Friday, 15 December 2017

Not addicted but still having an impact: children living with parents who misuse drugs and alcohol

Guest post by Dr Ruth McGovern, Institute of Health & Society, Newcastle University

There is growing political interest in the misuse of alcohol and drugs by parents and its impact upon children. The newly published Drug Strategy 2017 highlights drug and alcohol dependent parents as a priority group with an estimated 360,000 children living with parents who are dependent upon alcohol or heroin.

As a registered social worker, I have often identified ‘dependent parental substance misuse’ as a risk factor in many ‘child in need’ assessments conducted by Children’s Services. Around half of all child protection cases, recurring care proceedings (repeat children removed and placed into local authority care) and serious case reviews (enquiries following child death or serious injury where neglect or abuse is known or suspected) involve parents who misuse substances. However, the impact of parental substance misuse is not limited to addicts. The number of children living with parents who misuse but aren’t dependent upon alcohol and drugs is likely to be substantially more than the number of children living with those who are addicts. As such, greater harm in the population as a whole is likely to be experienced by these children.

I have been part of a group of academics and clinicians who have recently concluded a rapid evidence review funded by Public Health England (PHE). The review found evidence that parents who misuse, but aren’t dependent on substances, can have a significant impact on the physical, psychological and social health of their child. For instance, in early childhood we found that children of mothers misusing alcohol [1] were twice as likely to suffer a long bone fracture and five times as likely to be accidentally poisoned, than children whose mothers do not drink heavily. Children of mothers misusing alcohol or drugs are also more likely to require outpatient care or to be hospitalised due to injury or illness, and for longer. The impact of substance misuse by parents continues into adolescence, with our review showing an increased likelihood of antisocial, defiant and violent behaviour in late adolescence as well as substance misuse by the child. However, many of these children and families are not identified as being affected by the substance misuse of a parent and subsequently do not receive the help they need in the form of an intervention.

Therefore, our review also examined the evidence for effective interventions to help reduce the numbers of parents misusing alcohol and drugs. Family-level interventions, particularly those that offer intensive case management, or those which provide parents with a clear motivation (such as those linked to care proceedings) show promise in reducing the problem. Unfortunately, there was little research examining the effectiveness of interventions for parents misusing but not dependent on alcohol and drugs.

PAReNTS study logo
To respond to this evidence gap, we designed the PAReNTS study (Promoting Alcohol Reduction in Non Treatment Seeking parents). Within this study we are examining the feasibility and acceptability of alcohol screening (using the AUDIT-C questionnaire [2]) and brief interventions with parents involved in early help and statutory children’s social care services. The brief intervention is an adapted version of the ‘How much is too much?’ programme for parents [3] which combines advice and behaviour change activities and is delivered by both social care practitioners and the local alcohol service. Whilst alcohol brief interventions have been found to be effective in adults who misuse alcohol, little is known about the effectiveness of such interventions for parents with additional and complex needs. This presents unique challenges, for instance, parents may be concerned about the stigma of being labelled as having an alcohol problem, particularly if this could be used as a reason to remove their child from their care. There is clearly a need for a sensitive approach. In future blog posts, I hope to update you on the progress we make with the PAReNTS study and whether it is feasible to deliver early interventions with alcohol misusing parents to improve the wellbeing of children, who are often overlooked in public health.

References:
  1. Below the age of 10 years, much of the evidence focuses on mothers with alcohol misuse problems as most caregiving is carried out by mothers during early years. 
  2. The AUDIT-C is a 3-item alcohol screen that can help identify persons who are hazardous drinkers or have active alcohol use disorders (including alcohol abuse or dependence): https://www.integration.samhsa.gov/images/res/tool_auditc.pdf
  3. This programme was highlighted by the National Institute for Health and Clinical Excellence alcohol prevention guidance (PH24): https://www.nice.org.uk/guidance/ph24.
Image credits:

Friday, 8 December 2017

Is it possible to have a research career without being a workaholic?

Posted by Peter van der Graaf, AskFuse Research Manager, Teesside University

This was one of the burning questions that NIHR trainees put to an esteemed panel of career advisers at their annual meeting in Leeds. Every year the National Institute for Health Research brings together their trainees at a two-day event to network, share experiences, take part in workshops and generally learn more about the largest national clinical research funder in Europe. This year’s theme: Future Training for Future Health.


