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Equinox works with mental health and substance misuse service users for climate harm reduction

Catherine Max, Equinox Trustee and sustainable health and social care specialist, describes Equinox’s climate harm reduction project to help mental health and substance misuse service users take action on the environment. The project is contributing to the National Adaptation Programme’s health and wellbeing theme and is supported by a grant from Defra.

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Equinox provides support and care for people with mental health and substance misuse problems who are often overlooked by mainstream services and marginalised by society. Equinox works across London and the South East with a range of housing, outreach and day services, all of which aim to assist their users in engaging with the communities around them and finding effective strategies to deal with the challenges they face in their lives.

Defra support to help vulnerable groups affected by climate change

One of only two charities nationally to be awarded a grant by Defra to improve knowledge of how “vulnerable groups” will be affected by climate change and how best to respond to its impacts, Equinox will focus on extreme weather events such as heatwaves, severe cold snaps and flooding, and associated risks specific to Equinox service users.

Defra’s grant recognises the commitment and prior achievements of Equinox in engaging with climate change as an issue where we all have responsibilities and can all make a difference.  Led by service users acting as peer mentors, the new project will raise awareness of climate change among people with drug, alcohol and mental health needs and consult on practical tools to help them adapt.  It will also give Equinox a platform to influence national policy and local government, especially emergency planning.

Service User Involvement Manager, Earl Pennycooke, describes how Equinox service users are central to the project:

“The Defra award to Equinox represents a first for people with mental ill health, drug dependence and alcohol dependence.  Service users from Equinox and other organisations are coming together to discover how extreme weather conditions affect these under-represented groups. We are proud that Equinox service users are leading this pioneering project – from focus groups through to final designed information leaflets.”

Chief Executive Bill Puddicombe explains how the project aims to reach groups often missed by existing advice and support:

“Our experience is that local authorities issue helpful guidance leaflets for voluntary organisations to distribute to the vulnerable, for example, about keeping warm in winter or cool in heatwaves. This is commendable but this vital information is not always relevant to our service user groups, as it tends to be aimed at the elderly.”

How Equinox got started with climate harm reduction work

Around the same time Equinox began to develop its Service User Involvement (SUI) Strategy in 2008 (Breaking Down Barriers, published 2009), the organisation started to think about its sustainability policy and also got involved in the Big Response initiative exploring the role of civil society organisations with respect to climate change.

Sharon Bye, former operations director at Equinox, describes Equinox’s involvement in The Big Response project to explore how climate change could affect its work

This was the perfect opportunity to model emerging SUI principles, and a working group of service users, staff, directors and trustees came together to think and act upon what climate change means to Equinox.  It soon became clear that everyone, whatever their role, wanted to relate the Big Response to what is important to Equinox.  This meant Equinox as a sustainable “business” in the long-term, the efficiency and resilience of everyday operations, and the place of Equinox in the wider community, as well as the wellbeing of service users.  In one of a series of workshops, facilitated by the Big Response team and involving people from across the whole organisation, the term “climate harm reduction” was coined to link the commitment to tackling climate change with the “harm reduction” risk management concept familiar to people in the sector.

Beyond mitigation and adaptation to resilience and recovery

Early on in its thinking about sustainability, Equinox had committed to a number of short and longer term actions to reduce carbon emissions which would also benefit the organisation in other ways, including smarter energy use, promoting walking and cycling, and food growing at some services.  For example, Equinox has vegetable gardens at Equinox Aspinden Wood, a care home in Bermondsey for people who have long term problems with alcohol, mental health and homelessness, and Equinox Southampton Way, self contained accommodation for men with enduring mental health problems, in Peckham. 

Equinox recognised the “win wins” in this kind of behaviour change, as being more active is good for physical and mental health, and contributing to the community engenders a sense of purpose which can in turn aid recovery.  Energy efficiency is also good for our pockets.  These things are important to Equinox as a charity, to staff and to service users alike.

With the Big Response, Equinox turned its attention to actions to adapt to climate change, including thinking differently about how to keep services open whatever the weather, and the kinds of messages for service users to share.  It was this which drove home the fact that information and support is not currently well suited to Equinox service users.  Issues identified included the importance for people on medications like methadone to keep hydrated during heatwaves; the possibility that extreme weather could cause or increase side effects for people taking medication; the increased risk of food poisoning due to scavenged food spoiling more quickly; and service users on benefits being less able to afford bottled water when fresh water is not available.  The Defra grant allows Equinox to test and expand this list with a wider group of stakeholders – and to do something about it.

Life experience and life skills:  climate harm reduction and “personalisation” in social care

The grant from Defra is part of the National Adaptation Plan (NAP), which includes a section on health and wellbeing, and the Climate Ready implementation programme.

Equinox’s information leaflets, with practical suggestions to help manage the risks identified, will be shared with the NAP team, with local authorities and the NHS, and groups like the London Climate Change Partnership so that they can be promoted more widely.

Equinox itself will feed its learning into service user support planning, for example, coping with severe weather as an essential “life skill”.

Last but not least, the project will demonstrate the know-how and creativity of our service users, who say they consider themselves “forgotten people”.  Equinox hopes this will help combat stigma in general and give people with drug, alcohol and mental health problems the confidence to work alongside commissioners and decision-makers on a global challenge which affects us all.  This aspiration is central to the Personalisation Strategy, co-produced by staff and service users, which includes objectives for Equinox to make the most of the skills of its service users, ensure they have a real say over the resources of the organisation, and encourage and support service users to influence the world around them.

Further reading

  • National Adaptation Plan: addressing the risks set out in the first UK Climate Change Risk Assessment
  • SCIE resources on personalisation in social care: thinking about social care by taking the person and their individual circumstances as the starting point, rather than the service
  • London’s Changing Climate – In Sickness and In Health: London Climate Change Partnership tool to aid health and social care commissioners and providers as they begin to design and shape their services in the new delivery landscape.
  • Vulnerable People and Climate Change: NCVO project building on the Big Response and involving VCS organisations working with older people in London, disabled people and those with mental health needs in London, black and minority ethnic communities in Greater Manchester, and people on low incomes in Hull & East Riding and Portsmouth.

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