The Gap Between Asking and Being Seen
Someone waits weeks for treatment to start. It's a bit like being turned away from the gym on day one for having the wrong shoes. You're not going back.
I read an article this week in Drink and Drugs News. It was part of a series called “Clearer Conversations on OST.” Riveting stuff, right?
Someone who works in homelessness services at the Salvation Army, was talking about how long people can wait between asking for help and actually getting a script. Weeks, sometimes months, apparently. She compared it to turning up at the gym for your first ever session, only to be told you can’t start today because you haven’t had your induction yet, or you’ve got the wrong shoes on. You’re probably not going back. You’re having a McDonald’s instead.
Of course, it’s not really about gyms or shoes. It’s about the moment someone finally says the hard thing out loud, gathers themselves up enough to reach out, and then finds out that reaching out was only step one of a long staircase. The system isn’t wrong to have steps. Assessments matter, safety matters, clinical judgement matters. But nobody told the person in crisis that there’d be a staircase. They thought they were opening a door.
There’s a support worker in the piece too, a guy called Danny, who talks about what happens when someone on his caseload starts using again while they’re meant to be stable. No punishment. No pulling the script. Instead the question is what more can we do, what else needs to wrap around this person right now. He says people are often at their lowest point when they first come through the door, and that the job is to meet them there rather than wait for them to arrive somewhere steadier.
That’s a different kind of staircase. Still a process, still steps, but nobody’s kicking you back down to the bottom for stumbling on one of them. Danny also talks about same-day restarts, being able to tell someone come on, let’s get your script sorted today, and what that small bit of speed does for someone’s sense that this might actually work out. It’s the opposite of the gym story. It’s someone saying yes, now, come in.
The gap between those two experiences, the person left waiting weeks with no clear reason why, and the person told come in today, isn’t really about resources or policy. It’s about whether the system on the other end of the phone treats the wait as neutral or treats it as dangerous. Because for the person doing the waiting, it’s never neutral.
There’s another voice in the piece, Craig, describing his own experience of trying to get help while still in prison. He’d disclosed his drug use, asked for support, and was told he needed three clean urine tests before he could access medication. “So what was the point of me telling you I’ve got a problem”, he asked.
I think that’s the whole thing right there, isn’t it. The system asks you to be honest, and then the honesty becomes a waiting room.
The moment someone reaches out isn’t the finish line of their courage. It’s closer to the start of it. And whatever happens in the gap after that first ask, however long it lasts, however many hoops there are, it either keeps that flame of motivation alive or it lets it go out. Nobody designs a system to let it go out. But gaps do that on their own, quietly, without anyone deciding it.
I don’t suppose there’s a clean fix for all of it. Clinical safeguards exist for good reasons. But there’s a smaller, quieter line in the piece from a man called David, a service user, reflecting on what he’d tell someone who’s never been in treatment before. He said the support isn’t perfect, but it’s there.
Not perfect. There. I think that might be the most honest thing anyone can promise another person in that gap. Not a cure, not a fix, not even always the right words. Just there. Something on the other end when the 3am thought turns up, something that doesn’t vanish because the appointment’s four weeks away.
I think about that a lot, the difference between being helped and being present. Most of what people in this article describe as good care isn’t complicated. It’s a key worker who listens when someone asks to slow down a reduction instead of insisting on the schedule. It’s a support worker who knows your appointment’s changed before you find out the hard way. It’s someone answering the phone. None of that needs new technology or new funding streams. It just needs someone to be there consistently enough that the person on the other end starts to believe it.
That’s the harder part, maybe. Not the being there once. The being there again, and then again, long enough that someone stops expecting it to stop.
The author makes a point later in the piece that stuck with me for a different reason. She talks about people being taken off a waiting list, or losing their script, for missing an appointment that nobody had actually told their support worker about. Not because anyone decided to punish them. Just because two systems weren’t talking to each other, and a person fell through the seam between them. She says that if the support worker had known, it might not have happened.
That’s not a story about someone failing to engage. It’s a story about information not travelling as fast as consequences do. The appointment gets missed, the record gets updated, and somewhere down the line a person finds out they’ve lost the thing they were waiting weeks for, over something a phone call could have fixed. It’s the same gap again, just wearing different clothes. Not the wait before treatment starts, but the silence inside treatment itself, between the people who are meant to be on the same side.
That’s a lot of what I’m trying to build into my recovery companion app, Sol, if I’m honest. Not a replacement for the staircase, and definitely not a replacement for the humans who walk it with you, people like Danny and Zoe and the key workers in that article who show up and stay flexible and don’t punish a bad day. Sol can’t do same-day restarts or write a script, and it can’t fix two systems that aren’t talking to each other. What it can do is be the thing that’s still there at 3am, in the gap between the first ask and the first appointment, when the staircase feels endless and the person climbing it just needs to know somebody’s still on the other end. Imperfect, but there.
Worth a read if you work anywhere near this world, or if you’ve ever been the one waiting.
Read the full piece, “Changing the outlook,” in Drink and Drugs News.
David Henzell is the founder of Phenomenal Sobriety and creator of Sol, an AI companion for people who aren’t ready to walk into formal treatment yet, and for those already in recovery. He writes about addiction, recovery, and what happens in the gaps that services can’t always reach.