Evidence from WY-FI Addiction and multiple needs Mark Crowe WY-FI Research and Evaluation Co-ordinator September 2016

What is WY-FI? WY-FI works across West Yorkshire in the districts of Bradford, Calderdale, Kirklees, Leeds and Wakefield WY-FI works with Adults not engaging effectively with or excluded from services who experience at least 3 of the following: Homelessness Addiction (problematic substance misuse) Re-offending behaviour Mental ill health WY-FI supports people who are not engaging effectively with services and are experiencing entrenched needs in at least three of the following HARM areas: Homelessness Addiction Reoffending Mental ill health WY-FI does not deliver services but works with existing local services to co-ordinate and work together effectively to fully meet individual needs in a person-centred and co-ordinated way via a Multi-Agency Review Board.

What difference does WY-FI make? Other results from the Insight Survey show the difference that having Navigator support makes to an individual’s experience of services.

WY-FI beneficiaries profile (gender) Locality Total caseload (351 starts; 309 detailed data) SUSSAR Info Male total Female total Bradford 75 71 49 22 Calderdale 56 53 31 Kirklees 40 24 16 Leeds 103 102 72 30 Wakefield 46 43 26 17

WY-FI beneficiaries profile (ethnicity) Locality English Other Not Known Bradford 45 19% 12 5% 18 8% Calderdale 43 11 2 1% Kirklees 31 13% 5 2% 4 Leeds 79 34% 10 4% 14 6% Wakefield 33 14% 1 0% Total 231   39 50

Number of people with addiction needs by age and locality 18 to 24 25 to 34 35 to 44 45 to 54 55 to 64 65 and over Bradford 5 20 23 11 3 1 Calderdale 12 22 13 2 Kirklees 15 7 Leeds 4 35 32 19 Wakefield 10 9

Percentage of people engaging with addiction services by age and locality 18 to 24 25 to 34 35 to 44 45 to 54 55 to 64 65 and over Bradford 40% 35% 52% 45% 0% Calderdale 20% 25% 41% 31% Kirklees 33% 60% 42% 29% 67% Leeds 63% 21% 14% Wakefield 50% 56%

WY-FI beneficiaries need and contact with services Locality Males with addiction need Males in contact with addiction services Females with addiction Females in contact with addiction services Percentage males in contact with addiction services Percentage females in contact with addiction services Bradford 40 16 21 10 40% 48% Calderdale 30 22 7 33% 32% Kirklees 24 12 50% 44% Leeds 69 18 29 19 26% 66% Wakefield 25 15 60% 47% Not everyone who needs support, makes it to an addiction service. The proportions vary from district to district but there are typically between a third and a half of beneficiaries experiencing addiction who do not access addiction services. WY-FI looked at an area where there was a very low proportion of males experiencing addiction who had not received a service. Reasons for low levels of recorded engagement, even with navigator support, included: Working with people who were acknowledged locally as never having, nor ever likely, to engage with addiction services Individuals being recalled to prison prior to attending their first appointment Individuals dying prior to attending their first appointment Individuals not having attended their first appointment at the point of the data snapshot Individuals disengaging from WY-FI but subsequently attending appointments at addiction services

Percentage of male beneficiaries with dual diagnosis - service engagement Locality Contact with addiction service Contact with mental health service Contact with both addiction and mental health services Bradford 39% 13% Calderdale 33% 20% 10% Kirklees 52% 17% Leeds 26% 18% 11% Wakefield 63% 42% 38%  People experiencing dual diagnosis tend to have much more access to addiction services than mental health services, certainly in the early stages of treatment.

Percentage of female beneficiaries with dual diagnosis - service engagement Locality Contact with addiction service Contact with mental health service Contact with both addiction and mental health services Bradford 53% 11% 5% Calderdale 32% 41% 14% Kirklees 44% 19% 6% Leeds 67% Wakefield 47% 40% 13% People experiencing dual diagnosis tend to have much more access to addiction services than mental health services, certainly in the early stages of treatment.

As you would expect, referrals to WY-FI of people with addictions come from a wide range of sources as number of different agencies have a stake in the individual’s recovery. The ten most frequent referrers are shown in the chart above. One of the most notable referrers to WY-FI are addiction services themselves (34% of WY-FI referrals) indicating that there is a proportion of their own clientele that they can’t engage with or are too chaotic or risky to work with, without a navigator.

Useful links Office for National Statistics Deaths related to drug poisoning in England and Wales The Guardian Our neglect of ageing heroin users has fuelled the rise of drug related deaths BBC Drug related deaths reach record levels in England and Wales Lankelly Chase Hard Edges: Mapping severe and multiple disadvantage in England Recent media reports highlighting the increased death rate of drugs service users for example in the Guardian and BBC demonstrate the change in the demographic profile of drugs services’ clients. Reasons for the increased death rate include: increasing age of drug services’ clients (particularly opiate users) and the additional health problems attributed to their drug use or lifestyle since the 1980s and 1990s (the last “waves” of heroin epidemic in the UK).

Any Questions? wy-fi.org.uk