Sandwell council: the Blue Light project
When people with an alcohol dependence are in the depths of despair, they can sometimes be quite suspicious of support. They may be suffering from complex physical and mental health problems compounded by other social issues. Gaining the trust of those with a drinking problem can be a battle. But the Sandwell Blue Light project is breaking through these challenges and changing lives.
Developed by Sandwell metropolitan borough council in 2015, the project has created a new system that identifies, engages and then builds a long-term rapport with the most difficult to reach drinkers. This includes those who do not engage with treatment, who are regular users of NHS services, or others involved in criminal behaviour.
While there were existing alcohol services in place in the borough, resources were limited and there was a risk people could fall through the net. With this in mind, the Blue Light project set out to ensure that people in need had access to an engaging, non-judgmental support system.
The project brings together a cross-section of partners, including public health professionals, the ambulance and probation services, and the police. Local GPs, mental health specialists, alcohol treatment providers and other NHS professionals are also on board.
The team coordinates its own work, identifying those having the greatest difficulties with alcohol in Sandwell, and develops jointly-owned action plans to provide them with support. Team members talk regularly to ensure they identify and monitor any clients at high risk. For example, a probation officer may have a phone call with a local GP to share information about a drinker’s risk and vulnerability. Every month, the team meets to review and assess client progress and agree on the next steps they can take to help.
Lisa McNally, the director of public health for Sandwell, says the project does not define people by antisocial behaviour. Instead, it looks to root causes. “Unless we get past people’s behaviours and look to see what’s driving them to continue to drink year on year, and not engage with services, we will never get anywhere,” she says.
She describes one man in his late 40s who was recently supported by the team. He was phoning the police several times a day and showing clear signs of distress. The Blue Light project visited the man and found he had physical health problems and some signs of brain damage. He had been the victim of domestic violence from his partner over several years – she would put cigarettes out on him, hit him around the head or have him beaten up by others.
When the Blue Light project got to the root of his problems and coordinated with other agencies, it was able to support him on a path to recovery. “We asked: ‘Why is he feeling the need to escape life every single day?’” says McNally. “Once we start dealing with the issues that may lead someone to start drinking, such as unstable accommodation, a breakdown of a relationship, difficulty with the law or other issues, we can start to see a full picture.”
The Blue Light project began with the involvement of 11 councils or agencies, with local staff and service users in each area contributing their expertise. Since then the model has been adopted by a number of other local authorities across England and Wales.
The project started with minimal resources, yet has delivered savings of up to £150,000 for local emergency services. To date, more than 40 people have benefited from its support. Of that number, 18 are receiving ongoing harm reduction and risk-management help, while others have reduced their alcohol consumption and found stable accommodation and employment.
The project is keen to dispel the myth that nothing can be done for those with an alcohol problem, because they “don’t want to change”. It believes that while it may be unable to change somebody completely, it can at least reduce the harm and manage the risks they pose to themselves and others.
“It’s easier for people to forget these people exist,” says McNally. “But we work to wrap full support around the person. Our aim is to leave no one behind.”
Public health & wellbeing runners-up
South-west London and St George’s mental health NHS trust: Merton Citizens
In our modern, disconnected world, it can be hard for residents to keep close ties with their neighbourhood. And while locals in the London borough of Merton look out for each other, they could see a gap in how institutions were supporting residents.
So an alliance of 14 faith, education and community organisations got together to set up the charitable initiative Merton Citizens.
In 2017 it conducted more than 11,000 conversations with residents to establish what issues were important to them. Mental health was seen as a top priority.
The programme has since lobbied local councils to improve funding for mental health services and activities, and has had huge success: £1.85m funding has been awarded to provide 25,000 young people with mental health support in local schools; 1,500 people have been trained in mental health awareness; and it has held its first ever mental health symposium for local schools.
The programme is also inclusive, working closely with the Muslim community in the borough. Ranjeet Kaile, its director of communications, says mental health was a universal issue. “There was just this sense of commonality that in spite of all our differences, here was an issue that affected many people, and that we could do something about,” he says.
A crucial part of the initiative’s success is simply listening to locals. “What’s been beneficial is that people who are affected by the issue talked to us about their experiences directly,” says Kaile. “It’s been important to keep their voice at the heart of it.”
The 2025 Movement, North Wales: tackling health inequality
In North Wales, those living in areas of higher deprivation are likely to die up to 13 years earlier than others living elsewhere in the region. This injustice drove a small group of people to set up the 2025 Movement, a partnership between like-minded organisations and individuals all working towards the goal of ending avoidable health inequalities.
The collective involves more than 500 people and organisations from multiple sectors, including health, education and housing. By having clear, open communication, the movement can identify issues, think creatively about solutions and create maximum impact.
Its “Just Do” teams deliver projects designed to improve health and wellbeing. For example, in Gwynedd, a team met rough sleepers to identify barriers to accessing health services. As a result, rough sleepers are now offered flu vaccinations, given information about how to access emergency dentistry and have better access to mental health services.
While the movement has a goal to eradicate avoidable health inequalities by 2025, members understand it is a long-term partnership about systematic change. And as the impact of austerity in Wales grows deeper, Nina Ruddle, the head of public policy engagement at Wrexham Glyndŵr University, says tackling a complex challenge could not be achieved by a single organisation.
“What we’re doing is different,” she says. “Instead of working in isolation, we came together from a range of backgrounds to have a bigger impact. We want to grow and develop the movement to change lives in our region – and we’ve got a brilliant group of people that can take that forward.”