1980: Ennals Quote"There is nothing . . . glamorous about those who drink too much. In men it is crude and embarrassing: in women it is plain sickening."
Mr. David Ennals, Secretary of State for Social Services, quoted in Camberwell Council on Alcoholism, 1980
1981: Birth of HAGA
Back in 1979, street drinking in Finsbury Park was starting to ruffle a few feathers and as a result Haringey Community Health Council (CHC) looked into the problem and published a report. The report found that there was little sympathy for dependent drinkers, and even GPs were of the opinion that nothing could be done but let them drink themselves to death.
That report, and a donation of £500 by Marks and Spencer, led to the formation of the Haringey Action Group of Alcohol; HAGA.
However, contrary to popular thinking at the time, HAGA’s novel approach was to offer counselling and support for street drinkers, seeing them as people who needed help, rather than a blight on the local area. And it’s this inclusive attitude, with a good dose of common sense, that has typified HAGA’s approach ever since.
1984: Space to growWhen HAGA started, they held counselling sessions in Haringey Community Health Council’s (CHC) meeting room in Tottenham town hall with one counsellor and two volunteer staff. When CHC moved to new offices in Tottenham High Road, HAGA went with them. Here, HAGA were given their own room and had access to dedicated counselling space; a vast improvement over the shared environment of the town hall.
1985: Groundbreaking approachIn 1985, if you needed help with alcohol misuse, you’d end up in a drug dependency unit in a hospital, and most residential treatment was Christian led.
1986: New name, new ideasHAGA changed its name to Haringey Advisory Group on Alcohol. It was around this time that it was noted that ethnic minority groups were not coming forward and using the services at HAGA. So, HAGA went into the local community to find solutions. Part of the problem was language, so HAGA devised a training course to train foreign language speakers as alcohol counsellors. Specific alcohol awareness work within ethnic minority communities continued for four years, training 40 counsellors.
1990: Alcohol in the newsWomen and alcohol, mother's ruin? Double standards still exist when it comes to men, women and alcohol, Guardian Headline, 1st May 1990.
1991: Project NewStart
Over the years it’s become clear that those with good jobs, a secure family environment and a roof over their heads have a much better chance of controlling their alcohol issues than those who don’t. Part of HAGA’s philosophy is to provide help with these related issues that go beyond the typical scope of an alcohol service.
Project NewStart provided dry and wet housing for those who needed a place to live and were in alcohol treatment. It was a collaboration between HAGA, private landlords and the local authority; the local authority would pay the rent to landlords and those under the care of alcohol services could have a place to stay.
1992: Home Detoxification: HAGA leads the way
HAGA becomes one of the first alcohol services in the country to treat people in their own homes. Two community nurses were employed for home detoxification support. This groundbreaking approach benefits everyone. The person receiving treatment can relax in their home environment and build up a rapport with the nurse providing medical and psychological support, plus it’s cheaper than providing hospital care.
Today, home detoxification remains a key service provided by HAGA.
1993: Providing key support to local authoritySometimes, due to a lack of support in the home, or maybe the person is homeless, not everyone is suitable for home detoxification. Some individuals do better within a care environment. But, as this level of support is quite expensive, a case needs to be made to support the claim for care. By providing independent assessments of individuals, HAGA helped to secure funding for those who need it. This is a service that is extended to family assessments today.
1994: A new home
Finally, in 1994, the London Borough of Haringey found a building that allowed HAGA to operate on a larger scale. Service-users and staff all worked together to decorate the building and get it up and running. The new building enabled HAGA to treat 297 people in 1994, almost three times the number they were able to treat in the previous year.
With their own building, HAGA could now start to implement all their ideas: training courses started for GPs, social workers, health visitors and A&E nurses. A women only day began to accommodate the different needs of female service-users.
The building itself became a hub of support and encouragement from staff and service-users alike. The atmosphere was relaxed and this approach led to a strong social network. What’s interesting is that data today finds that a drinker’s social network has a huge impact on recovery. “The addition of just one abstinent person to a social network increased the probability of abstinence for the next year by 27%”
1996: A lottery win for families
In 1996 HAGA employed a Children and Families Worker thanks to National Lottery funding. HAGA had recognised that women often wouldn’t come in for treatment, either because they didn’t have anyone to look after their kids, or because they didn’t want to admit to having a problem for fear of losing them. The Children and Families Worker began as a childminder, playing with the children and looking after them while their parent had treatment. However, over time, the role transitioned into something much more when it became clear that children needed intervention in their own right, and whole family work would benefit parents in their recovery.
During 1996 HAGA treated 513 people. This increased to 690 in the following year due, in part, to the demand for the Children and Families Worker.
1997: Alcohol in the newsAlcohol: Parents' drink threat to children, The Independent headline, 12th November 1997.