With all these bright minds in the room and a dedicated session on successful fellowships and grant applications, you would think ‘top tips on surviving an interview’ and ‘what mistakes to avoid in an application’ would be on the top of their list. However, after several inspiring presentations from previous and current award holders who had climbed the academic ladder - including Fuse Director Ashley Adamson a NIHR Research Professor - participants were equally, if not more, concerned about maintaining a healthy life-work balance.

Follow the yellow brick road to academic success
While Brexit questions made a brave entrance (Q: How will Brexit affect future research? A: In the long term, not all all!), they could not knock questions about mental health and wellbeing from the top spot. When Ashley included pictures of her son in a musical-inspired animation of her academic pathway (follow the yellow-brick road!) to explain that she preferred part-time work to spend more time with her family, participants immediately asked “but how do you fit family in with an academic career?”.

New gadget SLI.DO was introduced by the NIHR at the meeting this year: participants could submit questions through a mobile app, which others could vote to be answered by the panel (Bush Tucker Trial for academics). Not having to stand up in front of an audience to say who you are, might have given some participants the confidence to ask uncomfortable questions. The honest and open stories from the presenters about their own struggles and failures in academia (“my new post oscillated between agony and despair”) might also have contributed to this confidence.

Paul McGee emphasises the importance of
 looking after your mental health in academia
Experiences of stress and concerns over mental health in academic careers were acknowledged throughout the conference in various presentations and workshops. This was perhaps most evident in the closing session by Paul McGee (aka The Sumo Guy) who emphasises the importance of looking after your mental health in academia. His four key messages (be kind to yourself; get perspective; hippo time - to wallow - is ok; and keep pushing) resonated with many participants and provoked a strong response on social media.

As public health researchers, we are familiar with these messages. In our studies, we underline the link between physical and mental health, express our deep concern over the lack of mental health services and highlight the importance of resilience training from an early age in schools. However, it appears that we are not very good at applying this evidence to our own life and work.

This was recently confirmed by a systematic review of published work on researchers' well-being featured in the Times Higher Education. The review, commissioned by the Royal Society and the Wellcome Trust, found that academics face higher mental health risk than many other professions. Lack of job security, limited support from management and weight of work-related demands on time were listed as factors affecting the mental health of those who work in higher education.

Given this evidence, is it possible to have an academic career and stay healthy? Despite the questions raised at the annual event, the NIHR trainees were keen to acknowledge positive mental health messages: you can have a life and family outside academia (no need to be workaholic, although being a data geek is acceptable*); it’s ok to be different and carve your own path to develop your intellectual independence; and most of all: the key to success is self-care and not funding.

* An after-dinner presentation by @StatsJen taught us that there is a perfect correlation between eating cheese and death by entanglement in bedsheets. Will midnight cheese feasts be the next public health scare?

Friday, 1 December 2017

When the Coca-Cola truck comes to your town

Guest post by Robin Ireland, Director of Research at Food Active and Beth Bradshaw, Project Officer at Food Active.

When Coca-Cola announced their 'Holidays Are Coming' truck tour (ironically coinciding with Sugar Awareness Week), our local media in the North West covered the story like it was the first sign of Christmas, the first cuckoo to be spotted in spring.

And in the run up to the big red shiny sugar-laden truck’s arrival to our towns and cities, from Bolton to Liverpool, Manchester to St Helens, the local newspapers will cover the story in page after page of advertorials, telling you where to get your picture taken posing with Coca-Cola's sugary products and even live blogs in some cases.

In previous years, at no time did the reporters consider that not everyone welcomed the truck in their neighbourhood. Many people are concerned that the truck was marketing Coke to children despite the company's protestations that they do not promote their products to the under twelves. Furthermore, in some locations in the North West the truck was allowed to promote their unhealthy drinks to children and families on Council owned landed. 

To demonstrate our concern, last year Food Active drafted a letter objecting to Coca-Cola's tour coming to the North West which was sent to the national and regional media. No less than 108 people signed in support including the current and past Presidents of the Faculty of Public Health, five Directors of Public Health, Professors, Doctors, educationalists and of course parents. If we are honest, we were shocked that the letter was almost entirely ignored. It would appear that Coca-Cola's commercial clout and public relations campaign counted more than the collective voice of those who are having to address the results of diets regularly fuelled by liquid sugar.

Just before Christmas 2016, Professor John Ashton and I (Robin) were in contact with the British Medical Journal concerning these issues and were invited to submit an editorial which was published in January [1]. In contrast to their previous experience the media attention was huge including coverage in over 60 regional and national newspapers and interviews on various channels including Sky News and Wales Today.

