WOMEN ' S OUTREACH
STREET SUPPORT
S ally Higgins is a mental health nurse with Forward Leeds. Her pioneering role is at the intersection of addiction, trauma, safeguarding and outreach work with women involved in street-based sex work.
In a new and almost unique post, Sally provides dedicated mental health support to women alongside the sex worker outreach team at Forward Leeds, offering a level of consistency, advocacy, and accessibility that many UK services cannot reach.
Sally has worked at the city’ s alcohol and drug support service since 2022 in the co-occurring mental health, alcohol and drugs( COMHAD) team, where she’ s employed by Leeds and York Partnership NHS Foundation Trust( LYPFT) as part of the Forward Leeds partnership. It was there that Sally, along with colleagues in the sex worker
A new role is providing vital mental health support for sex workers on the streets of Leeds, says Mark Hindwell
outreach team, noticed a persistent problem. The women they supported had extremely high levels of unmet need, but current mental health services struggled to meet them where they were. Missed appointments, lack of fixed address, chaotic life circumstances, and traumarelated avoidance frequently resulted in women not being able to get the support they needed.
Her role, launched in September 2025, was created to solve that problem. It allows Sally to carry her COMHAD expertise directly into the outreach environment, without waiting for formal assessments or appointments in one of the Forward Leeds hubs.
Sally’ s work is almost entirely street based. Most days begin at a Forward Leeds hub, planning the day with recovery coordinators in the sex worker outreach team. Then she’ s out in Holbeck,
Beeston, Armley, or Harehills – wherever she thinks the women are likely to be that day.
Her support isn’ t delivered in therapy rooms or offices, but on pavements, in parks, in cars, and sometimes outside houses known for drug activity. The approach is flexible, patient, and rooted in consistency.
‘ It’ s just sort of showing face and being consistent, and showing them that I’ m someone that’ s going to keep turning up,’ says Sally.‘ And then once we ' ve built that little bit of rapport and trust, we have some conversations about their mental health, what they ' re concerned about, what type of support they think they need.’
One of the people Sally is working with told her,‘ I’ m not ready for therapy, but I need someone to help me understand what I’ m going through. People think drugs cause my mental health to be bad, but I use drugs because of what I’ ve been through.’
Too often women find that mental health support services say‘ come back when the chaos is sorted’ – when housing, safety, sobriety, and stability are in place. As Sally points out, some of the women she helps have been in the same circumstances for a decade or more. Waiting for‘ stability
Sally Higgins ' work is almost entirely streetbased. Roles like this barely exist in the UK, yet the impact is unmistakable. first’ can mean they never receive mental health support at all.
Sally’ s presence means women who would normally fall out of community services get another chance. She attends meetings, advocates for women who struggle to speak for themselves, and personally brings people to assessments if that’ s what it takes. The difference is profound – without her, many would simply be discharged for non-attendance. The nature of the work is emotionally heavy. Sex worker outreach staff witness relentless sexual violence, exploitation, deprivation, and harm. Winter brings particular strain – cold, dark nights spent driving around searching for women shivering on the roadside with nowhere safe to go. Sally offers reflective sessions and day-to-day emotional support to her colleagues, something that would be impossible without her dedicated role.
The nature of the work is emotionally heavy. Sex worker outreach staff witness relentless sexual violence, exploitation, deprivation, and harm.
Roles like Sally’ s barely exist in the UK. Within the NHS this level of specialist, embedded mental health support for sex workers is virtually unheard of. Yet the impact is unmistakable. Colleagues describe her role as‘ exceptional’, and the value has already become clear to the outreach team, Forward Leeds leadership, and external partners.
As Sally puts it,‘ It is niche but I’ m really proud of what I do. And I hope to stick around and keep doing this for some time to come.’
Mark Hindwell is marketing and communications officer at Forward Leeds
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