Taking the reins

Anfield, L4, is a location that resonates around the world, but even with its giant new stand the home of Liverpool FC is out of sight and out of mind as the Big Issue North arrives at Tom Harrison House, a few hundred yards and half a world away.

Operational for four years, Tom Harrison House works with armed forces veterans with addiction problems – people who are lauded by the nation’s leaders but often disregarded once their purpose is served.

The centre was founded by Paula Gunn, who asked her friend Jacquie Johnston-Lynch, a professional in mainstream addiction treatment, to run a military-focused centre to be named after her grandad.

Johnston-Lynch says: “She asked me and I said: ‘Are you mad?’ The country was in a period of austerity, with severe budget cuts for treatment programmes. There was no military approval. But within three weeks I’d left my job and we’re still here.

“Levels of alcoholism are higher in veterans. After leaving service, the transition is hard.”

“Squaddies at the best of times can struggle with adapting to civilian life – they’re used to their RSM telling them when to eat, when to sleep, where to go at all times. Life isn’t like that, so plenty think ‘I can’t fit in’, give up on treatment and end up sitting in the house drinking all day.

“These are men programmed not to show weakness. They’re trained to see enemies everywhere, so it can be hard for them to take the step and admit they need help.”

It’s a warm, welcoming place, this. At ground floor there’s a meeting room, a room with sofas, PC and books, a quiet room, and a large kitchen. Upstairs, there are more meeting rooms, a family room and the staff office.

Whereas some rehab centres are residential on-site, that’s something THH set out to avoid. Doing normal things, living normal lives is the mantra. The residents, of whom there are 12 at any time, have to get up, get showered and dressed, and get themselves in from the two THH houses in Tuebrook by 9am – a bit of structure and responsibility. The day is bookended with the residents’ own group meeting, no staff involved.

THH aims to bring the good bits of military service – the comradeship and belonging – and show people that it can exist in civilian life too.

Johnston-Lynch – who previously founded the Brink, an alcohol-free bar and restaurant in Liverpool, in the wake of her brother being killed by a drunk driver – says: “The values we try and keep are that no man or woman is left behind, and the community comes before the individual.”

Thus far, it has mostly been men – the service has only taken in six women in total, two of whom have graduated.

Today’s Monday, which means open day, and there are a few graduates – those who’ve successfully completed their 12 weeks – milling around. Staff and residents take turns doing breakfast on alternate Mondays, but this week the staff are shorthanded. The residents step in uncomplainingly.

The other big Monday morning thing is the community meeting. There are others sitting in: four or five graduates, a guy from another charity with a candidate for residency who’s gone through detox and hopes to get a place. But the floor is for the residents.

Each resident is asked to give a “push up” and a “pull up” for each of the others – encouragement about something they’re doing well and an observation on something they’re slipping at. A lot of thought clearly goes into this. Observations range from “you need to contribute more”, or “you’re being distracted by outside influences”; praise includes “you’re there for everyone and notice when people are down” and “I know I can trust you”.

What it’s all about is behaviour. As recovery lead PJ Smith tells me, alcohol and drugs in themselves aren’t the problem – it’s how they affect behaviour. If people can start to break down who they are, what they’re like, build on the positives and remove the needs that have driven them, they’re on the path.

As the official line runs, the service “works in meaningful partnership with other agencies, providing trauma-informed addiction treatment through a sensory and wellbeing model of care, support, therapy and education”.

That includes therapy sessions, group meetings and one-to-ones with staff. There are activities including football, yoga and equine therapy. “Moral reconation” sessions aim to promote changes in behaviour.

The residents go out and do community activity – mending fences and clearing shops. Four times a year there’s a trip for a few days to Rydal Hall in the Lake District, an old pile with a huge acreage but only one gardener.

Actor Kevin Kennedy was recently a huge help, sorting tickets for Rock of Ages and talking to the group. The programme also includes personal assignments such as writing their life stories. There’s a choir, and photography lessons starting soon. The gym is popular.

Staffer Craig Nicholson says: “There’s a lot of peer evaluation – looking at their qualities, the things that will see them right in their recovery, but also to look at the problems, the sides of you that are fucking you up. ‘You’re a know-all, you’re stubborn, you’re aggressive’ – we’ll see the same things coming up. It’s all about changing their behaviours.

“Jacquie leads the therapy groups, and there are powerful moments when they get to the underlying problems. Every single person that has graduated here that has taken on the advice of the staff has stayed clean and sober. Graduation is just the beginning.”

