Inclusive Recovery Cities Building Local Recovery Innovation and Sustainable Partnerships within the City

How has your story of Inclusive Cities begun? Could you please explain the meaning and the aims of Inclusive Cities?
 As far back as our original work on recovery capital in 2010 (Best and Laudet, 2010), it was apparent that the role of community had been under-stated and that the role of social capital had not been adequately operationalised. It was clear that communities differed not only in the number and type of community resources they had, but in the accessibility of these resources to excluded and marginalised populations (which speaks to issues of inequality). On the positive side, each of us had witnesseed recovery groups and communities that made a huge difference and that offered rich resources and opportunities to people at every stage of their recovery journeys. But that was not all they did – they contributed to the wellbeing of their communities and were a real asset to those communities. So the science question was really whether we could capture what was distinctive about those communities and what were the essential elements that made some communities and cities more suited to recovery. However, there was also a vision of sharing learning and creating a contagion or cascade of the innovations and successes of those cities and bringing together that model of success to share ideas and build recovery into the fabric of caring, compassionate and connected communities.
How is stigmatization an obstacle to sustaining recovery? Could you share a case that affects you a lot?
The idea of Inclusive Cities started from the evidence to focus on the role of the community to promote and facilitate (stable) recovery. While the community could be central to recovery by building and strengthening bridges between excluded and non-excluded groups (positive community recovery capital), this community could also act as a barrier to recovery (negative community recovery capital).
Negative community recovery capital (Best & Savic, 2015) arises from the discrimination, stigmatisation and exclusion from housing, employment, treatment, recreation, active citizenship towards persons in recovery.
Several studies acknowledge the negative effects of stigma on people suffering with substance use disorders (Room, 2005). The general public holds stereotyped and negative views, considering persons who (problematically) use drugs as lacking self-discipline (Jones, Simonson & Singleton, 2010) and as ‘dirty’ (Sloan, 2012, 407). This could impact not only several life domains, such as employment, housing and social relationships but also access to treatment (Radcliffe & Stevens, 2008).
Phillips and Shaw (2013) showed that, when compared with smokers and obese people, the general public (in the US) preferred greater social distance from persons with substance use disorders. What is troubling about this study is that it would appear that social distance did not markedly diminish when those persons were described as being in recovery, suggesting that, for many people, a substance use disorder is an irreversible strain. In 2010, the UKDPC commissioned a survey of 3 000 adults living in private households across the UK (Jones, Simonson & Singleton, 2010). The findings indicated that people recognize the importance of providing support for individuals in recovery and the need for them to be part of the community. However, they do not want them as neighbours and are fearful of having treatment and support services in their neighbourhoods.
Equally worrying are the findings of a follow-up study conducted in the UK (Cano et al, 2019) with a group of trainee health and criminal justice professionals, indicating the same issues persisted. Thus, not only is there limited openness to recovery among members of the general public, that scepticism persists among professionals as well. This evidences two sets of barriers that people in recovery must overcome - the perception that substance use disorders are a lifetime stain in the general public, and the resulting scepticism about meaningful change in professionals who are tasked with supporting their recovery pathways.
The fear among members in our community is mostly not based on personal experiences since less than half of the respondents reported knowing someone with a history of substance use disorders in the Cano et al study. Less negative attitudes have been found among those people who currently, or in the past, had lived, worked or been friends with someone with a history of substance use disorders, compared to those who did not. This indicates that knowledge and contact is generally associated with lower levels of stigmatising behaviours and attitudes. Therefore, making recovery visible and discussable is key in an Inclusive City.
 A society that discriminates, stigmatizes and excludes, imposes negative consequences for sustaining the recovery process of her citizens. Where structural and attitudinal barriers persist, the pathway to recovery might be harder to travers and might pose significant threats to long-term recovery. Addressing structural barriers (as well as personal exclusions and stigmatisations) are essential to maximise the likelihood of long-term recovery.
 
In how many countries and cities are you actively running this project? Can you give examples of good practice (with pictures)?