How and why we set a new direction
We know our work matters and makes a difference. But something big has to change.
More than 50 years ago, a mother called Molly Craven wrote an open letter to other parents. It was published in a national newspaper under the headline “My son takes heroin”. Her words touched many families and started a movement that became the charity we are today.
Here’s part of what she said.
We’ve helped hundreds of thousands of people since then. We know our work matters and makes a difference.
Yet we are a long way from solving the problem. Millions of people across Scotland and England live today with a difficult relationship with alcohol, drugs, gambling or poor mental health. More people died last year from drug related deaths than ever before. That’s not ok: something big has got to change.
We started by listening.
We have spent the last year exploring how we can make the biggest possible difference. As a charity, this is the only thing that counts: we don’t have shareholders or owners, so we can focus on what matters most.
We looked inwards to understand what we do well and what we find harder. And we looked outwards to understand what people need today — and what’s missing.
We spoke with people with lived experience who use our services today. We talked with people who are deeply worried about their loved ones, and people who drink, gamble or take drugs with no concerns.
And— just as importantly — we spent time with people who don’t feel comfortable asking for help right now, or don’t think we’re right for them.
And of course we’ve had a lot of conversations inside and across our charity, drawing on the expertise and experience of our staff and volunteers, right from Dundee to Penzance.
Finally, we thought hard about what matters most to each of us. It turned out that was the easiest bit: almost everyone who works or volunteers with here is in it for the same big reason.
Asking new questions has helped us change what we do.
Our public blog now has a lot of careful, thoughtful pieces — written by many different people across our charity — that share what we’ve learned alongside mistakes and things we’d do differently in future.
Have a read next time you’re waiting for a bus or a checkout. You might find better ways to reach to older drinkers, how webchat can reach new groups of people, what it’s like to be with A&E outreach teams, how to increase Naloxone take up, or thoughts on a more design-led approach to how we run projects and change services. Or something else entirely. Tell us what you think or what we could try next.
We can also see the big challenges more clearly
Three simple facts stood out from our conversations time and again. Not enough people get help. Treatment isn’t effective enough. And we’re not working well enough together as a charity or a sector.
These are big. They’re not easy to shift. But they need to change. And we’re clear that the time is right and we can take a different approach.
This is a good moment to be radical
The way our sector approaches mental health, substance misuse and similar support hasn’t changed that much for a long time. It relies heavily on one to one intensive work, ‘service users’ coming to a central physical location, and has a relatively small role for peers, families, wider communities and digital. There is much here that we do well and need to keep hold of: we have a strong evidence base and a lot of good, effective work happens.
But we’ve reached the limits of what the traditional model can achieve. There’s no more money — at least not until we have a levy on gambling and alcohol. We can’t raise caseloads further. Keeping our heads down isn’t going to reach everyone who needs help or radically improve outcomes.
Yet there are big opportunities to do things differently. People’s expectations and behaviours have been changing faster than our sector has responded. While there will always be an important and central place for face to face support and intensive outreach, many people increasingly want self-help tools and information they can use online, on their own or with their friends and family, and to make connections with others like them. We can put people in touch and start them on their way; we don’t need to be there all the time.
More human = more effective
We’ve done a lot of experimenting over the past year. There’s been a clear common thread through what’s worked best: we get the best results when we treat people well, as equals, and give them a stake and a say.
That means a conversation about what I want from life and what’s worrying me; not a checklist based assessment. Being able to choose when I see someone; not an appointment slot sent through the post. Remembering my children’s names, not just my prescription.
In the end this comes down to being human, and consciously thinking about what real people will actually do and prefer. It sounds obvious and simple, but it means doing a lot of things differently.
A new direction
Alongside all this, there is also appetite for change. Many commissioners want a new approach. Local authorities are freer than at any recent time to experiment and do things differently. There are also real opportunities for individual giving around these issues that affect so many people.
All this means we’ve set a new direction for our work. We’ve kept it short. You can read it here.
Thinking differently.
This is a strategy for the long term. It means some big changes to how we think about our role. We’re still working out what some of those are, but here are some that we feel confident about.
- We are focused on solving a problem in the world, not growing our income for the sake of it. Being ok with this has given us a huge sense of freedom. For example, it means we look for work where we can be open, share and experiment. Cultural fit has become more important.
- We are here for everyone. This is actually much harder than it sounds; it’s surprisingly easy to end up in a generic place that attempts to please everyone and actually appeals to no-one. There’s no obvious start or end to the issues we help with.
- We are trying to show our thinking and make it easy for others to copy, challenge and improve on what we do.
Please learn from our experiences and take whatever is useful.
