For months now, I have been hearing about the upstream, downstream and that consumer concept.  

Those lectures were really about consumerism… the upstream is the supplier, the downstream is the consumer. 

I would like to propose a slightly moderated concept of that thought… 

Let’s look instead at the upstream in terms of the services that the client (consumer) accesses, and the downstream in terms of how wider society may benefit from this supply chain.  

In view of that, I thought I would share my own thoughts and experiences of the upstream/downstream, and how accessing upstream services have impacted on my life over the long haul.  

 

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 It goes something like this… in 2000AD, I became acutely schizophrenic… and when I returned to London after a time recovering from an acute psychotic episode from 2000 – 2001, I was definitely in dire need to access the right services.  

In those days, I was not aware of any services I may have been able to access, save for the psychiatrist every six months and to be compliant with my meds.  

I was not aware that I could be in receipt of Disability Living Allowance until I became homeless. I was truly very “services naïve”.  

In view of that, be it good or not, still I came back to London and expected to continue a great career that I enjoyed pre-schizo days… my reality was a lot different… I came back, got a place to live (which was the truest crap hole) and was lucky to have a few temp jobs. 

Long story short, I lost my paid jobs due to being a wee bit “strange” in the workplace, became homeless, smoked a lot of weed and just did not contribute much to society, save the drug dealers who I’d occasionally score a couple of (MDMA) pills and blow my cash on pot with! 

Eventually, I was lucky enough to get my own flat and wanted to get my life back on track… 

I had a home but was hooked on weed and had paranoid schizophrenia and was in the latter stages of the negative symptoms of recovery. 

My dream was to be a professional environmental campaigner for Friends of the Earth or Greenpeace. Or maybe even an environmental lawyer.  

Still, every night, I’d sit in my little flat, watch some cheesy comedy on tv and skin up. Meanwhile, I wrote letters to all the big hitters, Amnesty International, Greenpeace and Friends of the Earth to gain some work experience… 

Amnesty took me on, and I’d turn up to the office with green teeth and my clothes reeking of spliff smoke residue.  

In due course, they were nice about asking me to leave.  

I tried Friends of the Earth too. They also nicely asked me to leave. 

I tried to become a chef after that calamitous short lived NGO career. After nearly poisoning a preschool with raw chicken, they weren’t so polite, but I left that career too.  

What were my options? The pizza place around the corner needed a leafleter, so I did that for free pizzas… I asked for too many pizzas, so they asked me to leave from there too.  

I knew smoking weed was not helping, so I begged my psychiatrist for support to quit my addiction. 

This is the upstream. The services.  

After a couple of years, he finally agreed to offer me dual diagnosis with an incredibly charismatic practitioner.  

On my first day meeting the practitioner, in October 2007, I quit the weed. She told me I would have to break away from my pot-head friends’ circle.  

We spoke about goals, and she put me in touch with an organisation called the Lewisham Service User Council. A group of guys who were trying to make something of our lives after coming off our addictions, be it booze, class a’s, class b’s and advice for those using class c’s. 

This is kind of the client/-downstream part of this.  

 

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 With the right support, instead of being a bit of waster smoking weed and watching the world pass by while I sat on my collapsed, ripe for the tip, sofa, I was given amazing support to make something of my life.  

As a bit of a wannabe businessperson, from my work at the Lewisham Service Users Council, I was given the opportunity to set up a social club social enterprise business for people like me… socially excluded for all sorts of reasons.  

Meanwhile, my dual diagnosis practitioner was in the background and supported me in my social no man’s land, keeping me inspired and offered the most amazing alternative to getting stoned every night.  

Eventually, my project had around 1000+ visits a year and was arguably the best peer-led social club in London. On my exit chat with my psychiatrist, I offered him my business card and he told me I was his first patient to offer him a card!  

For me, that was very much the downstream of the services… from being a bit of a dope head with little opportunity, to accessing a life-changing service (downstream), to offering society a really cool service, as in my social clubs (upstream)…  

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An amazing service like dual diagnosis impact offered massive life changes, not only for me personally, but with my own family, society (I was not breaking the law anymore) and the ability to support hundreds of some of the hardest to reach demographics in London – as well as taking on volunteers, some of whom even moved onto new careers and are enjoying amazing lives.  

Having said that, on reflection, I worry that as the government continue to cut taxes overall, impacting the services that helped me as much as they did, there will be increasingly fewer options for people like me to establish a life with so much potential. 

In 2007, when I started this journey of a new self (discovery), there were crazy amounts of money spent on drug and alcohol support and mental health. My colleague commented at the time that in Lewisham alone, there was more money spent on those services than even NHS cancer treatments.  

Whichever political leanings you take, surely, it would be wise to try to build more on the homeless, substance management services and mental health support than what we have now.  

A friend who works for the mental health services in the NHS commented not long ago that the cut backs our present government have implemented left very little meat on the bones. The carcasses of what have been left over are mostly providing a service to those who go through the revolving door system, whereby they leave the services and return over and over again, leaving little room for new people who may have long lasting enduring service needs, but get left on the sideline suffering, completely unfairly. 

Hopefully, after the election, whoever takes office, there will be far more investment for the downstream services so those who quietly suffer with homelessness, substance mismanagement and/or ill mental health can access services they need, rather than be sidelined by those who shout the loudest.