Forward Leeds delivers a fresh approach to dual diagnosis

Covid-19 has demonstrated the incredible value of treatment and recovery in providing life-changing – and life-saving – support to some of the most vulnerable people in our country – and the vital role the voluntary sector plays in doing that. In a new series of blogs, we will shine a light on the extraordinary breadth and depth of services across our field and hear from some people who are finding solutions to some of the most intractable issues for our field. Look out for future blogs on naloxone, residential rehab and peer-led community charities.

Forward Leeds is the city’s alcohol and drug service. It is a partnership led by the charity Humankind and delivered with Leeds and York Partnership NHS Foundation Trust (LYPFT) and the charities BARCA-Leeds and St Anne’s Community Services. Lee Wilson is the service’s Operations Director – below he describes how Forward Leeds has driven innovation and collaboration across the system to support some of the city’s most vulnerable inhabitants, including people struggling with both mental health and substance use problems.

We support one of the largest treatment populations in England – almost 7,000 people over the course of a year and about 3,500 clients at any one time. Since the service started in 2015 we estimate that more than 1 in 50 adults in Leeds has been helped.

We were commissioned in 2015 by Leeds City Council to replace a fragmented local offering with a single integrated service. The service supports everyone in Leeds, regardless of their needs. So the people who use our service may be concerned they are having a glass of wine too many, or they may have been using heroin for many years and feel they have become fixed into that lifestyle.

Having LYPFT as a partner means we can access midwives and mental health specialists to support people in a broader way than would otherwise be possible. Nobody in Leeds is trapped in that difficult situation where they have co-occurring mental health and alcohol/drug issues or “dual diagnosis” and are bounced between services. The benefits of the partnership mean access to the dual diagnosis service is seamless; it’s effectively one Forward Leeds team referring into another one, and service users can continue to access help at the location they have always used.

Even if the dual diagnosis team doesn’t take on full case management they offer co-working with other teams around suicidality, low mood, anxiety and other mental health issue; this upskills other workers but also ensures the timely support is available. We have psychiatrists, psychologists and a mental health nurse ready to offer specialist support. Although three different colleagues might be employed by three different organisations they all sit in the same office with the same badge on. So for people who need help there’s no confusion about different names or brands.

At the same time and on the same site, our service can take care of any prescribing needs a person might have, which could be done through one of our specialist GPs. They can also see one of our Housing Workers, receive harm reduction advice, use the needle exchange, or speak to a specialist family worker about their children. Crucially, it all happens under one roof and under one badge – Forward Leeds. Consistency and access is also key, so we’re delivering this service from three main hubs spread out across in the city to minimise travel – it’s an identical service no matter which hub you visit.

Outreach is another important part of our work. We have four staff working on the streets of the city with those who are rough sleeping or living street-based lifestyles. As a service we are transitioning a fully trauma-informed approach: our workers provide trauma-informed care and work collaboratively in multi-agency teams that include social workers and housing officers. All our staff are being trained on trauma-informed practice.

A Leeds city council review in 2019 concluded the service was “high quality, well performing and innovative”, leading to a three year extension of our current contract. We’re obviously delighted that the service is receiving praise, but the most important thing is that people are being supported and helped to achieve their goals in Leeds. Last year 1,543 people positively exited the service, having achieved their treatment goals – 145 more than any previous year. The Council has made a pledge for Leeds to be the “the best city in the UK: compassionate and caring with a strong economy; which tackles poverty and reduces inequalities” and we’re proud to be playing a part in that.

You can find out more about the Forward Leeds service on their website and on Twitter.

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