Hello All,
What experiences do you have when clients of different backgrounds are co-located.
For example, "clean" clients and "using" service users, or ex-offenders and folk who have not been through the criminal justice system?
Is it frought with problems to locate all services under one roof, for all clients?
Thanks
Al

An absolute nightmare i must agree but it is something that is becomingly increasingly important for a number of reasons, such supporting people etc etc. Through and Aftercare etc.
Dignity, respect and empathy are pretty good places to begin, along with good meaningful consultation with service users. Imperative that this is done in an open, honest and ethical way. Gold Stnd.
Language can also be very helpful or not. I began my career a few years ago with a passion for the negative language used in drug treatment and MH.
After some presentations and much fighting for the rights of people to be treated as such, to be told by one or more service user that if they could accept language such as 'clean' and 'dirty' and 'User' then who am i to go on about it. Well i am one of the s/u's that doesn't like to be referred to as clean cos i wasn't dirty. I am not and tried never to be a 'user' but have been and am still a person who uses drug treatment services.
Is a car driver who has been fined once for speeding, parking tickets or whatever referred to as a car abuser or car misuser. No they are a driver still, not a good one maybe but still a driver or car user.
Good luck
TonyB

I think it is only a matter of time when a service user rightly refuses to attend a service for a legitimate fear that it exposes him/her to greater relapse cues.
Drug services are populated by drug users all at varying stages on their journey,to borrow a well worn AA line
If you keep going into the barbers eventually you will get a hair cut.
This is where Shared care can make a difference. However, I have heard of instances when for example Wednesday is the drug clinic and word quickly spreads that attendees on that particulay afternoon are likely to be drug usrs.
Not an easy one this,but deserves consideration. At its most basic are we putting some people at risk by asking them to attend.?

I think this is the problem when services become all singing all dancing one stop shops. Cram everyone into the same space and hope for the best as, long as it gives back the figures and statistic the funders are looking for.

Does it represent society as a whole, offering drug users the micro world they are going to have to navigate anyway. There is only so many days in the week and ultimately segregating people to different days of the week or time slots, produces pockets of intense service user groups.
Workers thinking its good for people to see were they have been as, well as what they could return to if the attraction of active using becomes to great to avoid. In saying that, could this be interpretated as making the cross over all that easier.
One could argue that a seperate service location could be developed to deal with people who have progressed into the abstinance world.

language and terminology is always going to be a sticky road to navigate. Like Tony B, I avoid the description clean despite the 12 step ownership of the phrase clean and serene.

I also think confidentiality becomes extremely compromised the wider a service becomes, from DSC (The Green Mile, Supertext dissolvers) to rooms full of service users waiting for all kinds of appointments.

In some ways the responsibility does become personal/individual a bit like catching a cold in the doctors waiting room, we can not protect everyone from everthing.

I think it highlights why things work so well in Primary care. It's great to see one and all under the same roof, mixed in with everyone else.

quote:

Originally posted by Alastair Monk:
Hello All,
What experiences do you have when clients of different backgrounds are co-located.

I've a couple that have moved to shared care because they didn't like the offers being made while waiting at the main unit.
They also refused to rat on those who made the offers so I've no idea what could be done about it.

Jeff

Hi Jeff and all - yes, we do have problems with service users sometimes intimidating others in the main service reception area. We have a zero tolerance policy but sometimes it is hard to see what is happening, and team discussion may revolve around the lack of treatment available to the individual client if we ban someone from the building. I tend to think that if one person intimidates 6 others, then the 6 wanting treatment should be treated, and the intimidator banned until they are ready to show respect to others. It is often those not ready to change who make life more difficult for others. We're trying to expand shared care so that more of the stable / stabilising clients can go to their own surgery for treatment.

I agree it's tricky and I endorse Tony's stance on terminology.. 'clean' and 'dirty'..
On the subject in hand, I think having all service users in one building is complex and not thought out.. we have CAT and CDT in one waiting area and the attitudes of both groups towards each other is often fractious to say the least.. What I have noticed is that shared care can make a difference in seperating the 'doing well' with 'could do betters'.. I also think the increase in crimianl justice clients hasn't helped because they are often the most chaotic and can manipulate the area and we have noticed more dodgy phone calls (dealing) going on as a result.. It's a logistics issue maybe, finding the right building, enough room etc etc..

Visited a drugs project recently sited in a row of terraced houses, separate entrances for needle exchange, young people, stimulant users, daycare and clinics. Separate clinic for women too. we had a debate about whether we are increasing the stigma, but concluded the benefits outweighed these considerations

Thanks very much for all your responses.
Alastair