I went to Penzance to figure out why the number of "dual diagnosis" sufferers has doubled in the last year.
Flags on the Penzance coastline.
Cornwall is David Cameron's favoured summer chillaxing spot, a coastal retreat where private schoolchildren go to spend their GCSE results money on Fat Face hoodies and retired doctors wander the National Trust beaches drinking scrumpy out of tubs and doing watercolours of trees. However, living within this relative idyll are some of the most deprived communities in the UK.
One of these areas is Penzance, locally dubbed "brown town" (because of the heroin) or "holiday homeless" (because of the large amount of homeless people). It's the terminus of the First Great Western railway, the last major town in the South West before you hit the sea and home to an abnormally high percentage of people with dual diagnosis – those suffering from both mental health issues and substance misuse problems.
The proportion of people in drug treatment in Cornwall with mental health problems has doubled in the past year and is now running at a rate way above the national average. As well as that, only 55 percent of people with mental illnesses are in settled accommodation and drug and alcohol misusers are the section of society most urgently in need of housing. Put these statistics together, and it seems like Cornwall is a county of mentally ill addicts with nowhere to go.
Earlier this year, a grandmother from Bodmin – a town an hour from Penzance – was arrested after police found £50,000 worth of heroin packed into shopping bags next to her dinner of Cornish pasties, an example of the integration of drug crime into Cornish culture that borders on the slapstick. And while nationally the number of young opiate users has dropped (I guess Britain's youth have finally realised that injecting poison into weeping scar tissue isn't nearly as glamorous as it sounds), the amount of older users in Cornwall has risen over the past year.
Richard Bryant is operations manager at St Petroc’s – a Cornish society for the homeless. He explained to me how organisations set up to help the mentally ill and drug dependent in other areas of the UK are contributing to the county's problems: "Some agencies in London have just been sending rough sleepers to Cornwall with £1,000 in their pocket, saying, ‘Go and live in Cornwall.'"
Penzance train station, the end of the line.
The county also suffers from admin problems of its own. "Dual diagnosis is a very difficult area for us," Richard told me. "There just aren’t the resources in Cornwall to get to every person – it's a rural area, which makes it very difficult for any agency to operate. It’s not like London where you’ve got access to every single service within a mile. You have to travel [the 17 miles] from Penzance to Camborne just to get shelter."
So what exactly is the attraction to Cornwall? Maybe it's that the surf is good, or that beaches make better beds than piss-stained bank doorways. Or maybe it's that it's the last stop on the South West sleeper train from Paddington and there are no barriers to jump at the end of the line, making it the perfect holiday destination for anyone who might not have the necessary funds to beep through a barrier.
I took the five and a half hour journey from Paddington to Penzance to find out why it's the place to be if you've got nowhere else to be. And if you're suffering from mental health problems and have a debilitating drug addiction.
When I arrived I went to speak to some of the ex-addicts who now spend their Saturdays supporting homeless drug users at Recovery Cafe, a scheme set up by UFO (a branch of the drug and alcohol treatment charity Addaction) that aims to form local communities to allow members to support each other. However, nobody had turned up. I was told it was because the weather was good and all the usuals were busy sunning themselves on the beach, so I had a chat with Peta from UFO instead.
She told me that there isn't enough being done to properly treat sufferers of dual diagnosis, saying, “From my own experience, I would like to see more sharing of information between the drugs and alcohol side of things and the mental health side of things. For example, when I was receiving treatment my drugs and alcohol worker didn’t necessarily know that I’d just come out of hospital having cut my arteries.”
Someone else who'd like to see the working relationship between mental health and drug treatment agencies improve in Cornwall is Ben Knox, head of communications at Homeless Link – an organisation that has made Cornwall a testing ground for its pilot investigation into dual diagnosis.
"We estimate that 95 percent of homeless projects are catering for people with mental health needs," he told me. "But people who have multiple problems sometimes fall through the gaps because their problems aren't picked up – their mental health issues could be masked by substance misuse, for example, or because agencies aren't working together as effectively as they could be to help an individual overcome their issues."
Kerry, a member of Cornwall's homeless population, next to the old look-out tower that he sleeps above.
While it was clear that more could be done to help Cornwall's dual diagnosis sufferers, I still wasn't any closer to understanding why their number in the area had doubled in the past year. So I arranged a meeting in Falmouth – an hour or so from Penzance – with a local guy named Kerry, an ex-heroin user who is homeless by choice.
Kerry got off the needle 14 years ago after flatlining from an overdose in Penzance. He currently lives in a tent on top of an old look-out tower, where he's been for "11 years, on and off". He once stabbed a guy 17 times for calling his girlfriend a slag and describes himself as "a nutter". His explanation for the high number of people with mental health issues in Cornwall was that it was where all the clinically insane were sent in the 17th and 18th centuries, to places like Cornwall County Asylum which became one of the first mental institutions in South West England when it opened in 1820.
“When the people were apparently better, they went back into the Cornish community and started producing kids," Kerry continued. "It’s in the genes. It’s like my dad’s side – we’re loons.”
After speaking to Kerry I bumped into a homeless guy named Mark Stone, who spoke to me about his dual diagnosis, saying that he travels around a bit but always ends up back in Cornwall. "My last employment was in London – I was a fabricating welder," he started. "And then I moved back to Cornwall. I got on a bus and left everything to come here to nothing. I love it here."
However, he didn't quite explain why he loves it so much, selling the area as less than perfect for his condition: "When I come out of hospital they offer me places [to live]. They want me to stay in Penzance, but it's full of heroin addicts. Or Hayle or St Austell, but they're pretty much the same: ill people and homeless people – we're not even pond life."
Back in Penzance I met other dual diagnosis sufferers whose stories were similar to Mark's – a man named Mickey who'd made the area his permanent home because his first son had been born in Penzance, and another called Douglas, who explained that he'd been shunted to Cornwall from Scotland in the 90s and stayed as it quickly became his "favourite place to be". Perhaps there's something in the idea that Cornwall's bucolic allure attracts people who can't necessarily afford to live in an area where wages are 20 percent below the national average and the house prices could make Warren Buffet wince. I guess if you can't find work and you can't afford a house, there are worse places to be homeless than scenic Cornish beaches and pretty little Cornish village orchards. Maybe other agencies in other parts of the UK really are sending homeless people to Cornwall, or maybe it's just a natural destination for those people dislodged from their old lives by the bailiffs and jobs and benefits cuts of austerity Britain. Maybe it's all of those things.
Regardless of why so many dual diagnosis sufferers are making Cornwall their home, the stats will hopefully raise awareness of the issue in the UK as a whole. Mental illness and drug addiction are both issues that plenty of services admirably dedicate their time and resources to, but perhaps it's time that more is done to address what happens when the two realms overlap, bettering some of the hardships for anyone suffering beneath the twin yokes of drug addiction and mental illness.
Follow Beth on Twitter: @bethwoodbridge
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