September2 2020 | Page 7

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 WWW.DRINKANDDRUGSNEWS.COM SEPTEMBER 2020 • DRINK AND DRUGS NEWS • 7