Social Reintegration in Europe Alessandro Pirona, Berlin, 12-13 May

What do we know…. ….very little! However….

EU initiatives Lisbon Strategy -> EU Social Agenda Priorities: Employment and combating poverty EU Funding (e.g. ESF) -> EU Social Protection and Inclusion Process: EQUAL, PROGRESS, etc.. National Social Strategies

EU Action Plan on Drugs 2009-2012 Objective 7 Enhance the effectiveness of drug treatment and rehabilitation by improving the availability, accessibility and quality of services Action 14 To deliver existing and develop innovative rehabilitation and social reintegration programmes that have measurable outcomes Indicator Increased availability and effectiveness, when possible, of rehabilitation and reintegration programmes in Member States

Social exclusion and drugs

Drug use among socially excluded groups (2002 data) Prisoners: 3-26% start use drugs in prison Ethnic minority groups: Not higher prevalence, but different patterns of use Homeless Up to 80% addiction problems Vulnerable Young People 37-49% use of drugs for children of users Sex workers Alcohol, tranquillizers and illicit substances (e.g. cocaine)

Social exclusion among treatment clients (2006 data) Never went to school/ never completed primary school 4-6% Primary level of education 40% (22% general population) Unemployed over 50% (9% general population)    Unstable accommodation 10% (32.000 estimated homeless drug users) Women with one or more children 25000

Unemployment DORIS (Scotland) Kemp & Neale (2005): 80% Jones, A. et al. (2007) Drug treatment outcomes research study (DTORS): only 9% of people commencing a new drug treatment episode were in employment 2008 NR data BG: The mean annual level of unemployment in the general pop in 2007 was 7.75 % Regarding the patients in substitution maintenance programs in 2007 the rate of unemployment was nearly 30 %. DE The portion of scene members without any completed vocational training has declined from 52% (1995) to 43%, but the unemployment rate is still very high (86%) with unemployment persisting for 4.6 years on average HU In the treated population the proportion of the unemployed was 26.7%. According to the data of the Hungarian Central Statistical Office (KSH) relating to quarters I-IV of 2006 the unemployment rate was 7.5%

Social reintegration

EMCDDA Definition ‘Any social intervention aiming at integrating former or current problem drug users into the community’

Social reintegration Other (counselling, leisure time activities etc) Housing Education Employment & vocational training

SR in a political and organisational framework 20 countries had a strategy for SR and 19 as part of their national drug strategy, 1 had an additional strategy (DK). 7 countries did not explicitly address SR in their national drug strategy (MT, FR, BE, NL, AT, SE, NO) but 4 had regional/local strategies (BE, AT, SE, NO)

Funding State/National : 11 countries Regional/Local: 8 countries Both levels: 8 countries

Predominantly decentralized mechanisms in terms of funding, coordination & implementation (DK, DE, ES, IT, AT, FI, SE, NO) Predominantly centralized mechanisms (EL, FR, IE, CY, LU, MT, PT, SI, TK) Mixed (BE, CZ, LV, LT, HU, PL, SK, UK, BG)

Education Basic education interventions dedicated to PDUs available in 17 countries Not available in 2 countries (CZ, SE) No information: 9 countries Availability: Very good: 3 countries Reasonable: 6 countries Low: 5 countries No info: 3

Although limited, access to education programmes for other socially deprived groups is also available, however.. Which groups do have access or are entitled to these programmes/interventions? In what context/setting? What is the coverage? What are the outcomes?

Social Reintegration Programmes Examples in EUROPE IE: “George’s Hill Step Down programme” “ The Bridge to Workplace” Initiative HU: EQUAL project “…being lost about life…” Comprehensive care for people suffering from addiction NL: “ Plan for Social Relief” – targeted to homeless drug users Diversified local activities, city-specific SK: Social Reintegration Centres (specifically for drug users)

No information available Employment and vocational training   Yes/No Availability Accessibility Belgium (F/W) Yes ++/ N.a. +++ / N.a. Czech Rep. + Denmark +++ Germany Estonia No information available Greece ++ Spain France N.a. Ireland Italy Cyprus No Latvia Lithuania Luxembourg Hungary Malta Netherlands Austria Poland Portugal Slovenia Slovakia Finland Sweden UK Bulgaria Romania Turkey Norway SPECIFIC

No information available Yes/No Availability Accessibility Belgium (F/W) Yes +++ / ++ +++ / + Czech Rep. ++ Denmark + Germany No   Estonia No information available Greece +++ Spain France N.a. Ireland Italy Cyprus Latvia Lithuania Luxembourg Hungary Malta Netherlands Austria Poland Portugal Slovenia Slovakia Finland Sweden UK Bulgaria Romania Turkey Norway GENERIC

Employment and vocational training Why is it important? Improves success rate of treatment and reintegration Structures the days of the recovering user Increases recovery capital (self-esteem, confidence) Pays back to society

Barriers to the employment of PDUs (Sutton et al., 2004) 6 key obstacles: Low education or skills or work experience Poor physical or mental health Multiple forms of deprivation (debt, criminal record, etc.) Lack of support services (transport, childcare, etc.) Personal barriers (communication problems, confidence, etc.) Interpersonal barriers (stigma, attitude of others)

Getting PDUs into employment (Harris et al., 2008) Job-readiness Employability External factors

Central components of successful initiatives Intensive tailored support From skilled and well trained staff Provided on a long-term basis where necessary Addressing a broad range of areas beyond just vocational Good partnership between drug services, employment services and local employers Care management for improve job readiness Long-term support: make sure the job is sustained, plus support against relapse Other areas: treatment provision, housing Local employers: facilitate job placements, understand local labour market

Getting employers involved… Create partnerships with local employers Reduce preconceived ideas about drug users Know the labour market Collaboration in developing programmes according to the needs and expectations Develop work tasters Provide services to employers and staff in return Get public employers involved Develop networks or forums for employers Collaborate with employment services

Conclusions We know the needs, but we struggle to monitor the responses Sound conceptual framework is missing, lack of visibility Employment is the ‘hot topic’ …