The place runs on a shoestring, with council support, and the team has become adept at eking out funding – £25,000 has just been secured from a Novus Property Solutions competition, which will be used to spruce up the yard. Public donations are vital.

The model works, staff say, because it’s small, personalised and friendly. Strong relationships are built. Johnston-Lynch says: “The bonding here takes place so much quicker than in mainstream addiction centres, where it takes weeks – there’s a suspicion. But these guys are used to being thrown together with others. There are often pre-existing friendships or they have mutual friends.”

There are five full-time staff and two part time at present. Some team members are THH graduates, giving it a squaddie-level understanding. Another graduate is training to be a prison officer. The successful completion rate at THH hovers around 75-80 per cent.

While post-traumatic stress disorder has long been recognised, with public sympathy and thus support from politicians, alcohol and drug abuse is somehow seen as shameful.

Once someone’s service is over, they become an NHS issue in the military’s eyes. Johnston-Lynch says: “There is no political will for funding drug and alcohol treatment. We went to see [minister for defence veterans] Mark Lancaster, and he told us that what we’re doing is amazing but that we’d shot ourselves in the foot by setting up something without evidential need.

“But we’d seen the need – there were clear signs of a lot of veterans really struggling. The drop-out rate of veterans from mainstream treatment is huge.”

Someone suffering with mental health can go to one organisation but if they’re using or drinking heavily get shown the door. They go back to mainstream addiction treatment and encounter a lack of understanding of mental health problems. A large proportion of THH residents have been “dual diagnosis” cases.

THH has been gathering evidence for a year now, putting together a case with academic help to show government that this a real problem.

Johnston-Lynch says: “We thought at the start we’d only have people from Liverpool and the North West but it quickly grew – but we can only take people if funding follows them. We’re the last resort. People are usually very unwell by the time they get to us. Over that 12 weeks what we can do is to make them feel part of something.”

When it comes to alcohol, the old-school military way has questions to answer. In a world where orders are followed and fitting in is a must, heavy boozing is rife.

“There has historically been a massive drinking culture. We can’t say the MoD causes alcoholism, but I will say that men and women who go in need to be more carefully assessed, because pre-existing vulnerability is overlooked,” says Johnston-Lynch. “The army becomes a family to a lot of kids who never had one – they’ve lived in care or in abusive homes.” Check the current suite of army ads taglined This is Belonging.

As to whether policy might soften, Johnston-Lynch says: “What might happen is some kind of government funding announcement of addiction treatment for military veterans. And as soon as that happens, everyone and his dog will be looking for that money – the big players among the charities, who have dedicated teams for bid-writing. But we know our model works.”

She continues: “Levels of alcoholism are still far higher than in the wider population. And after leaving service, the transition is hard. There should be support for people who’ve lived this way for years. The MoD need to realise it’s way bigger than ‘just’ PTSD. Depression, anxiety, suicide, drink and drugs – none of these happen in isolation.”

Dogs used in military service have a two-year deprogramming. Humans “medicated out” are given a few quid and stuck on a train home.

After graduation, most local graduates go on to the Bridge House Project, also Anfield-based, a transition to finding accommodation of their own. In all, there can be support for up to 18 months of abstinence-based living.

Johnston-Lynch says: “The difficulties can arise when they leave, especially if they’ve come from further away. We prefer them to stay in the area and start to be able to do normal things, but the draw of home is too much for some. The ones who stay do really well. The ones who go straight back don’t do so well.”

The graduates who stick around are more able to support each other. There’s a graduates’ meal once a month and a WhatsApp graduates group, providing a support network and acting as a warning signal. If someone who’s cheerfully messaging every morning misses out, or if an off-key message appears, someone on the team will check up.

One recent graduate wobbled but, with people rallying around, was pulled back on track quickly – the saving to the NHS of another detox admission could be up to £17,000 just for that one case, Johnston-Lynch says.

Since the end of October, three more THH residents have graduated. Lancastrian Andy has started an NVQ in health and social care level 2 and moved into the Bridge House Project. He’s joined there by Londoner Gerry, who has now attended his first Everton match. Liverpudlian Tony graduated on 11 December, with his partner, son and mum present on an emotional day.

So are people in other cities looking to follow the model? “Everyone wants to, but no one will. The money it takes is significant, and we’re ever thankful for Liverpool City Council’s support. There have been a number of times we’ve had to hold our nerve. We’re very fortunate that we’ve got great benefactors, including the Armed Forces Covenant, Mersey Care and the Royal British Legion.”

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Craig’s story

‘My life just went into a spiral at 28. I was living in a graveyard, injecting’

Craig was in Birkenhead, addicted to crack and heroin, wanting desperately to change his life but struggling to find the strength. He called THH on a freephone call.

