DDN June 2017 DDN July2017 - Page 6

outreach Vital connections Most drug-related deaths are of people not in treatment. DDN visits Equinox outreach team in Brighton to hear how they engage with a growing population of rough sleepers R ough sleeping figures continue to rise. In the government’s latest report, local authority counts showed 4,134 people out on the streets in England on a snapshot night in autumn last year – up 16 per cent on the previous year’s count. Brighton is near the top of the league table with one in 69 people homeless, and the challenge is clear for the city’s outreach team. Among the members of Pavilions, Brighton’s partnership of treatment services led by Cranstoun, Equinox are hard at work at the community base in Queens Road, a few roads up from Brighton’s seafront. There’s plenty going on as usual, and people buzzing in and out offices shared with many other agencies, from housing support to mental health. While explaining what they do, they break off to deal with an urgent suicide threat nearby. One of the regular clients is threatening to kill himself, having been caught shoplifting again. Anti-social behaviour caseworker Kristina has rushed up there to help out, knowing that he will have been shoplifting to feed a drinking habit of 40-50 units a day. It’s a situation he’s been trying to escape, but he has a girlfriend who drinks and he’s finding it hard to change. For this man, as with many other Equinox clients, there are no quick fixes. The team members know they are in it for the long haul, explains manager Jesse Wilde. The working model is ‘assertive outreach with recovery at its heart’. In practice this means going back again and again, taking the knockbacks and offering a friendly chat until one day it’s welcomed. ‘These are people who will never make that call for help,’ he says. ‘Their life is often a web of chaos, often involving begging and jail. One day something will change – maybe they’ll have had a bereavement – and they’ll want to talk.’ The assertive outreach is the only way, as ‘signposting isn’t going to work’. The key workers are obviously vital to what happens next, and Wilde explains that their training equips them to build rapport. ‘Some people are avoidant, wary of intimacy or any interaction, even being told “well done”,’ he explains. ‘So we’d 6 | drinkanddrugsnews | June 2017 keep it very business-like in this case, and chat on the way to appoint ments.’ In the textbook it’s called ‘attachment theory’; he calls it ‘keyworking by stealth’. Outreach worker Scott Crossley is well versed in these techniques. He acknowledges that many clients can be ‘chaotic, disruptive and challenging’, but he rises to the challenge of gaining their trust, trying to look at the root of their behaviour, and working out how to offer support. ‘It takes time to establish trust and a rapport,’ he says, and the first stage is demonstrating reliability. They might have complex trauma and personality disorders, and a history of people saying they’re going to do something but not turning up. We’re always going to turn up.’ After a while you see people soften and reciprocate. It can be a long road, and at the start ‘the worker can be running around a lot, almost like a PA’. But then you need to find a way of ‘handing responsibility back, giving that power back’, so they are not dependent on the worker and can take charge of their own life. The results can be life-changing: ‘We’ve had people who screamed and shouted, and they’re now in their own accommodation, completely different people… but that takes time.’ The scope to work in this way comes from being part of Pavilions, Brighton’s network of support. The important parts of Crossley’s work takes place away from mainstream hubs, ‘taking recovery to people who can’t do mainstream’. ‘You’ve got one person but lots of strands, almost like a spider web, for housing, mental health, whatever they need,’ he says. Through multi-agency working, they can get a support package together, including OST at the right titration. ‘We can get them so we’re holding them,’ says Crossley. ‘We’ve got a platform and can then do the good work of prepari rFVf"7FB&V"bRW@6VRvF6V6G&VvFWB&W&Fv&FFWFFRV'0FBG'Vw2fR7W&W76VB( 2F2fƖr6&WBbfVVƖw2( 2V2WBFW6PfVVƖw2vWfW'vW&R( FRffVVBbVFVFFV2W2fFFffW&V6RR&VƖWfW2( &Vf&RvRvVBFFRv&F&W&RFVBVfRFVBFR&V wwrG&FG'Vw6Ww26