Trevor grew up in what he would describe as a ‘dysfunctional’ family. His parents drank heavily, something he remembers from a very early age. This influenced his choices, and ‘normalised’ drinking. In his late teens, Trevor served time in prison for an alleged assault. By this point, Trevor was also drinking heavily.

After being released from prison at 21 years old, he was kicked out of the family home, and in order to avoid being homeless, he went to live with his brother. Both were now drinking regularly, and their relationship was difficult, but Trevor had nowhere else to go.

The lack of support available to Trevor, particularly in his teenage years and early twenties, meant that his needs were able to escalate and become entrenched.

Trevor got married at aged 22, and tried hard to stay away from criminal activity. He continued to drink, and was involved in limited drug dealing, but overall was able to live a stable life.

At 26 years old Trevor got divorced. This was the starting point of a journey to Multiple Disadvantage, and an almost 40 year cycle of being in and out of prison.

Trevor moved to London and became heavily involved in criminal activity. He was drug dealing on a large scale, including ‘harder’ drugs such as cocaine and ecstasy. By this point he was also using drugs himself (including heroin). In his late twenties, Trevor was charged with drug dealing and sent to prison. Upon release he moved back to the Nottingham area, and continued to drink and deal drugs. Eventually, Trevor received a longer prison sentence of eight and a half years. By this point he had been drinking and using drugs for some time, and was also experiencing mental ill health.

Trevor tried to seek help for his substance misuse during his earlier prison sentences. When arriving in prison, he would have no choice but to go ‘cold turkey.’ Despite asking for help, he did not receive it from prison staff. Instead, fellow inmates would try to help Trevor as he experienced withdrawal symptoms. This meant that Trevor’s needs were not addressed and therefore able to manifest over a long period of time.

With little help available to address his specific needs, Trevor did try some alternatives. Whilst in prison, he completed an NVQ in plastering and bricklaying. This was helpful to a point, offering Trevor a chance to focus on ‘other things.’ However, with such entrenched needs, the impact was only short-term.

His substance misuse impacted on all aspects of his life. His money was used to purchase substances, meaning that Trevor did not eat well. It also impacted his mental health, causing hallucinations and making sleep difficult. At times, Trevor also experienced suicidal thoughts, and severe anxiety. He also displayed aggressive and volatile behaviour when ‘under the influence.’ This created challenges with accessing services and support.

Trevor’s needs also impacted his ability to maintain a tenancy. Due to spending money on substances, he was frequently in arrears with rent.

One of the main issues Trevor faced, was where to ‘find’ help. He struggled to access services due to his substance misuse, but his substance misuse was fuelled by his mental ill health. This left Trevor with very few options, and enabled his complex needs to continue untreated for many years.

During later prison sentences, Trevor did start to seek help. This was driven by fear, and an increase in his mental health symptoms, notably feeling very low and anxious.

Initially Trevor requested access to a rehabilitation programme, and was eventually accepted. This did help to some extent, but he relapsed prior to leaving prison. His ‘fear’ of leaving the institution he had spent a large part of his adult life in, was a trigger for this relapse. However, due to reaching out for help, and starting to discuss his problems with a Probation Officer, he was sent to a rehabilitation unit upon release. Whilst this didn’t ‘cure’ Trevor in any way, it did make him think about his past choices, and where he wanted his life to go.

Trevor contacted an addiction service in Nottingham called Double Impact. Through working with them, he was able to consider the impact of his substance misuse, and ways he could make changes. The process was slow, and difficult, but most importantly for the first time in many years, Trevor was actually receiving some support, and that was a very powerful motivator.

With Double Impact, Trevor was able to look at his addictions, and realise the impact they were currently and had previously been having on his life. He was also able to understand that whilst addiction may never ‘leave’ a person, it can be replaced with more positive behaviours. As a result of this, Trevor began to live a healthier lifestyle. He slowly reduced his substance misuse, and was in ‘recovery’ for a number of years.

Unfortunately, some years into his recovery, Trevor faced a criminal charge relating to past financial activity. This was extremely damaging for Trevor and his coping mechanisms of the past reappeared. His mental health in particular was impacted, leaving Trevor feeling very low. He was at risk of eviction, using substances again and facing criminal charges.

At this point, Trevor referred himself to Opportunity Nottingham - a service that supports people facing Severe Multiple Disadvantage. With his dedicated Opportunity Nottingham Support Worker, Trevor started to consider all of the needs he was facing, and received help accessing services. His Support Plan included a programme of Cognitive Behavioural Therapy, looking at ways to change and not give in. Perhaps most importantly, Trevor was encouraged to admit and accept that he had an addiction to substances. This enabled him to start dealing with his addiction, for the first time in nearly 40 years.

This has led him to focus on other activities in his life, and he now regularly attends the gym and practices Buddhism. This has positively impacted his mental health, and also his behaviour towards others.

For the first time in nearly 40 years, Trevor is able to positively look to the future. He has been working as a volunteer Peer Researcher with Nottingham Trent University on behalf of Opportunity Nottingham, and he aspires to be a Drug Support Worker in the future.

Trevor believes the system could be improved if support systems are set up to address all of a person’s complex needs collectively, and not as individual needs. The restrictions around accessing services are also unhelpful. In the past, Trevor missed many appointments, not because he chose to, but because he simply couldn’t get there due to his substance misuse. Discharging people who don’t attend appointments, does not mean their problems will go away. In fact it means the opposite, they are likely to get worse, as support options become even more limited, and the person becomes even more isolated.

Trevor also believes that the prison service needs to make significant changes in their approach to mental health support. During his time in prison, Trevor was never offered mental health support. He believes that even something as simple as a leaflet under the cell door, detailing possible mental health support options, and who to contact, could result in positive life changes for some inmates.