication date: 11 December 2020

Linda Bell, Rachel Herring and Fizz Annand

The purpose of this paper is to review the following research questions from the available literature: What evidence is there to suggest that substance misuse specifically…

Abstract

Purpose

The purpose of this paper is to review the following research questions from the available literature: What evidence is there to suggest that substance misuse specifically by fathers (including alcohol and other drugs) causes wider harms, including child welfare concerns? substance misuse, recovery, parents, fathers, fathering, drugs/ alcohol services. How do professionals respond specifically to substance misuse by fathers? Do interventions aimed at parental substance misuse (particularly in the UK) include both mothers and fathers and if so how?

Design/methodology/approach

A scoping literature review was conducted which identified 34 papers (including scoping reviews published in 2006 and 2008, covering the period 1990-2005) and 26 additional studies published between 2002 and 2020.

Findings

The review in this paper is organised into six themes: Negative impact of men’s substance misuse problems on their parenting behaviours; quality of the relationship between parents affected by substance misuse of the fathers, in turn affecting the parenting behaviour and outcomes for children; importance to fathers of their fathering role (for example, as a financial provider); difficulties fathers may face in developing their fathering role; sidelining of the fathering role in substance misuse services; and professionals tending to focus on the mother’s role in parenting inventions and services.

Originality/value

This paper focusses on fathers and substance misuse, which is an under-researched field within the wider contexts of fathering research and research into parental substance misuse.

Details

Drugs and Alcohol Today, vol. 20 no. 4
Type: Research Article
ISSN: 1745-9265

Keywords

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Article
Publication date: 7 September 2012

Angela Daly, John Anderson, Denis O'Driscoll and Kathleen Pitt

This paper aims to illustrate realities of homeless people's lives during a time of significant change in UK public sector funding and welfare policy.

Abstract

Purpose

This paper aims to illustrate realities of homeless people's lives during a time of significant change in UK public sector funding and welfare policy.

Design/methodology/approach

A participatory research approach was used including working with two co‐researchers; two people who have direct experience of homelessness. A sustainable livelihoods approach was adapted to provide a framework for analysis. The research was undertaken during May to October 2011.

Findings

The paper interrogates five areas of assets held by people themselves that support sustainable livelihoods, an existing approach used in other research. Life journey narratives show that a connected range of services, operating through an empowerment model, promote human dignity.

Research limitations/implications

Findings resonate with issues identified in larger studies; however, as the funding and policy context is rapidly changing it is recommended that additional local qualitative studies could be conducted during the next three years to illustrate impacts in people's lives.

Practical implications

The paper suggests front‐line services must include resettlement as well as crisis and stabilising services in order to ensure homeless people can successfully move from home to home.

Social implications

The research identified negative attitudes towards homeless people. By illustrating homeless people's achievements the study provides evidence of the impact of, and the value of continuing to fund, homeless services.

Originality/value

The paper suggests that people who have experienced homelessness achieve a successful life with support by drawing on their considerable life experience and personal talents. This message is important for practitioners, commissioners and policy makers working through a period of change for homeless services.

Details

Housing, Care and Support, vol. 15 no. 3
Type: Research Article
ISSN: 1460-8790

Keywords

Content available
Article
Publication date: 18 September 2019

Farrukh Alam, Nat Wright, Paul Roberts, Sunny Dhadley, Joanne Townley and Russell Webster

The purpose of this paper is to examine the current provision of opioid substitution therapy (OST) during and immediately following release from detention in prisons in…

Abstract

Purpose

The purpose of this paper is to examine the current provision of opioid substitution therapy (OST) during and immediately following release from detention in prisons in England and Wales.

Design/methodology/approach

A group of experts was convened to comment on current practices and to make recommendations for improving OST management in prison. Current practices were previously assessed using an online survey and a focus group with experience of OST in prison (Webster, 2017).

Findings

Disruption to the management of addiction and reduced treatment choice for OST adversely influences adequate provision of OST in prison. A key concern was the routine diversion of opiate substitutes to other prisoners. The new controlled drug formulations were considered a positive development to ensure streamlined and efficient OST administration. The following patient populations were identified as having concerns beyond their opioid use, and therefore require additional considerations in prison: older people with comorbidities and complex treatment needs; women who have experienced trauma and have childcare issues; and those with existing mental health needs requiring effective understanding and treatment in prison.

Originality/value

Integration of clinical and psychosocial services would enable a joint care plan to be tailored for each individual with opioid dependence and include options for detoxification or maintenance treatment. This would better enable those struggling with opioid use to make informed choices concerning their care during incarceration and for the period immediately following their release. Improvements in coordination of OST would facilitate inclusion of strategies to further streamline this process for the benefit of prisoners and prison staff.

Details

International Journal of Prisoner Health, vol. 15 no. 4
Type: Research Article
ISSN: 1744-9200

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Abstract

Details

Mental Health Review Journal, vol. 1 no. 2
Type: Research Article
ISSN: 1361-9322

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Article
Publication date: 1 March 2003

Jane Fountain, Samantha Howes, Colin Taylor and Strang

A survey of the substance use of 389 homeless people included questions on current income and expenditure. The two sources of income most often reported were state…

Abstract

A survey of the substance use of 389 homeless people included questions on current income and expenditure. The two sources of income most often reported were state benefits and begging. Those whose main substance was heroin or crack cocaine were more likely to have a larger financial expenditure, and to obtain this income from criminal activities, than those whose main substance was another drug or alcohol. By far the most commonly‐cited main items of expenditure were drugs and alcohol. The findings are discussed in terms of current interventions and service development.

Details

Drugs and Alcohol Today, vol. 3 no. 1
Type: Research Article
ISSN: 1745-9265

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Article
Publication date: 8 June 2015

Laura Aslan

It is common for people to view dropping out of substance misuse treatment as an unsuccessful attempt at recovery. The existing literature emphasises that those who drop…

Abstract

Purpose

It is common for people to view dropping out of substance misuse treatment as an unsuccessful attempt at recovery. The existing literature emphasises that those who drop out of treatment do worse than those who complete their treatment programme. More recently, however, those who discharge early are faring better than ever before.

Design/methodology/approach

In total, 13 service users who discharged early from three residential therapeutic communities were interviewed over the phone to discuss life after treatment. Interview transcripts were analysed using thematic analysis and found four main themes evidencing that “unsuccessful” really can be successful.

Findings

The study unearthed significant findings in the area of motivation for continued recovery in that 85 per cent of the sample were actively accessing further substance misuse treatment after leaving the service early. Five participants who had entered treatment as opiate users were all abstaining from Class A drugs at the time of interview; indeed 100 per cent of the sample were opiate free. Furthermore, self-reported psychological health had improved following discharge by 78 per cent.

Practical implications

Recent changes in policy and treatment design within drug treatment services may explain such positive outcomes in that a more responsive programme allows people to gain skills and make changes in a shorter time frame.

Social implications

Indeed, improved early discharge procedures and increased links to aftercare and follow on treatment may have impacted on this finding.

Originality/value

This study therefore proposes the notion of “right dose of treatment” as opposed to “time in treatment” and highlights the importance of exit procedures and aftercare.

Details

Therapeutic Communities: The International Journal of Therapeutic Communities, vol. 36 no. 2
Type: Research Article
ISSN: 0964-1866

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Article
Publication date: 1 June 1996

Mike Lindsay

Abstract

Details

Mental Health Review Journal, vol. 1 no. 2
Type: Research Article
ISSN: 1361-9322

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