Four of them all at once, like the proverbial buses...

1 Tim Makower and Homestead. 

We’re in the middle of Tim’s firm’s participation in LFA (London Festival of Architecture) – which is 3 Wednesday evenings just near Tate Modern. They are all part of the networking and cross-fertilisation needed to get the project - for better designed (fabric, psychosocial and occupational) residential mentl health facilities - under way.
Brigid, Neels and I slightly subverted the first one, last Wednesday, by turning it into into a TC-style democratic community meeting - after the panel of four experts had presented their own contributions. It was very interesting to see how the 'design' of the social space - in a circle rather than rows with pre-defined  boundaries and democratic facilitation, changed the nature, participation and openness of the conversation. The next one is on TCs anyway… 

The overall structure of Homestead is still evolving – but looks like being a collaboration of like-minded organisations overseeing ‘franchised’ projects in different places. Hopefully not like McDonalds, though – and allowed to ‘grow in their own soil’, as good therapeutic communities always should.

 It’s great working with architects rather than health services – I just love the way they think big and scattergun their ideas out there… When we had the 3-day meeting at Tim’s Wiltshire house in April it felt to me like most of the clinical people were rather preoccupied with risk and what’s not possible, while Tim and others were wanting to make a plan for a whole new way of reforming mental health. One of my joys of retiring from clinical work is that I am free to think more like an architect! (But need to be surrounded by some sensible clinicians so I don’t just have a manic meltdown). 

 2, 3 & 4 North American initiativess 

... in the addictions TC tradition – sometimes called ‘Classic’, ‘Addiction’, ‘Hierarchical’ or ‘Behavioural’ TCs, or ‘Concept Houses’ - as opposed the UK’s ‘Democratic’, ‘Maxwell Jones-type’ or ‘Mental Health’ TCs. The things they have in common and how they differ is a question with never-ending answer – but all the Americans and Canadians we’re working with come from the addiction tradition, and quite a hard-line version of it. They also have a never answered question about choosing between harm-reduction and recovery +/- abstinence 

They have come across the democratic model in different ways, but both interestingly involving dear old Steve – the Canadians by having their reding groups go through our TC book, and the Utah people being put onto us by George DeLeon – who is the main addiction TC researcher in USSA (and probably everywhere); Steve Pearce and I both knew George quite well, and he helped Steve get started planning his RCT research in Oxford. 

 But they see some of the addiction TC tradition as perhaps old-fashioned, or maybe just not quite compassionate enough who are more vulnerable or less robust (it’s the original ‘tough love’ I think), so want to learn about the democratic TC tradition and probably end up using elements of both. 

2 Vancouver and British Columbia 

(for BCARA – BC Addiction Recovery Association) The dates and place for the LLEs are set now – 13-18 and 15-20 September at Manning Park, BC. They have read the book (several times I think – they know it better than I do!) and are planning to train staff from 12 pilot projects with the two LLEs. For that, there are 2 from Bangalore (Shama and Anando), one from Portugal which is current president of INDTC (Joao) and two of us coming from UK (Veronica and myself). Maybe one or two others too – I think Joao has a trainee with him. Maybe others too – it is always interesting to have extra people there as researchers/social therapists/general extras. We have a monthly zoom community meeting with them all at the moment. The pilots are mostly in or near Vancouver, but a wide variety of types of places – and the project lead Rob Turnbull is calling them ‘Adapted TCs’., an excellent term. They’re also planning some serious research and evaluation. 

 Map: https://www.google.com/maps/d/u/0/edit?mid=1_YMdE1sYB3FesACwIIxostqkCEkNu44&ll=52.125476640480954%2C-121.22534945000001&z=6 

3 The Other Side Village, Salt Lake City, Utah 

The plan is for a newly built village of tiny houses for 400 people who would otherwise be living rough – through the various entangled factors that lead to homelessness. Once settled in, residents will be expected to work in one its connected social enterprises, pay rent and be abstinent. Addiction isn’t the main problem here, but amongst them: they know that Classic Addiction TC methods are too severe, or just aren’t right, for this vulnerable population. They have been running ‘The Other Side Academy’ for several years now, using that model as a fairly standard USA-type TC – pretty hard core from how they talk about it. What they now want is a DTC-based community programme as a 1-2 year induction to people living in a community of others in the same situation. BTW – they are not a Mormon-based initiative, I wondered, and did ask. 12 of them came over to London in April to see lots of TCs, CofC, Grendon Prison etc – and two of the Slough TC founders (Geoff and Natasha) are going over there lin June. We also do some online training for them. They are very determined to get it all started pretty soon! 

4 Alberta, Canada T

wo retired psychiatrists – who have worked with the Vancouver people before – are also wanting to use some DTC ideas in the next province across. It’s a very different approach, organised province-wide with provincial government support and funding. Alberta is a rich stare with its oil money, so can afford to do it well – a bit worrying maybe, but maybe ok as long as they don’t have oil or petrochemical sponsors? But that one is only in its infancy.

Just some thoughts about some interesting things going on at the moment.

Even if the NHS doesn't think much of DTCs, maybe others do!