Housing, Homelessness and Substance Misuse Recommendations from the Advisory Group

Homelessness & Substance Misuse Advisory Group  Where we started  The process  The recommendations  What next?

Why is this an issue?  Health and Homelessness Action Plans…  One of the most challenging groups to provide services for  Service users often don’t/can’t co-operate  Wellbeing of service users v wellbeing of community  Which service takes the lead?  But - one of the most vulnerable groups

You get to a point (…) there’s no point in trying any more (…) things get so bad that no- one will help you any more and there’s no way they’ll give you a house in that state (…) so you just keep using even more …

The group  Set up winter 2005  Range of voluntary & statutory sector organisations represented  Range of different understandings

Remit  To develop and recommend a set of appropriate and adequate integrated approaches for working with substance misusers, i.e. problematic drug and alcohol users, affected by, or vulnerable to, homelessness. This should be based on joint working through integrated services at a local level to promote – - appropriate accommodation and levels of support - appropriate accommodation and levels of support which promote long-term and sustainable which promote long-term and sustainable independence independence - access to primary care and relevant secondary care - access to primary care and relevant secondary care services services - understanding and means of implementing harm - understanding and means of implementing harm reduction to prevent damage to self and others reduction to prevent damage to self and others - holistic input to improve well-being and promote - holistic input to improve well-being and promote change change - access to information about other appropriate - access to information about other appropriate services, suitable means of referral to such services and services, suitable means of referral to such services and adequate support when necessary to assist their adequate support when necessary to assist their engagement with mainstream services engagement with mainstream services

The Research  Agreed to commission research to provide empirical evidence/information re ‘what works’  Centre for Housing Policy, University of York - Identify and review evidence on service models and - Identify and review evidence on service models and approaches that produce positive outcomes approaches that produce positive outcomes - Consider how to identify & measure outcomes - Consider how to identify & measure outcomes  Published 2008: ‘Effective Services for Substance Misuse and Homelessness in Scotland: Evidence from an International Review’

Key Findings  Abstinence based & treatment only models may be less effective in producing positive outcomes  Provision of appropriate housing at an early stage may increase likelihood of positive outcomes  We need to be realistic in terms of what constitutes a positive outcome

Response to the research findings  3 local seminars across Scotland  Development of ‘Recommendations from the advisory group’

The Advisory Group recommends that:  A joint strategic response at national level is developed  A joint strategic response at a local level is developed (responsibility sitting with ADP)  National and local government and those planning and commissioning services recognise the importance of investing to save over the long term

The Advisory Group recommends that:  A joint operational response at local level is developed  More flexible approaches are developed in rural and island areas  Mainstream services supporting people affected by homelessness or substance misuse routinely consider the impact of substance misuse and homelessness on the ways in which they provide services

The Advisory Group recommends that:  Service development and commissioning are based on evidence of good practice  The starting point for service delivery is an individual’s priorities  There is ongoing evaluation of services in this field managed through the ADP planning and monitoring processes

The Advisory Group recommends that:  Targeted service user participation and involvement is supported  Training across homelessness, housing, alcohol and drug fields is supported in statutory and commissioned services  The stigmatisation of these populations is addressed at a local and national level

What next?  Event today and discussions this afternoon  Outcomes Approach  ADPs to take forward agenda supported by national support co- ordinators & outcomes toolkit  Role of advisory group in monitoring  Down to all of us to make this real!