Alcohol Harms: Crisis Team Practitioner

A Crisis Team Practitioner for the CNWL trust has shared her powerful and personal reflections on working in addiction and crisis care, while also navigating the grief of losing family members to addiction.

She has worked in the NHS for nearly a decade, spending six years in inpatient mental health before joining her local crisis team in 2019. In her current role, she supports people in the community, many of whom are experiencing acute distress and complex needs involving both mental health and substance use.

But behind her professional experience is a personal story, one that continues to shape how she approaches her work, and the people she supports.

She lost her mother due to alcohol-related harm. Just four weeks later, her cousin also passed away. “I was really struggling,” she explained. “I’d feel frustrated. But then I reminded myself—I couldn’t help my mum, but I can do absolutely everything possible to support someone else.” The loss of her family members has sharpened her focus and commitment to providing care that’s compassionate, joined-up, and grounded in real understanding.

In her daily work, she often meets professionals from all walks of life struggling with addiction, including NHS staff. “Doctors, nurses, pilots, dentists… we see it all,” she said. “But the public doesn’t expect it, and the people going through it don’t always recognise it in themselves. Or they feel like services aren’t for them.”

Stigma remains one of the biggest barriers to seeking support. “People assume they’ll be judged before they’ve even spoken. They think services are for ‘other people’, not for them.”

A major challenge she sees in her role is the lack of integration between mental health and addiction services. People are often forced to choose which they want to seek help for, and risk being turned away if they don’t fit within narrow criteria.

“There’s very little flexibility,” she said. “Someone might be drinking because their mental health is so bad, but if they turn up intoxicated, they’re discharged. That doesn’t help anyone.”

She also spoke about medical diagnostic overshadowing, where addiction deprioritises a person’s mental health needs. “You get told: ‘We can’t treat your depression until you stop drinking.’ But often the drinking is because of the depression.”

Another challenge is continuity of care. In her team, people don’t always see the same practitioner, which can make it hard to build trust, and lead to people feeling they have to relive painful experiences repeatedly.

“Having to tell your story over and over is exhausting. It wears people down,” she said. “I always try to say: ‘You don’t need to go over everything, I’ve read your notes. Let’s just talk about how you are today.’ That makes a huge difference.”

She also sees the impact of selective attachments, when someone builds trust with one practitioner, and then struggles to engage with others.

“It’s not about being difficult. If they’ve only ever opened up to one person, and that person’s not there, they might not come in. They might not take their medication. They might drink. That trust is fragile, and when it breaks, it can set someone back massively.”

Despite the challenges, she has seen progress. Her crisis team now includes an embedded drug and alcohol worker, which has made access to support faster and more responsive.

But to truly meet people’s needs, she believes more investment and better service design are essential, especially for people with co-occurring conditions.

“Mental health and addiction are treated like two different things,” she said. “What we really need is a service that can do both, something unified. Because when people don’t fit neatly into one box, they fall through the cracks.”

Reflecting on what she hopes to see from national campaigns like Stigma Kills, her message is clear: focus on unity, reduce stigma, and make services more flexible.

“Services need to meet people where they are, not where a referral form says they should be,” she said. “Rigid processes don’t work when someone’s in crisis.” She also highlighted the urgent need to support healthcare professionals who are experiencing addiction themselves.

By sharing her experience, she hopes to make others feel less alone, and to highlight the human side of addiction that systems too often overlook.

Stigma stops people asking for help. Disjointed care makes recovery harder. And the people who fall through the gaps? They’re someone’s mum, cousin, colleague, or patient.