2001: Part time DV counsellor employed
An analysis of case notes and key working sessions at HAGA highlighted a statistic that was difficult to ignore. In 2000, over 40% of women seen reported issues of domestic violence in their lives, and up to 50% identify some form of abuse when they were children as one of the mitigating factors in their current situation.
In 2001, HAGA secured funding for a domestic violence (DV) counsellor under New Deal for Communities. With this, HAGA employed a worker for one day per week based in the day centre on the weekly women’s day. She offered advice and information sessions, advocacy in contacting other services and ongoing counselling; aiming to empower women to make safe and positive changes that enhance and improve the quality of their lives.
The high demand for family support seen since the employment of the Children and Families Worker five years previously led to the Children of Substance Misusing Individuals Conference, or COSMIC.
The conference, held at the old TUC centre in Muswell Hill, had an impressive guest list. It was designed as a national event, and nationwide charities, such as Childline, came along to join the discussion. The high profile nature of the conference caught the attention of the local authority and they provided funding for HAGA to set up a provision for children and families.
HAGA used the funding to create a purpose built space for kids to come and play while their parents had treatment. As a space dedicated to children within an alcohol service, catering for their needs, it was one of the very first in the country.
2003: HAGA joins DV ConferenceHAGA were invited to sit on the panel at a multi-agency conference on domestic violence held at the civic centre.
2003: HAGA begins IT trainingIn 2003, HAGA began in-house IT training for service-users to help them gain access to employment and education. The response to this service was overwhelming and it soon became clear that the single computer in a room with informal training was not going to meet demand . . .
2004: Kinesis provides essential help
The daycare IT training service outgrew its space and moved into newly upgraded premises in Northumberland Park and was renamed Kinesis. In addition to structured IT courses, service-users could also get help with CV writing and job seeking skills.
The helping hand back into employment provided a huge boost to the self esteem of those who had been out of work for some time. Not least those who came from professional backgrounds, but had lost their jobs due to their drinking.
2004: First National Alcohol Strategy
In 2004, New Labour published the Alcohol Harm Reduction Strategy for England. In it, they set out their key approach to alcohol harm reduction, which focussed on education, light-touch regulation and partnership with the alcohol industry. Part of their harm-reduction strategy was a strong commitment to Identification and Brief Advice (IBA); an intervention that HAGA employ both in-house and to the wider community.
Following the Alcohol Harm Reduction Strategy, alcohol-focussed Local Enhanced Services (LES) were set up across the country with local practices. An alcohol LES is a package targeted at meeting the needs of the local population, most often involving screening existing patient lists and delivering Brief Advice.
2004: Full time DV and substance misuse worker employedFrom 2001 to 2004, HAGA had a part time DV worker, who would come into the day centre to offer advice to women. It had become very clear that the need for a dedicated worker was high judging from the number of women seeking help. HAGA then proposed a full-time DV and substance misuse worker role to work in their services, drug services and domestic violence settings. Funding was secured and HAGA are still doing this vital work today.
2006: Hidden Harm ReportHidden Harm’ report, by Advisory Council of the Misuse of Drugs, estimated that there were between 200,000 and 300,000 children affected by problem substance use in England and Wales.
2007: Safe. Sensible. Social.
The Department of Health and the Home Office launched an update to the government alcohol strategy. Named ‘Safe Sensible Social’, it sets out clear goals to promote sensible drinking and to reduce harm.
2007: Turkish Cafe Project
The Turkish Café project was set up in December 2007 by the London Boroughs of Enfield & Haringey.
The aim was to focus on targeted outreach work around drugs and alcohol along the ‘Green Lanes’ corridor among the Turkish and Kurdish speaking communities. The project aimed to reduce the stigma associated with drug and alcohol misuse and reach this diverse community by providing information so that they could engage with HAGA's services.
2007: Bringing alcohol intervention to A&E
HAGA employed an Alcohol Liaison Nurse to work in hospitals. The main role was to train A&E and ward staff in Identification and Brief Advice (IBA) and deal with alcohol misuse generally. The nurse also assessed patients directly and offered pathways into treatment.
Later, in 2008 - 2009, when the SIPS trial started recruiting at North Middlesex University Hospital, HAGA’s Alcohol Liaison Nurse contributed to training and recruitment for the study. SIPS is the largest UK trial of IBA, it investigated IBA use in A&E, primary care and criminal justice. The findings led to a number of major research papers, including A&E focussed studies.
2008: Alcohol treatment in GP surgeries
In April 2008, NHS Employers and the General Practitioners Committee (GPC) of the British Medical Association (BMA) agreed five new clinical Directed Enhanced Services (DES); one of which was a DES specification for alcohol. Under the alcohol DES, practices are financially rewarded for screening all new registrations aged 16 and over. As part of the DES, practices deliver Brief Advice to patients identified as drinking at Increasing and Higher Risk levels. Following practice returns, payment is made annually to practices. The total investment for this DES in England in 2008/09 and 2009/10 was £8m per year.
