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Scottish Government’s announcement last Thursday was a very welcome one. A £5 million “recovery and rehabilitation fund” to provide additional residential rehabilitation capacity and to support people financially through residential rehabilitation. This fund will now ensure that people don’t ever have to make the choice between health and housing again.

But we must not lose sight that this is a safety net while we address the issues at hand. That the sticking plaster won’t last forever.

But right now, Gary can go to rehab and not have to give up his home. Stuart can now stay in rehab and focus on his recovery; he won’t leave homeless now.

Let’s never lose sight of what “health and housing” means to them, what it means to everyone. Let’s not lose sight of how that would feel if it was us.

It’s not a fight they have to fight alone.

Can you really imagine having to make that choice?

Imagine yourself attending a health service for essential treatment and being told “you’ll need to give up your home before you can get help”.

That’s the reality for many people seeking treatment for drug and alcohol addiction in Scotland. In a country where we see ever increasing numbers of people becoming homeless and also those dying from a drug related death, it’s appalling that people are being given an impossible and inhumane choice – your home or your health.

Anyone who has tried, or knows someone who has tried, to beg for statutory funding for rehab, via the inconsistent addiction services, knows only to well how non-existent this can be. Anyone who has actually accessed this recently is very lucky indeed. Due to this ridiculous funding system for residential rehabilitation, and with some areas being funding “deserts”, many rehab beds are funded by housing benefit.

This then creates a choice where people can get “clean” or “sober” and thus be homeless or keep their home and just suffer or die from the illness that is addiction.

That is because the current Department of Work and Pensions (DWP) regulations do not allow dual housing benefit to be paid for a person’s home AND these third sector rehabs. If we are serious about addressing the significant drug/alcohol related issues, and homelessness, in Scotland we must make sure that these rehabs are accessible to all who need them, and not fully reliant on a benefit to pay for them that could then result in someone being placed in an impossible position.

That is just not good enough for those who urgently need access any health-related service.

Addiction is not a choice and is something that’s very difficult to understand. Nor are people with substance misuse disorder solely to blame for their own often tragic existence. Often harm reduction is all we can do to try and stem the tide of avoidable deaths, but when someone seeks help for their addictions, we should never be presenting them with the fact that they will also need to be homeless to get that help. Ever!

Can you imagine if we told that to someone suffering any other health condition? The noise would deafen you. But often the stigma surrounding addiction means the noise is often low and all too often unheard.

Our Work

Last April I was contacted for advice on what is commonly known as “Dual Housing Benefit”. Dual housing benefit is available in very specific circumstances, like fleeing violence, this pays for two types of accommodation at the same time – for a limited period.

This request came from a residential rehabilitation service which provides support for people with addictions and their services are paid for by the DWP through housing benefit. The service had been advised that a resident there was not eligible for rent on his home AND rehab.

Having sought advice from a Welfare Rights worker at a partner law firm we were able to confirm that in fact the decision not to award payment for rehab and a tenancy was legal. This was due to the service type not being one of the examples where this can be paid.

But just because its legal doesn’t make it right and there was no way that would force us to walk away. The safety of the people should always be the highest law and so those in power can’t just wipe their hands of this issue.  Actually, when I asked the Council in question to pay this discretionary, I was advised “I can’t just do that, that’s taxpayers’ money”. It just feels so morally bankrupt and void of any sympathy to someone’s situation.

I made contact with other similarly funded services who advised me that this was indeed an issue that was often played out mostly on “luck” – that they would “apply and see how we get on” – like a game of rehab roulette. But advised that increasingly this was becoming more and more the case. That they had to tell someone, assessed as eligible for rehab by them, that they would need to give up their tenancy – or not go to rehab at all. Not a position these services should ever be in but due to many of them surviving on a small budget, a necessity.

This decision to give up a tenancy should always be down to choice, always. I say this as people often go to rehab knowing that a fresh start will be needed, that they cannot return to that area. But we can’t force people to decide that with what can often be “life or death” choices. That is the way recovery should always work – person centred, and person led.

Very quickly we ended up with 6 cases. This included a single mother of two children. She didn’t want to lose her tenancy but was advised the only rehab able to take her and her youngest son, was funded through this means.

I’ll leave that there – the only residential service for single parents is a female service that requires the resident to claim HB. So, now we have a position where people have to give their kids AND their tenancy up to access residential rehabilitation.

A Warning

November came and I took on the case of K. K went to one of these services. A housing first case. Suffered multiple near fatal overdoses that very year.

For K, rehab was a way out.

He applied. He was refused HB for both and after 3 weeks his Housing Association advised him his rent had stopped and that he would lose his home if it didn’t get reinstated. Now anyone with an ounce of housing knowledge will tell you that the legal basis for eviction had not happened yet. Anyone with a heart will tell you that morally this is not in the spirit of being a “social landlord”.

Having picked his case up after this, I issued my concerns that K was at risk of leaving rehab. That his life would be at risk if he was forced to leave. I set him up a lawyer’s appointment and left for the weekend. When I returned, I was advised K found the stress too much and had left.

I didn’t really engage with him after that. I did speak with his support worker though. He told me K had begun using again. Which is not that surprising to anyone in the addiction field.

I then returned on the 27th December to find out that K had died of a suspected drugs overdose on Christmas day. I can’t begin to tell you even now how upset I am about that.

We can never say what would have happened to K. Drug deaths can be like that unfortunately. But what I can say is he did not get the chance due to red tape, regulations and an over eager landlord. He should have been able to stay there and focus on his recovery – instead he was backed into a corner – a corner he never fought back from. It was preventable too.

We really must do better, let his case be a warning to those that ignored him. His death should a lesson to us all. A lesson that this is a health emergency, that without immediate action the deaths will continue to rise.

Our Asks

The response to this shouldn’t be a short term one, we cannot put a temporary plaster over this issue, nor should it be in the hands of someone with discretionary powers. A nameless and shameless person more concerned what they should have for lunch than if someone goes to rehab, or even if they become just another statistic – another number to the list.

The Scottish Government must act immediately and be transparent in its process of doing so. This is not a Westminster issue. If that’s the case then is Westminster funding these rehabs – so what are we actually funding, where does the money go? Should we just accept it and stand by while watching our friends, our brothers, our sisters, our mum’s and our dads merely exist or drop-down dead? I for one won’t.

We have a moral duty to act. It’s a time for real and lasting change.

What we want:

  • An immediate pot of money that can be accessed with something as simple as a letter from the rehab. This is a mandatory pot and payable until the person returns to their tenancy.
  • That the Scottish Government seriously assesses how these residential rehabilitation services are funded and registered to ensure everyone who needs access them can do so without losing their home. These services must be allowed to operate effectively, providing a vital service for those who need it. Facilitate the correct programme for those it serves and not worry where they will balance the books.

These aren’t big asks, they aren’t “out of order” either. They are genuine life changing decisions for anyone who may need them.

We must make sure, as we are making progress, we don’t leave anyone behind.