Today “The House of Lords science and technology committee said ministers seemed to be mistaken in their use of what is known as the nudge theory.” ( http://www.bbc.co.uk/news/health-14187802 ) Nudge theory is the idea that changes are made to the social and physical environment without legislation that encourage (or discourage) specific behaviour. One example of this would be for fast food restaurants to have salad rather than chips as the default side order.
The committee made the point that a balance of approaches should be used rather than relying solely on ‘nudging’ people. This seems a blindingly obvious ‘finding’ for anyone who has worked personally or professionally around changing problematic behaviours. Perhaps this is more about where power and influence truly lies rather than personal perspectives on what is a sensible approach.
My point here is there is already a very well balanced set of approaches to something like illicit drug use where the agenda is quite simple. The problems with balanced approaches and the use of legislation become far more complicated when things like minimum prices for alcohol and supermarket food labelling are on the agenda. The challenge with the use of legislation here is that some influential organisations and individuals might lose money; suddenly there is apprehension about moving forward.
It’s great to see all the ‘courageous’ stands by politicians about ‘the press’ in light of the News of the World scandal. But it seems unlikely that the same courage is going to follow through into other areas.
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Posted in addiction, emotional support, Health, heroin, homeless, mental health, motivation, Poverty, problematic behaviour, rough sleeping, street homelessness, tagged addiction, alcohol, children, emotional support, engagement, homeless, Homelessness, offending behaviour, rough sleeper, rough sleeping, street homelessness, support work on July 12, 2011|
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The Children’s Society yesterday reported on the numbers of pre-teen runaways increasing (link below) and the risks that these young people face once they have fled their home or care. The report noted that a child runs away from home every five minutes in the UK and one in three of these will go unreported.
As a society we seem easily able to understand the impact that this type of thing has on children and how unacceptable it is that they are left in such a vulnerable position. The report also said:
“Agencies are unaware of the scale and nature of the problem and often fail to see runaways as children in need. Yet the report reveals that a quarter of them are forced to leave, often fleeing violence, abuse and chaos at home.”
For us we know these young people who miss out on a good start in life and then slip through the net of services all too often end up as adults with some fairly challenging support needs. The tough bit for us to swallow is when these people aren’t children anymore ‘as a society’ we seem to think differently. But they are the same people with the same traumatic pasts, they simply can’t be seen as ‘helpless’ anymore even though they are officially vulnerable adults.
A few hundred years ago these people were known as ‘sturdy beggars’, and were punished for begging when they were physically able to work. Today society is still obsessed with people’s physical ability to work and blames ‘choices’ to become drug or alcohol dependent adults or their irrational and problematic behaviour as the reason for their situation. As the above shows we have to get away from the physical and have more capacity to work with the emotional and psychological state if people in this situation are to find a way to reach their own potential.
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Posted in addiction, emotional support, Health, homeless, mental health, offending behaviour, problematic behaviour, rough sleeping, Service user stories, street homelessness, support work, tagged addiction, alcohol, death, domestic violence, emotional support, engagement, homeless, Homelessness, Huddersfield, offending behaviour, outreach, problematic behaviour, rough sleeper, rough sleeping, street homelessness, support work on June 3, 2011|
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Jon, one of our support workers shares the experiences of a day ‘at the office’ in Huddersfield:
As I was walking down to the Mission to meet Tim I bumped in to Julie who I have been doing some short term work with regarding her abusive relationship and domestic violence. She had blood on her coat and clothes and what appeared to be a cut on the side of her head. I spent some time talking to her and tried to get her to either go to the doctors’ or to let me call her an ambulance due to the fact she had a head injury. She refused to go seek any medical help and insisted she was fine. While talking to her she informed me that she had been stabbed in the leg with a screwdriver repeatedly and had been attacked by her husband but she still refused to see a Dr or to have an ambulance called.
As I had an appointment to go to and I could not get anywhere with Julie and she insisted on staying in the park I went to meet Alan. I managed to book him an appointment at the Doctors’ in order to talk to the Dr about his mental health and the options available to him for treatment. While waiting for the appointment we managed to phone and restart a benefits claim for him and he is now just waiting for the statement to be posted ou.
I also called the addiction service for Alan to talk to his worker there about his community order. When I managed to talk to his worker there she told me that he had not been engaging, as we knew, and that all efforts on their part from home visits and outreach that they had been unable to re establish contact. His worker was keen to help me to help Alan re engage with herself, his
CPN and probation and gave me the names and contact details of his probation officer and his CPN. On contacting these I managed to establish that Alan has been discharged from the mental health team due to non engagement, however they are willing to re asses him if the need arises. I was also told by probation that if Alan re engages with either the addiction service or probation or both them he would not be in breach of his community order and they could work to sort things out for him. I made an appointment for Alan at Lifeline tomorrow at 10am, his worker agreed to contact me to let me know if he did or did not attend so that we can discuss ways to help him to engage.
