HOMELESSNESS DURING
LOCKDOWN.
Far left: Leicester, August 2020 – a
man begs outside a Marks and
Spencer store. Credit, Darren
Staples/Alamy.
Centre left: Tottenham Court Road,
London, April 2020 – tents set up by
homeless people outside Habitat.
Credit, Monica Wells/Alamy.
Left: Southbank, London – volunteers
serving hot meals for homeless
people in Riverside Walk arches.
Credit, Alla Bogdanovic/iStock.
ors
chaos’ at first, because of the
speed everything had to be put
in place – there was a chance to
tackle ‘the whole suite of drug and
alcohol issues’. Anyone could call
anytime from the hotels to ask
for advice, and many of the calls
related to alcohol withdrawals and
prescribing issues.
Harm reduction was a high
priority, so naloxone was introduced
and people were given a workbook
of psychosocial interventions to
complete in their hotel rooms
as a way of bridging the gap left
by lack of face-to-face contact.
One of the big initiatives has
been the opportunity to tackle
smoking, with 2,000 e-cigarettes
distributed alongside other nicotine
replacements – a window to reduce
tobacco harm as well as enabling
people to stay in their rooms to
avoid transmitting the virus.
‘Harm reduction initiatives
can really work well with this
population, as well as preventing
COVID spread,’ says Roberts. ‘It
showed that there is willingness
among people to reduce their
tobacco consumption.’ He hopes
that funding being made available
for a pan-London coordinator
for tobacco harm reduction will
improve access for people who are
rough sleepers and help them to
reduce their tobacco use long term.
As Roberts stresses, each part of
the initiative has been a learning
curve, so supporting the hotels
to house their guests safely has
been paramount. ‘We’ve been
working with local hotels to provide
education and training to minimise
risks relating to alcohol withdrawal,
naloxone training and how to use
e-cigarettes,’ he says.
The other part of the project that
needed to be bedded in fast was
the strategic working between the
partners. Where there were normally
‘turf wars’ between services there
had to be a change in approach, so
that people could stay with their
original treatment providers when
they moved location to prevent them
from dropping out. The proactive
partnership culture was also helpful
for feeding into health alliances
– the GPs and nurses working in
the hotels, as well as the homeless
charities steered by St Mungos.
Much of the time and energy
has been taken up through
facilitating new referrals into
treatment, says Roberts, and ‘a lot
were people who have never been
in the treatment services before
or are generally hard to reach. We
facilitate their involvement with
local services and prevent any bad
practice happening in the hotels,
including dodgy detoxes and
people not understanding about
substance misuse.’
While ‘lots of things have gone
well’, the team is bracing itself for
an ‘uptick in homelessness’. ‘I don’t
know what the future holds and
‘We’ve been
working with
local hotels to
provide education
and training to
minimise risks
relating to alcohol
withdrawal,
naloxone training
and how to use
e-cigarettes.’
DR EMMERT ROBERTS
we’re not out of the crisis yet so it’s
very difficult to know what we’re
going to return to or what the new
normal is going to be,’ says Roberts.
‘I would hope that we’ve learned
some lessons about how we treat
homeless people within our services
– but given that we don’t know what
the lie of the land will be over the
next few months, it’s hard to know if
this will have any lasting impact.’
Getting people off the streets
and into a safe place had to be done
very quickly and in an emergency
situation, so he is frank about it
being ‘chaos’ at the beginning.
But through bringing the health
teams, homeless charities and
substance misuse teams and hotel
staff together, they have been able
to help with all kinds of issues,
including immigration and benefits.
Each of the hotels in London has
a resident homelessness sector
organisation – mainly St Mungos
– running the day-to-day life, with
HDAS being the central coordinator
for the substance misuse sector.
‘It’s been challenging and
chaotic, but the fact we’ve been
able to come together and have citywide
input has been very useful,’
says Roberts. ‘The government has
agreed to try to end homelessness
by the end of parliament in 2024
and the work we’ve done will
hopefully help that.’
He is painfully aware that ‘the
state of funding in the entire sector is
quite dire at the moment, with over
£250m of disinvestment over the
past five years’, and that ‘this isn’t
going to rectify that’. The abolition
of PHE feels like another hammer
blow. But there’s no denying that
being plunged into this emergency
situation has already had some
amazing results for individuals who
were invisible before COVID turned
our world upside down.
‘This isn’t going to be a substitute
for the overall disinvestment,’ says
Roberts. ‘But it might go some way
towards improving access for this
particular population.’ And if you’re
one of the 5,000 people in London or
15,000 people nationally who have
entered a housing support scheme
for the first time, that could feel like a
wide-open door. DDN
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SEPTEMBER 2020 • DRINK AND DRUGS NEWS • 7