This year, the media attention and discussions around the Coca Cola Christmas Tour has continued. Before the tour was even announced, a news story hit the local press in the North West from Liverpool councillor Richard Kemp CBE (also Deputy Chair of the Community Wellbeing Board at the Local Government Association of England and Wales), who raised concerns about its arrival in Liverpool given the city is ‘in the grip of an obesity epidemic’ – although we know this is not an issue only in Liverpool – the whole country is in the grip on an obesity epidemic. Once the tour was announced, including six visits to the North West, we were pleased to see none were on council-owned land (in 2016 the truck visited Williamson Square in Liverpool which is owned by the Council)

Following this came a cascade of news stories from local and national newspapers and radio stations. This year, Food Active joined up with Sugar Smart to encourage Directors of Public Health, Council Leads and Clinical Commissioning Group Chairs across the country to sign an open letter to Coca-Cola opposing its arrival, given the health harms associated with the consumption of their products and calling for more responsible marketing during the festive period. The North West represented one quarter of the 29 areas, cities and towns who signed the letter. This advocacy may have helped to prompt a response from Public Health England and Public Health Wales – there is a sense that the argument against the Coca-Cola truck are now being taken seriously and media coverage of the 2017 Coca Cola Christmas Tour is not just about when and where you can get your photo taken - but also the health concerns. 
Coca-Cola says that it does not promote its products to the under twelves

Following excellent work by Public Health England, by national organisations including Action on Sugar, the Children's Food Campaign and many others, and of course by Food Active in the North West, we know that we must target sugary drinks as part of a strategy to address the tsunami of obesity, type 2 diabetes and dental disease we face in our poorest and most deprived communities. Moreover, as highlighted in a blog by Dr. Alison Tedstone, Director of Diet and Obesity at Public Health England, the truck will be visiting some of our poorest areas which are often disproportionately burdened with higher levels of obesity [2]. As such, a symbol of ill health should not be welcomed nor celebrated within our communities during a season of good will and cheer. 

However, this is not only about high sugar drinks. Protecting children from junk food marketing has been outlined as the number one priority in tackling obesity by the Obesity Health Alliance (a coalition of over 40 organisations committed to reducing obesity – of whom Food Active is a member). We must not mistake the Coca-Cola truck for anything but a very high profile marketing stunt. We do not allow products high in fat, sugar and salt to be advertised to children on children’s TV programmes, so why is the Coca-Cola truck welcomed into our communities year on year with such open arms? Speaking at the Socialist Health Alliance Public Health Conference, we called for junk food marketing controls to be extended to cover family attractions such as the Coca-Cola truck, as well as sports sponsorship and marketing communications in schools. By allowing the truck into our towns and cities, we are allowing Coca-Cola to exploit the festive period to market their products to the community – and to children in particular.

Our experience shows us that public health has to be persistent in ensuring our messages are heard in the current victim-blaming culture. There is little point in local authorities spending their ever restricted funds on promoting healthier eating and drinking if each Christmas we allow Coca-Cola and others to highjack our messages. There is certainly no excuse for local authorities at to allow this truck on their land and it is the responsibility of public health advocates to continue to make the case to Give Up Loving Pop in 2018. 
  
References:
  1. Ireland, Robin, and John R. Ashton. "Happy corporate holidays from Coca-Cola." (2017): i6833. Available at: http://www.bmj.com/content/356/bmj.i6833
  2. Tedstone, Alison. “An update on sugar reduction”. (2017). Available at: https://publichealthmatters.blog.gov.uk/2017/11/14/sugar-reduction-an-update/


Photo © Oast House Archive (cc-by-sa/2.0)


All views expressed in a post are exclusively those of the author or authors.

Saturday, 18 November 2017

‘Afore ye go’… across the border for a cheap pint

John Mooney, University of Sunderland and Sunderland City Council, asks how Scotland’s minimum unit pricing policy would go down in North East England.


Like many former native Scots now living and working in North East England, the geographical, social and cultural parallels are just three areas of overlap that help keep homesickness for my country of origin at bay!

As a public health researcher some less fortunate similarities are often at the forefront of my mind, including a fondness for deep-fried food, an aversion to fresh vegetables and a damagingly long-ingrained culture of heavy drinking.  This is accompanied by an almost Scottish-scale public health burden to match. It will come as no surprise that as a whole, the North East has among the worst health statistics for alcohol related harm in England [1].