At the doctor’s appointment Alan was told that he needed to start re engaging with the addiction service as his short to medium term problems were best addressed by them and that once engaging with them more medium and long term solutions could be considered for his mental health. Alan gave the doctors’ permission to share his information with me and to contact him through me. From this I learned that when Alan was discharged from hospital his assessment was that there were no mental or psychological needs and that he was not in need of any medication. I am not sure if this diagnosis/assessment is still accurate as Alan talks about hearing voices and has told me he is a paranoid schizophrenic. He does exhibit signs of increasing paranoia and has been very agitated since the passing of a friend of his.
Later on when I went back to the mission I was told that an ambulance had been called for Julie as she was looking to be very sleepy and people were worried about her injuries. I talked with the paramedics and because she refused to be taken to hospital there was little they could do except to inform us of the signs to be aware of with head trauma. After this Julie wanted to go to a housing appointment we had booked previously and so we went up and presented at housing.
Initially they processed the application as a domestic violence application but after going through the interview and checking details the only places they could offer were in Keighley or Rotheram, neither of which Julie wanted to go to for differing reasons. As she had been sleeping rough for 2 nights we managed to go down the rough sleeper process rather than domestic violence. Once this was done they found her some temporary accommodation in until such a time as they can give her a temporary flat. Julie was over the moon with this and was very thankful that I had managed to get her somewhere to stay and said that although she still felt scared she did feel safer. I called into the mission with her on the way back in order to make a referral for clothes as the only ones she had were the ones she was wearing and they were all covered in blood. Julie appeared to be ok when I left but I’m still worried and will catch up with her again as soon as I can.
Jon, Support Worker
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I first met Alice when I received a call from a drop-in centre saying that they had someone who urgently had to go to the Homelessness Advice and Prevention service for emergency accommodation but would need someone to accompany her. They can not always accompany service users themselves as the centre is generally very busy and their support is based on the premises
When I met Alice I did an initial assessment of her support needs. She was 42 years old, rough-sleeping and suffered from a speech impediment and learning disabilities. She told me herself that she has anger management issues and can get verbally aggressive. She has a tendency to get frustrated when she feels worried about her situation and thinks that she’s not going to get help or support. She promised me she would try and stay calm. Alice also used to have a problem with alcohol but she had recently stopped drinking. It was my concern that she was not accessing any support and therefore increasing chance of relapse.
Alice had been renting a private flat for nearly 2 years until recently when an incident of verbal abuse towards her landlord resulted in her losing her tenancy. She had been homeless some years ago but had been supported into getting her own tenancy. When Alice lost the tenancy she was not engaged with any supportive services. She initially self-referred to a hostel, however lost her place shortly after for the same reasons as she lost her flat. Alice had been rough-sleeping for a couple of weeks when I met her and had been subjected to physical abuse during that time, leaving her very vulnerable.
We went to the Homelessness Advice and Prevention service but found on arrival that the local authority had discharged a duty to house Alice due to her behaviour in the past. This means they will not provide her with emergency temporary accommodation, although she could still put in bids for council tenancies. Alice was clearly becoming distressed and we left the service. I tried contacting the hostels in Leeds but none would take her because of the duty discharge. We were fortunate that day in running in to a friend of Alice’s who agreed to take her in for a few days.
I hadn’t been able to track Alice down for a couple of weeks, when she phoned me. She’d managed to self-refer to a hostel as she’d known a member of staff who’d refused to see her carry on sleeping on the streets. We met up and continued supportive contact. Alice was doing well and keen to get moved on in to longer term accommodation. I communicated with her workers at her hostel and together we helped Alice to place bids every week for a tenancy of her own as well as following up on other accommodation options. Alice phoned me roughly once a week to go food shopping with her and we worked on her budgeting skills and healthy eating. We also arranged and attended an appointment at the emergency dentist when she needed teeth pulling out. Alice is now engaged with support from her hostel key-worker and a specialist housing agency. She is accessing medical and dental care and is in the process of tackling her anger management issues.
I think the support I offer Alice works as she knows I am not confined to one space but that I am able to focus on whatever or wherever her needs dictate. I will visit her in her current hostel which is a 15 min drive outside of the city centre, or can walk to the doctors or catch a bus with her. Most of my work has been accompanying Alice when she has a new challenge to face, and does not feel confident, the lack of this vital support in the past has been where Alice’s anger management issue arises which then has the knock-on effect of reducing her other support options. When I first met her she did not have the regular and appropriate support that she needed. Now I know that she is working on the issues that she has. Recently, Alice was nearly out on the streets again, but this time, she had some great support around her and the crisis was resolved quickly. There is still a lot of work to do and Simon on the Streets and other agencies will continue to mutually support Alice, preventing initial homelessness and working on a long term support plan to move Alice towards a point where she no longer needs support.
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