A visit from one of the denizens of the urban jungle called by for a free lunch over the weekend. A couple of rashers of bacon and some chicken slices swiftly disappeared although the digestives were turned down.
What you can't see are two of the cats watching the proceedings from their front row seats on the wall. Nary a concern about the fox but a keen interest in the food, THEIR food, I was giving away to the interloper. The dog was locked away indoors going berserk because she could see and smell the fox. The cold weather had given her the courage to pop in for a handout and she happily posed for the photo opportunity. It put a smile on my face throughout the day at work. Wonderful!
Apart from that brief excitement I have been busy at work although the referrals fall mainly in the category of inappropriate. Alcohol problems mainly with homelessness and relationship problems. Not a whiff of mental illness. It is like phoning a plumber and asking him to fix your electrics. Yes. We can sort out alcohol problems. We can mediate relationship problems. But alcohol services, AA, Relate, etc... can also do this whilst our true forte is mental health crisis. One example is that of a chap who has a drink problem. Let's call him Bob.
Bob has a drink problem...he drinks two or three bottles of very strong and extremely cheap cider every day. He then phones the police, ambulance, GP or us stating he can't cope and wants to die. Cue service response but Bob is extremely drunk and denies any suicidal ideas. He would like help to stop drinking. He agrees to an assessment the next morning before he starts drinking. However, when we arrive he says he is alright or tells us to stop interfering in his life so we go away. He likes drinking and there is no evidence of a mental illness so no role for us. We inform his GP and the other parties involved. The roller coaster has started because over the next six months we receive twenty plus referrals from a variety of agencies which result in variations of the above theme. He presents as drunk and makes threats to harm himself and / or wants to quit drinking alcohol. Bob is not alone because Amanda, Cyril, Eric, Sarah, Pauline, Paul, Sid, Tom, Geoff, etc... are also doing the same.
Meanwhile, Claude who has problems mixing with people and lives with his elderly mother doesn't get the service he needs because he doesn't bother the police, ambulance, GP, neighbours, etc...This is despite his paranoid beliefs that MI5 are watching him and reading his thoughts. Not a problem but, he refuses to claim benefits and he cannot work, his mother is physically ill and worries about Claude if she has to go into hospital. He is never left on his own but there is no one else to look out for him. We would support him but we aren't able to because we are too busy rushing around to support people who demand help for their alcohol / relationship / housing / financial problems.
Happily for Claude and others with mental health problems we can point those with no mental health problems and one or a combination of the above to other agencies whilst we get on with the remit of the team. Mental health crisis resolution and home treatment. There will be those who cry "Halloa! Alcoholism is a result of depression so it is your job. Get on with it you backslider and trotskyist".
People who have alcohol problems drink for a variety of reasons. Let's look thro' the round window and look at some of them.
1.Addicted to the amber nectar and that craving is all too physical as well as engrained into the very core of that individual's psyche.
2.Depressed - Yet people with depression do not ordinarily crave the substance or become addicted, whether it be alcohol or wotsits. To be depressed does not immediately lead one to alcohol addiction.
3.Psychologically flawed - very probably true but I have yet to meet someone without some psychological quirk of some sort. They do not necessarily become addicted to alcohol and that desperate need to feed the habit.
4.An underlying severe and enduring mental illness - some people unfortunately turn to alcohol to alleviate the awful impact of their illness. Someone with a psychosis may drink to assuage their anxiety and drown out the bizarre ideas or the voices or to manage their paranoia. Medication and support usually allow a full assessment of the true extent of their need for alcohol.
5.Sensitive individuals who have been damaged by the awfulness of society and it's sheer hypocrisy. Alcohol anaesthetises one against the full horrors of the modern world. So why isn't everyone steeped in this cheap anaesthetic?
6. Slid into it as a result of drinking with their mates and the alcohol addiction is a mental illness you cruel heartless cynical bastard CPN you. Bollox! Absence of alcohol = no alcohol problem. Absence of what? = no psychosis.
I have to own up to a personal interest here as well as a professional one. My father is an alcoholic as was one of my uncles. I cannot remember how many alcohol detoxes I have supported over the years, both in hospital and community. The successful ones are successful because the individual accepts it is their problem and takes ownership of it. They attend the alcohol programmes, AA, etc...Sadly I have seen people die as a result of alcoholism, patients, friends and family members. But central to dealing with an alcohol problem is accepting responsibility for their drinking behaviour. Whether you call alcoholism an illness or irresponsible behaviour is many ways immaterial. Drinking 6 litres of cheap cider, or three bottles of wine or a litre of spirits per day will fuck your life up. It becomes the problem of others when your drinking affects those others and often fucks other people up. Family, friends, colleagues, etc... Drink long enough, often enough and to excess and you will possibly develop a mental illness
As for it only happening to 'wino's'...I have nursed quiet little old ladies, doctors, lawyers, housewives, nurses,etc...with alcohol problems.
My rant took me slightly off track...