Of course it is also no coincidence that both North East England and much of Scotland’s central belt, particularly Greater Glasgow and Clyde Valley, have some of the most longstanding and concentrated areas of social deprivation and economic disadvantage in the UK. As recent research from Glasgow University has highlighted [2], deprivation and alcohol related health damage, present a particular kind of “double whammy”, even after adjusting for alcohol intake and other lifestyle factors such as smoking.

With these similarities in mind, there is an inescapable logic in looking to Scotland for a steer in terms of policy interventions that might reduce the unacceptably high public health burden due to alcohol in this part of the World. I refer of course to the introduction of a minimum unit price (MUP) of 50p for a unit of alcohol, which on the basis of rigorously evaluated international studies combined with sophisticated cost effectiveness modelling from the Alcohol Research Group at the University of Sheffield [3], is one of the best evidenced policies for reducing alcohol harm in the population.

Scotland is also at the forefront of (what may eventually lead to) a much more ‘fit-for-purpose’ legislative framework around alcohol licensing and availability: namely the inclusion of 'health' as a licensing objective (or ‘HALO’). In principle, this has the potential to transform the capacity of public health teams in English local authorities to make much more use of information on health harms as part of the licensing process. This would ensure that challenges to new licence applications - however potentially damaging the new licence may be - no longer need to be based exclusively on crime and public disorder evidence. To explore whether HALOs could also be used in England, our team at the University of Sunderland looked at the practicalities and logistics of using health information in English licensing decisions. The results have recently been published by Public Health England [4].

So what are the prospects for importing MUP and health objective policies to North East England?

Thankfully, on both policy and research fronts, there are also significant grounds for encouragement in the North East! Indeed, some of the most progressive public health policies around alcohol harm reduction, such as cumulative impact zones and late night levies, are now well established in a number of local authority areas. This has been possible thanks to strong political will and high profile regional level advocacy for alcohol harm reduction policies from Balance North East [5], which is funded collectively across most North East local authorities. Balance NE has already been calling for better controls on cheap alcohol availability in the wake of the Scottish Policy decision [6].

There is also no shortage of public health alcohol research effort in the North East, with a long tradition of internationally renowned research from the Universities of Newcastle, Teesside and most recently our own contributions to several national level evaluations (such as HALO mentioned above).

In brief, there are many regional policy drivers already in place for North East England to emulate Scotland’s very progressive approach to the reduction of alcohol harms. With regard to the often raised criticism that price based measures such as MUP are ‘regressive’ due to a disproportionate financial impact on the poorest, it is difficult to rival the response of Scottish novelist Val McDermid on Thursday's (16 Nov) BBC Question time: “it’s actually about preventing people in our poorest communities drinking themselves to death with cheap alcohol”. It is difficult to figure out what particular definition of the term ‘regressive’ that this conforms to…


References:
  1. Local Alcohol Profiles for England [May 2017]: https://fingertips.phe.org.uk/profile/local-alcohol-profiles/data#page/0
  2. Katikireddi SV, Whitley E, Lewsey J, et al. Socioeconomic status as an effect modifier of alcohol consumption and harm: analysis of linked cohort data. The Lancet Public Health 2017;2(6):e267-e76. doi: https://doi.org/10.1016/S2468-2667(17)30078-6
  3. Sheffield Alcohol Policy Model:  https://www.sheffield.ac.uk/scharr/sections/ph/research/alpol/research/sapm
  4. Findings from the pilot of the analytical support package for alcohol licensing: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/620478/Alcohol_support_package.pdf
  5. Balance North East: http://www.balancenortheast.co.uk/about-us/
  6. Balance North East news item: http://www.balancenortheast.co.uk/latest-news/balance-calls-on-government-to-follow-scotland-on-mup 
Images:
  1. 'cheap booze, hackney' (3892082333_943f3cc70e_o) by ‘quite peculiar' via Flickr.com, copyright © 2009: https://www.flickr.com/photos/quitepeculiar/3892082333 (cropped)
  2. Courtesy of Alcohol Focus Scotland: https://twitter.com/AlcoholFocus/status/922822671599054848

Monday, 13 November 2017

Public health, social justice, and the role of embedded research

Posted by Mandy Cheetham, Fuse Post doctoral Research Associate and embedded researcher with Gateshead Council Public Health Team

On this date (13 November) in 1967, Martin Luther King was awarded an Honorary Doctorate in Civil Law from the University of Newcastle upon Tyne. The speech he gave at the award ceremony is both powerful and moving. It was the last public speech he made outside the US before his assassination in April 1968. You can read it for yourself here or watch it here.