HAGA sent an IBA worker into local GP surgeries to give training on IBA. For many people, just 5 minutes of advice is the most effective. Given early intervention and advice, one in eight Increasing and Higher Risk drinkers will reduce to within Lower Risk levels*.
*2002 study by Moyer et al
2008: DV project classed as best practiceIn 2008, HAGA’s Domestic Violence project was cited as an example of best practice in Innovative Responses.
2008: Wheels of recovery‘Wheels of Recovery’ was a service-user led cycling project that brought people in recovery together to have fun and exercise. Initially funded by the London Cycling Campaign, it was also a way to raise money for service-user projects at HAGA and in both 2008 and 2009, fundraising cycling events were held. Today, the project is called Cycle Fun and is run by the Tottenham Hotspur Foundation.
2009: RISEBuilding on the success of Kinesis with helping people back into employment, HAGA partnered with the Westminster Drugs Project (WDP) to form RISE: Resettlement Independence Stability Enterprise. RISE provided highly individualised care leading to employment for those in recovery from drugs or alcohol misuse.
2010: Alcohol awareness stalls beginHAGA started alcohol awareness stalls across Haringey. Based around Identification and Brief advice and manned by trained service-users, HAGA brought alcohol screening and advice right into the heart of community settings.
2010: New partnership with Mungo's Broadway HousingBuilt on the success of Project NewStart, HAGA partnered with St. Mungo’s Broadway to provide housing and treatment. St. Mungo’s are now Mungo’s Broadway Housing, and they provide the accommodation and HAGA provide the specialist substance misuse support. The type of housing available ranges from a high support environment to those who are ready for independent living.
2010: Polish Service extends reach into communityHAGA has always aimed to provide support to as many communities as possible and were keen to reach the increasing Polish community in Haringey and the surrounding areas. HAGA offers Polish speaking services as well as activities to engage with the Polish community, such as open days and a Polish music group. These events are always very popular with the local community.
2010: HAGA implements first GP hub
Keen to extend their reach and to provide support for those who would not, or could not, come to an alcohol service, HAGA implemented a ‘GP hub’ in one surgery in Haringey. Individuals could make an appointment to see a HAGA alcohol specialist at specific times, often in the evenings to accommodate those who work.
This approach supplies the least intensive method of intervention for people who might be Higher Risk, but are motivated with a good support network in place.
Today, HAGA runs GP hubs across the boroughs where we work as a key way of reaching people.
2011: DontBottleItUp launched
DontBottleItUp is HAGA’s innovative alcohol screening, advice, intervention and referral website, leading the field of online alcohol interventions in the UK. Seeing a need for young people and professionals, HAGA solicited the views of local residents, and the idea for an online screening tool was formed.
In a single year, from August 2013 to September 2014, 40,000 people accessed the site and 15,773 people took the quick and easy alcohol test to find out whether their drinking is risky. Of these, 14,110 (or 89%) were identified as risky drinkers, which is up from 75% in the previous year. Those identified as risky drinkers are offered support and a personalised plan to reduce their drinking and prevent further harm.
2011: Alcohol in the newsAlcohol-related hospital admissions top one million, The Telegraph headline, 26th May 2011.
2011: A new project: 171
The 171 Project is an abstinence based twelve week programme. Launched in 2011, the project offers a 5-day-per-week structured programme that promotes whole person recovery through:
- psycho-educational groups
- creative therapies
- health, nutrition and wellbeing
- peer support via SMART Recovery
- social / community activities
- one to one support
Today, this project is still part of our service, but is named The 590 Project to reflect the new site for recovery services.
2011: Hospital link worker commissioned
National statistics for A&E admissions during 2009 - 2010 show that during the day 35% of A&E visits were alcohol related; at night, this increased to 70%. Analysis of North Middlesex University Hospital’s A&E admissions data by HAGA’s Alcohol Liaison Nurse during that same year highlighted some equally telling trends. The data showed that some individuals are admitted time and time again for alcohol related issues. From 2009 - 2010 just 51 people were responsible for 393 alcohol related hospital attendances, 38 of which led to an overnight stay.
This information lead to the commissioning of a Hospital Link Worker in 2011. This person is charged with working assertively with people who frequently attend hospital with alcohol related health issues. These issues include sickness which has come about from alcohol’s effects on the body, as well as injuries sustained while intoxicated.
2012: HAGA's projects cited at best practiceThe 2012 National Alcohol Strategy showcases HAGA’s IBA and DontBottleItUp online tool as examples of best practice. Read the case studies here.
