5 May 2026 · 4 min read
On Section 136, the missing crisis commissioning, and the ideology that has made structural failure invisible.
A person in mental health crisis arrives at A&E. Half the time, the crisis involves alcohol or another substance. They’ve been brought in under Section 136 of the Mental Health Act — the police’s emergency power to detain someone they assess as a risk to themselves or others. These attendances make up 50% of all Section 136 presentations nationally.
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28 March 2026 · 12 min read
Why UK alcohol policy keeps talking about price — while the people dying keep talking about pain.
The subject of mental health and substance use has been part of my life for almost a decade now. Academically, through my research, but also professionally, through years of practice in the NHS. I never stop looking for something that challenges how I think about it, something that unsettles the assumptions I’ve built up, because the moment you stop being unsettled is the moment you stop learning.
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24 December 2025 · 4 min read
Why progress so often collapses just when things start to improve.
Most practitioners recognise the pattern. Someone finally gets housed. Their substance use reduces — and then the system congratulates itself for an outcome it did not produce. Six weeks later they are back in crisis, and the same system shrugs.
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18 December 2025 · 7 min read
How homelessness, distress, and substance use collapse time.
We often talk about homelessness, mental distress, and substance use as if they unfold neatly over time. We speak of pathways, trajectories, recovery journeys. The lived experience does not behave that way, and our services are built on the wrong clock.
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