DDN Sept_2022 September 2022 | Page 19

Blown away
‘ We have been absolutely blown away by the professionalism , commitment , and trauma-informed practice of your team . They have been brilliant . Since working with WDP we have been able to support two of our clients – both with long histories of entrenched homelessness and chaotic substance use – to access a script . I strongly believe that the is a result of the assertive outreach and in-reach support that your team has offered .’
A DAY IN THE LIFE
Mike says …
Today starts outside Angel tube station . I ’ m meeting my colleague and we ’ re on outreach patrol . We have a set of bedding-down addresses , a list of rough sleepers who may be facing challenges with drugs and alcohol , known hotspots , and clients who have fallen offscript or who aren ’ t engaging .
Nearby a young man is sleeping at the back of a supermarket . He says he doesn ’ t drink or take drugs , so we have a discussion around him being offered temporary accommodation .
The absolute priority is an initial conversation and to gain a level of trust . For those with accommodation , it ’ s easy to be open about who we are and what we ’ re doing . However , for those bedding down on the street , there are more risks associated with exploitation , robbery , and violence . For some rough sleepers it ’ s not a safe environment to discuss alcohol and drug use with someone who has just introduced themselves . However , our conversation with this young man is good natured , and I leave having developed enough rapport to say hello next time we meet – either on the street , or ideally in a hostel .
Our next stop is a stairwell at a block of flats , and I almost miss a man huddled in a corner asleep under some blankets . We introduce ourselves but the man refuses to talk and would rather go back to sleep , so we leave him saying we ’ ll pop back another time . We make our way to a popular local site for rough sleepers . It ’ s here I meet one of my clients who has recently fallen off his methadone script . He has a bed space at a nearby hostel which he ’ s not been using .
FEELING THREATENED It can be quite challenging for our clients to stay at a hostel / bedspace for many reasons . Common issues are owing money to , or feeling threatened by , other tenants , being unsettled by noise , or just not being happy living in a room with a set of rules to follow . I offer to make an appointment to get my client back on his script and after a flurry of phone calls , one is made at one of our clinics for the following day . I agree to meet my client at his hostel to take him to clinic , but suggest that I ’ ll look for him at the current vicinity if he ’ s not at his hostel , to which he agrees .
I head to one of our office spaces where I meet with my colleagues on a video call and catch up with my notes from the morning ’ s outreach . I inform the team of my plan to visit a local hostel where a number of my clients are staying . I quickly make my pharmacy checks to see who is on script and check my email before leaving .
I arrive at the hostel and sit with the keywork staff to discuss my clients before making room visits . I have a varied caseload with people who differ greatly in their personal challenges with drugs , alcohol and / or mental health . Working in a hostel environment is a good time to talk about current drug or alcohol use and to offer naloxone and safety advice . If the opportunity presents itself there are a number of conversations to be had such as general health and weight , are they using and if so , how much are they spending and do they feel safe .
Next , I arrange to meet my colleague to visit some popular begging and bedding-down sites . We chat to a man who looks rather unkempt and is selling pictures and drinking beer in a doorway . He becomes animated when I ask if he requires support with drug or alcohol use and asks us to leave , so we oblige .
STREET ASSESSMENT We then attend an appointment for a street assessment , meeting a rough sleeper in the corner of a park . We find a park bench which is private and secure , and a long and detailed conversation begins . One of the challenges is to keep it concise , and answers to later questions can often be found in earlier discussions . As the assessment comes to an end , we arrange another clinic appointment for the next day and my colleague arranges to attend with this individual .
We visit a client of mine at a hostel who is struggling with alcohol . Detox and rehabilitation are on the agenda , but it ’ s something my client doesn ’ t feel ready for .
‘ The script has helped settle me down , and now I ’ m ready to start going to activity groups , something I ’ ve never done before , but I know it will help me ... Thanks a million for everything .’
SERVICE USER
We ’ re working on completing alcohol diaries and extending the window between drinking each morning and starting to drink again in the afternoon . This window is a great time for them to think about eating some wholesome food and we talk about making egg and beans on toast and the sort of food they should be looking to eat .
When our session is finished , my working day is nearly over . I hop off the train at Caledonian Road to check for one last client who is reported to be sleeping rough in the area , but I can ’ t find him . I make a mental note to check again later that week before heading home .
Adam Denny is dual diagnosis coordinator and Mike Coffey is outreach practitioner at WDP
WDP INROADS services include :
• Drug and alcohol outreach workers who will build relationships with street-active individuals .
• A specialist women ’ s outreach worker who will work with women with additional support vulnerabilities including experiencing domestic abuse or being involved in sex working .
• A dual diagnosis coordinator who will work with those experiencing both complex mental health and substance misuse problems .
• A nurse who will provide healthcare access for rough sleepers , including GP registration , BBV testing / treatment , and urgent healthcare .
• A clinical lead who will deliver rapid prescribing and opiate treatment support .
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