Newcastle was the only UK University to award an honorary degree to Dr King in his lifetime. In accepting the honour, he said “you give me renewed courage and vigour to carry on in the struggle to make peace and justice a reality for all men and women all over the world”. As I listened to the speech, it struck me that the three “urgent and indeed great problems” of racism, poverty and war, which Dr King described in his speech, are just as relevant today as they were then. It made me reflect on our role in universities now and on my role as an embedded researcher in Gateshead Council.

That's me on the left
On Sunday 29 October, I had the privilege of being part of the Freedom City 2017 celebrations held on the Tyne Bridge to mark this significant anniversary, inspire people, and stimulate academic debate about potential solutions. Performances across Newcastle and Gateshead came together to mark different civil rights struggles across the globe, including Selma, Alabama 1965, Amritsar, India 1919, Sharpeville, South Africa 1960, Peterloo, Manchester 1819, and the Jarrow March, Tyneside 1936.

The celebrations were timely, as I am just finishing an embedded research project in Gateshead, undertaken less than a mile from where we stood on the Tyne Bridge. It has been an inspiring year. I’ve learnt a lot, but I have also seen the devastating effects of austerity and poverty on North East families and communities. The research findings demonstrate all too clearly the continuing impact of the social injustices which Martin Luther King talked about fifty years ago.

I believe our role as writers and researchers in public health is not just to highlight the effects of these grave injustices, but to be part of the solutions, developed with the communities affected. If we accept that we are all caught up in what Dr King described as “an inescapable network of mutuality”, then universities have an important part to play in changing attitudes, working with others, facilitating connections, and inspiring efforts to “speed up the day when all over the world justice will roll down like waters and righteousness like a mighty stream”. (Dr Martin Luther King Jr. Speech on Receipt of the Honorary Degree, November 13, 1967).

I believe embedded research affords us valuable opportunities, to work alongside local communities with colleagues in public health and voluntary sector organisations, to challenge injustices and push for the kinds of social and political change advocated by Dr King.


Photo credits:
  1. Martin Luther King Honorary Degree Ceremony: http://www.ncl.ac.uk/congregations/honorary/martinlutherking/. Courtesy of Newcastle University.
  2. Photo by Bernadette Hobby of "the judge", representing the establishment, about to receive the Jarrow Marchers petition. The judge was made by Richard Broderick sculptor.
  3. Freedom on the Tyne, The Pageant: http://freedomcity2017.com/freedom-city-2017/freedom-city-tyne/. Courtesy of Newcastle University.

Wednesday, 8 November 2017

Spice up your research life: match-making in public health

Posted by Peter van der Graaf, AskFuse Research Manager, Teesside University

Three years ago, we had a crazy idea: what if Fuse had its own dating service for academic researchers and health professionals? Instead of innovative research findings gathering dust on lonely bookshelves, we wanted to provide a stage for academics and health professionals to meet and discuss how that evidence could be used in practice. We were keen to facilitate early conversations on how to collaborate on research that is useful, timely, independent, and easily understood.

Instead of health practitioners wandering around University campuses, trying to find the right academic to work with, we envisioned an open door leading to a welcoming friendly-faced guide. Someone who could do the matchmaking and help them to find or create evidence for spicing up their policies or interventions.

After checking our idea with various health practitioners in the region to make sure that it would make their hearts beat faster, we launched AskFuse in June 2013: Fuse’s very own rapid responsive and evaluation service with a dedicated match-maker (research manager) in post – that’s me!

Coming from an applied research background in social sciences, this post was certainly a challenge but also an incredibility exiting opportunity to develop something new with the support of an enthusiastic group of people across Fuse. The job has been a steep learning curve, but also a great way to meet a lot of people working in public health across the region, getting to understand their passions and … what keeps them up at night.


I quickly learned that there were many great public health projects and programmes being developed and delivered locally that deserved more attention and research (e.g. My Sporting Chance, Ways to Wellness, Boilers on Prescription).  I was encouraged by a real appetite among academics to support this work but felt the frustrations of health professionals caused by budget cuts and the need to decommission services rather than to develop them. I also noticed the limited research evidence informing some of these decision-making processes and the lack of knowledge among academics about how to influence these processes and mobilise their research evidence effectively.