2013: DrinkCoach launched
DrinkCoach is HAGA’s smartphone and tablet app that lets users track their drinking and set goals for cutting down. Launched In 2013, it gained positive press reviews in the UK and abroad.
In 2012 HAGA entered two proposals into a Small Business and Research Initiative competition for innovative tech solutions to alcohol misuse. We were up against over 100 others, mainly from tech companies, and amazingly both were among the eight that received Phase 1 funding (six months). The bids we put forward were:
1 To improve DontBottleItUp in terms of look, feel and functionality, adding innovative features like a Skype appointments and GP information sharing
2 To develop DrinkCoach.
All eight projects applied for Phase Two funding (a further year) and again both of ours were chosen.
2013: All Change!
In Nov 2013 HAGA’s alcohol service moved from the Seven Sisters Road building to HAGA’s other site at 171 Park Lane, and vice versa.
The RISE and 171 Project team move to 590 ahead of new contract for the Haringey Recovery Service to be based at 590. The Seven Sisters site became a central recovery centre for alcohol and drugs misuse and provides many different recovery options, such as the photography project, recovery academy and various therapeutic activities.
171 Park Lane became home to the Breaking Ground project and the Community Alcohol Team (CAT).
2013: HAGA wins contract for IBA training in IslingtonIn 2013, HAGA won the contract for delivering sensible drinking awareness campaigns and events and Identification and Brief Advice training in Islington; this contract was retained in 2014 and a further contract doing similar work was secured in Camden.
2013: Breaking Ground
Structured over twelve weeks, Breaking Ground is a stabilisation programme that offers a range of groups and one-to-one support. Those participating in the programme are required to attend eight hours of support activities per week.
Many people find the peer support and encouragement through group work particularly helpful, and the emphasis on a daily routine helps participants create a structured lifestyle.The programme runs at the HAGA alcohol service and Haringey residents may come to HAGA directly through one of the drop-in sessions, or be referred by their GP or other health professional.
Building on our experience of working with children and families affected by drug and alcohol misuse, HAGA launched the Communities Overcoming Misuse Empowerment Team (COMET) in 2014. COMET focuses on supporting children, families, friends and carers affected by alcohol and drug misuse, and provides specialist training for professionals working in this area.
2015: Online Brief Treatment Service launches
Following a successful pilot in 2014, HAGA launched its online Brief Treatment Service in Haringey in early 2015. The service aims to offer those people who do not want or need standard alcohol treatment an easy, convenient support option in their homes and at times that suit their lives, such as weekends and evenings.
HAGA believes that this new online Brief Treatment offer will refresh mainstay alcohol treatment, bringing it up-to-date with modern lifestyles and opening up support to a whole new cohort of people who would not otherwise seek help for their alcohol problems.
2015: How HAGA came to Shine
The story of Shine Enterprise Centre illustrated by Scriberia. HAGA launched the Shine Enterprise Centre in November 2015. Shine is a self-sustaining multipurpose community, retail and enterprise hub on Turnpike Lane with a programme of events, covering business, arts and crafts, health, community and leisure and a large open double shop-fronted space suitable for group sessions, training, events and pop-up retail. Shine offers workspace, event space, market place and gallery space. Through mentoring and volunteering opportunities, we hope to offer people in recovery from alcohol misuse direct work experience opportunities, supporting individuals to gain skills, experience and qualifications that will lead to secure and sustained employment. Watch this #Space2Shine. Illustration copyright Scriberia 2015. www.scriberia.co.uk
2015: A new approach to home detox
Following consultation with service-users, HAGA identified a new approach to delivering detox treatments for service-users with complex needs usually requiring residential and inpatient admissions. What if service-users had overnight support during their home detox from a skilled worker trained in supporting people through the process? The Enhanced Community Detox (ECD) Pilot launched in April 2015, and in May 2016, we completed the first year evaluation of service-user and staff feedback and reviewed outcomes. Thirteen service-users, who would otherwise have been sent away to our residential provider at twice the unit cost, were detoxed in their own home with overnight support via our new treatment approach. The pilot was extended with on-going funding in 2016 from Haringey Council.
Tackling social isolation
In 1st April 2015, HAGA launched the Neighbourhoods Connect project in Central and East Haringey. Funded by Haringey Council, the project aimed to reduce social isolation by connecting people to their communities through social activities, peer support, community groups and volunteering. Whilst our main focus was to connect residents into existing community activities, we found that offering group activities, workshops and events ourselves provided a bridge into wider activities and 1:1 support from our team. Our resident-led Women’s Sewing Group supported residents to connect with others and develop basic sewing skills, and well-being workshops supported residents to consider some lifestyle changes and set realistic lifestyle improvement goals. In the eighteen-month pilot period, we engaged and supported 1,163 socially isolated people.