“They said ‘come in tomorrow for a meeting’ and straight off I tried to back out: ‘I can’t afford the bus.’ They said: ‘You’d find the money for gear, wouldn’t you? If you’re serious about this you’ll get here.’”

Craig made that meeting, and every subsequent one – seven in all. A bed became available on a three-week detox programme in August 2017 and a Tom Harrison House place came free. He graduated in December and is now on the staff as the residents’ live-in support worker. He’s being a dad and living a life that seemed impossible. 

Craig served four years in the Royal Artillery, leaving in 2000. “I’d been taking drugs since I was 14,” he says: “Everything really – cannabis, speed, LSD, coke, ecstasy. I went in the army at 24, and didn’t touch drugs for those four years, but we were on the ale every night. When I came out, I started buying coke again, then one night couldn’t get any and ended up getting crack instead. Within six months I was a heroin and crack addict.”

The THH process is one of tough love – he had to leave for a week because he was taking painkillers. For that week, he reported in at 9am every day for a breathalyser and drug test and went to an NA meeting every night.

“I’d tried rehabs before. My life just went into a spiral at 28. I was living in a graveyard, injecting. I’d knowingly ODd a few times – I didn’t want to live. I weighed eight stone.” 

Craig, a healthy 12 and a half stone now, looks up. “I’d go days without eating and root through bins for food. My family washed their hands of me. I wasn’t living but just walking around, a lost soul.”

After graduating, he says, there was a “where do I go now?” sense. “My head was burnt out. I started visiting people, trying to help, and then got offered a place working here.”

Unsurprisingly, Craig’s as ardent an advocate as it’s possible to be. “We want commitment. Places are valuable – this place is unique. I’d learned nothing in other treatment centres.

“I’ve done more living in 12 months than in the previous 20 years. It’s corny, but I used to rattle through the night, but now I wake up in the morning and just to sit and have a piece of toast. It feels great.”

Lee’s story

‘It was a choice of life and death, and I was looking at certain death’

Lee graduated from Tom Harrison House this summer. He spent five years in the Royal British Green Jackets, came out of the army in 2009 and worked mostly as a wagon driver.

He says: “The drink and drugs really took off when I got home from Iraq, and it was a downward spiral for a long time, trying to deal with the things I’d seen and the things I’d done. I lost my mum and son within four weeks of each other. One of my best mates, who suffered with PTSD, hanged himself in May. I came into Tom Harrison House in June. I’m now at Bridge House.”

Getting back to a “normal” world of work is “miles away”, he says. “I’m only just learning about myself. People are like onions, and I’m peeling back the layers.

“I started to get inspired the moment I arrived here. It was a choice of life and death, and I was looking at certain death. Family-wise, I’ve only got my sister left and she was expecting to bury me by Christmas. I had to ‘get it’ right away, and thankfully I listened and learned.”

He comes back in to give something back, to offer advice to residents – “at the start, three months feels like a long time, a big ask, but they can do it” – and to keep talking with the staff who’ve helped him see a future, and to cope with the losses. He says: “This place has given me
my life.”

Lee shows a photo on his phone from the week before he started his detox. At 8am, he’s sitting outside with a beer, wounds from cutting himself visible, face grey, eyes lifeless. It looks nothing like the bright-eyed young man sitting opposite, on his road to recovery and to helping others.

Chris’s story

‘Drinking is the culture. If you weren’t working, you were in the pub’

Chris, now more than three years clean and sober, has been volunteering at Tom Harrison House for 18 months.

“It was the first time I’d done a rehab and we related a lot to each other in the groups. I’d signed up for the army at 17 – an adult but still only young. I was based at York at first, passed out, then went onto Colchester and out to Belize for six months. I went to Kenya, then did 12 months in Northern Ireland. I served just under five years and left at 22.”

That was a quarter of a century ago, and three years after leaving Chris was diagnosed with PTSD. “I used drugs to self-medicate. I’ve done five jail terms and went through 20 years of hell before I realised it was drugs and alcohol doing it.”

He won’t blame the army – he even enjoyed Northern Ireland, he says – but comes from that era where booze ruled. “You’re earning good money and drinking is the culture. If you weren’t working, you were in the pub.”

Chris clearly loves being involved in stuff. “I just show my face, pick someone up from the hospital, get someone’s messages. If I can do it, anyone can. If I’d not done this, I’d probably be hanging around being a nuisance in St Helens, street-drinking, causing mayhem. I’m a better man without drink.”