AskFuse has supported more than 270 enquiries from a wide range of sectors, organisations and on topics ranging from Laughter Ball Yoga to Whole Systems Approaches to obesity. We have helped to develop new interventions and evaluated existing ones, made research evidence accessible and understandable, organised events to explore new topics, and pioneered new methodologies; all in collaboration with our policy and practice partners. We have also made mistakes, misunderstood procurement procedures, were not able to help in time, could not find relevant expertise or did not always follow-up on conversations.

Despite these challenges - or perhaps because of them - we have been able to build a dating service that (I think/hope) is perceived as useful by our policy and practice partners, that has helped us to build relationships (even in times of considerable system upheaval with public health moving to local authorities), and has informed new research agendas for Fuse going forward over the next five years as a member of the national School for Public Health Research.

As the service is expanding and my role is changing (I recently became a NIHR Knowledge Mobilisation Research Fellow, which I will talk about in another blog), we are looking for a new AskFuse Research Associate to work with me on strengthening the service and taking it in new directions. If you are interested in mobilising knowledge, fancy a challenge and want to work with a fantastic team, why not be part of it?

Friday, 3 November 2017

Why are veterans reluctant to access help for alcohol problems?

Guest post by Gill McGill, Senior Research Assistant, Northumbria University
 
With Alcohol Awareness Week fast approaching, the Northern Hub for Military Veterans and Families Research is busy planning a national conference to share findings from a project on improving veterans’ access to help for alcohol problems. The project was funded by the Royal British Legion and arose from two questions frequently posed by clinical practitioners working within the field of alcohol misuse services: 
  1. Why is it so difficult to engage ex-service personnel in treatment programmes?  
  2. Once they engage, why is it so difficult to maintain that engagement? 
     
In an attempt to test these perceptions, we carried out a systematic literature review of the existing evidence.  We then explored the relationship between being a UK military veteran (ex-serviceman/woman) and alcohol misuse services; and veterans’ experiences of engaging with these services. The research study involved interviews with commissioners and managers of services for alcohol misuse, interviews with veterans who are currently experiencing, or had experienced, problems with alcohol misuse, and focus groups with veterans who had no apparent experience of alcohol misuse.
 
The findings will be discussed in detail at the conference, so please join us there to hear more, but that quick plug aside, we thought we’d give you a sneak preview here!
 
Paradoxically, although alcohol misuse amongst UK veterans is estimated to be higher than levels found within the general population, we found a limited amount of research that specifically considered alcohol problems among UK veterans. Given that there are an estimated 2.56 million UK military veterans[1], this represents an important, but as yet, largely unaddressed public health issue.
 
Commissioners and managers of alcohol services expressed the view that veterans have difficulty navigating available support due to ‘institutionalisation’. Yet, when speaking to military veterans themselves, we found no support for this. Such a view point is also potentially problematic in stereotyping veterans as (at least in part) the architects of their own difficulties.
 
In all cases, it could be said that meaningful engagement with alcohol misuse services was being ‘delayed’ to a significant extent by the veterans involved in our study. They ‘normalised’ their relationship with excessive alcohol consumption both during and after military service and this hindered their ability to recognise alcohol misuse. Yet this was not mentioned by healthcare staff participating in the study. Participants also suggested that seeking help was contrary to ‘military culture’ and that this frame of mind tended to remain with UK military veterans after transition to civilian life. Delay in seeking help often meant that by the point at which help was sought, the problems were of such complexity and proportion that they were difficult to address.

Service commissioners/managers and military veterans highlighted a need for greater understanding of ‘veterans’ culture’ and the specific issues veterans face among ‘front line’ staff dealing with substance and alcohol misuse.
 
As a result of the research, one possible solution identified as worthy of further exploration is a ‘hub-and-spoke’ model of care. At the centre of the hub would be a military veteran peer support worker, with knowledge of local and national services, and experience in navigating existing pathways of care. This solution perhaps offers one way in which UK military veterans experiencing alcohol misuse problems might engage with the full range of existing services in a considered and individually bespoke way.
 
Reference:
  1. Ministry of Defence (2015) Annual Population Survey: UK Armed Forces Veterans residing in Great Britain 2015. Bristol: Ministry of Defence Statistics (Health).

National Conference – Northumbria University and Royal British Legion
Veterans Substance Misuse: Breaking Down Barriers to Integration of Health and Social Care
Newcastle United Football Club (Heroes Suite)
Thursday 16 November
More information on the Fuse website.