Mark Smith: The epidemic that’s coming after the pandemic … are we prepared for it?

For months on end, we were used to the coronavirus statistics. Number of infections. Number of hospital admissions. Number of deaths. Up. Up. Up. But now, as we start to move out of the pandemic, we’re getting statistics of a different kind. Number of drug deaths. Number of alcohol deaths. Number of homeless. It is the crisis after the crisis. It is, following the pandemic, an epidemic of a different kind: an epidemic of poverty, addiction, and struggle.

All of it, of course, is deeply inter-connected and all of it has been made worse by the policies associated with the virus, such as lockdowns and furloughs, which have, in many cases, detached people from their jobs and support and help, which was pretty poor to begin with. And so people with alcohol problems drank more. And people with drug issues used more. And – related to it all – people with mental health problems felt their problems more intensely and so they drank more and used drugs more and so the circle turns.

Just to be clear, I’m talking here about people like Alex. Alex was a fifty-something guy from Glasgow I spoke to who struggled with mental health problems and ended up homeless. He told me about the first few nights that he had nowhere to go. “I would find places,” he said. “Alcoves and things, next to pipes where there was heat. I had all my possessions in my rucksack.” He’d relied on friends for a while but sometimes, he said, your friends can only put up with so much.

In many ways, Alex’s story followed a familiar pattern because, although he’d held down a job as a teacher for a time, he also had mental health problems and when the stress got too much, he lost his home. To make matters worse, what he found on the streets was that the support was patchy to put it mildly. And the people who were trying to help Alex confirmed to me what he said: the services are inadequate and unconnected, they said, meaning for instance that even when people are found a place to live, they often have no furniture to put in it.

During the pandemic, a solution of sorts was found when a temporary freeze was put on evictions, but not only has that effectively come to an end, we’re discovering it wasn’t enough. Analysis by Labour of the Scottish Government’s most recent report on homelessness shows the number of people with mental health problems assessed as homeless or at risk of being homeless has almost doubled since 2013. What this means is that, even though we know that mental health struggles, like the ones faced by Alex, are a pre-eminent cause of homelessness, we’re allowing the problem to get worse, with the number of homeless people with mental health issues up by 90 per cent.

You probably know the other figures, which are unhappy cousins of the ones on mental health. Statistics published by the National Records of Scotland the other day showed the number of alcohol-related deaths increased by 17 per cent to 1,190 in 2020, which is the largest number due to alcohol recorded since 2008. It is also worth noting, with no surprise whatsoever, that alcohol deaths in the most deprived areas were around four times more than those in the least deprived. And you don’t need me to remind you about the figures on drugs: the number of deaths last year was at a record high for the seventh year in a row.

The pandemic has obviously made all of this worse but the causes – and the lack of effective solutions – were in place well before we first heard of coronavirus. A community worker in Ferguslie Park – famously often labelled the poorest part of Scotland – told me long before the pandemic that the benefits system was one of the major problems there, in particular universal credit. It meant some people could suddenly find themselves cut off from funds or without any money for weeks. But another serious problem was the lack of support for people dealing with the side effects which often come with poverty: the drink, the drugs, the stress, the homelessness.

Again, the lack of action on all of this by government was obvious long before the pandemic and all the pandemic has done is make the original problems worse. The lack of facilities for young people with mental health problems, for example, were shocking before coronavirus but we learned in June that the number of children and young people forced to wait more than a year for treatment is now at the highest level on record. “Highest level on record”. It’s becoming a familiar phrase isn’t it?

The same applies to drugs, notoriously. We know that rehab is many times more effective than methadone at keeping heroin addicts clean, and yet there has been a long-term, critical decline in the number of rehab places, which has only very recently been acknowledged and accepted by the Scottish Government. They have now said they are going to spend £250million on a new drug policy, with £100million going to rehab in the next five years, which is good news – belated but good.

However, if we are to prevent this getting worse and prevent an epidemic of ill health and death after the pandemic, then more action is needed. And in some ways it’s not that complicated. You’ve got to offer serious treatment and support so people can quickly access the help they need with addiction and mental health issues. Someone needs help. They get help. Quickly. And hopefully, it doesn’t get worse. That’s the link that seems to be broken in so many cases in this country.

We know, of course, that, underneath, deeper than the alcohol and the drugs, there are the cultural and social causes, lurking persistently in the Scottish psyche. Our problem with alcohol. Our problem with addiction. And our inability to talk about our problems. We also know that drink and drugs are issues in themselves but they are also symptoms of the poverty that persists generation after generation. And, of course, we know that the surest route out of poverty is education and Scotland’s education system is proving ineffective at providing that route.

However, until the education system can be improved, and until we tackle poverty, and until we deal with our troubled cultural norms, we can at least make sure that the people struggling with the symptoms of the crisis – stress, addiction, drugs, the lot of it – get the help they need when they’re suffering. People like Alex. I’m pleased to say that he found a place to live in the end, thanks largely to the charitable sector. But we can’t be confident about other people like him. Will the help be there for them when they need it? Next week. Or tomorrow. Or today?

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The Herald Scotland

The Herald Scotland

The Herald is a Scottish broadsheet newspaper founded in 1783. The Herald is the longest running national newspaper in the world and is the eighth oldest daily paper in the world. The title was simplified from The Glasgow Herald in 1992