To Dance With Grace

Outreach & Engagement To Drug Users On The Street

Outreach is viewed as a process rather than an outcome, with a focus on establishing rapport and a goal of eventually engaging people in the services they need and will accept

Outreach work is based on a foundation of strong values, principles and unique worker stances Outreach work is based on a foundation of strong values, principles and unique worker stances Engagement is the key in Outreach Engagement is the key in Outreach The outreach is designed for are those who are unserved or underserved by existing agencies and who aren’t able or are service resistant to seek services from those agencies The outreach is designed for are those who are unserved or underserved by existing agencies and who aren’t able or are service resistant to seek services from those agencies

The goals of outreach are to develop trust, care for immediate needs, provide linkages to services and resources, and to help people get connected to mainstream services and ultimately into the community through a series of phased strategies The goals of outreach are to develop trust, care for immediate needs, provide linkages to services and resources, and to help people get connected to mainstream services and ultimately into the community through a series of phased strategies Effective outreach has been demonstrated, with positive outcomes Effective outreach has been demonstrated, with positive outcomes

Peer based outreach and the use of the expertise of homeless and formerly homeless persons and consumers are valued and should be actively sought out Peer based outreach and the use of the expertise of homeless and formerly homeless persons and consumers are valued and should be actively sought out Discrimination and marginalisation are part of the experience of both outreach clients and workers; as a result, advocacy must take place at all levels Discrimination and marginalisation are part of the experience of both outreach clients and workers; as a result, advocacy must take place at all levels Outreach services cannot exist in isolation Outreach services cannot exist in isolation

Values & Principles Of Outreach A person centered orientation: a philosophy which aims to restore dignity, dealing with clients as people A person centered orientation: a philosophy which aims to restore dignity, dealing with clients as people A recognition of clients' strengths, uniqueness, and survival skills A recognition of clients' strengths, uniqueness, and survival skills self-determination: facilitated by presenting options and potential consequences, rather than solutions, by listening to clients rather than "doing" for them, and by ensuring a balance of power between individuals and outreach workers self-determination: facilitated by presenting options and potential consequences, rather than solutions, by listening to clients rather than "doing" for them, and by ensuring a balance of power between individuals and outreach workers

Goals of Outreach Our main goals of outreach are: Firstly to care for immediate needs, including to ensure safety, provide crisis intervention, refer to immediate medical care, and help clients with immediate needs. Firstly to care for immediate needs, including to ensure safety, provide crisis intervention, refer to immediate medical care, and help clients with immediate needs. To develop a trusting relationship To develop a trusting relationship To provide services and resources, whenever and for as long as needed To provide services and resources, whenever and for as long as needed To connect clients to mainstream services To connect clients to mainstream services

Worker Stances These characteristics are critical because successful engagement will largely be determined by the relationship between clients and workers. We have found effective worker characteristics include: These characteristics are critical because successful engagement will largely be determined by the relationship between clients and workers. We have found effective worker characteristics include:

Good judgment, intuition and street sense: this includes safety for themselves and the client-being observant and vigilant, as well as using good common sense. Strategies include going out with a partner, avoiding closed, remote or dangerous areas, developing a relationship with local police dressing appropriately, and assessing situations before acting Good judgment, intuition and street sense: this includes safety for themselves and the client-being observant and vigilant, as well as using good common sense. Strategies include going out with a partner, avoiding closed, remote or dangerous areas, developing a relationship with local police dressing appropriately, and assessing situations before acting

Non-judgmental attitude Regardless of the worker's personal beliefs, no behaviour on the part of the client is judged Non-judgmental attitude Regardless of the worker's personal beliefs, no behaviour on the part of the client is judged

Team player: Workers must know when to ask for help, from getting backup on the streets to a second opinion in clinical assessments. Outreach staff must have a strong commitment to the "team" approach to service delivery Team player: Workers must know when to ask for help, from getting backup on the streets to a second opinion in clinical assessments. Outreach staff must have a strong commitment to the "team" approach to service delivery

Flexibility: Outreach workers are flexible in reassessing daily work priorities, in setting work schedules, and in the treatment planning process, and content Flexibility: Outreach workers are flexible in reassessing daily work priorities, in setting work schedules, and in the treatment planning process, and content

Realistic expectations: Workers have an "expectation of non- results." They understand that they will not be able to "cure" or "save" clients, and at the same time continue to persevere. Realistic expectations: Workers have an "expectation of non- results." They understand that they will not be able to "cure" or "save" clients, and at the same time continue to persevere.

Commitment: Outreach workers are both consistent and persistent in their dealings with clients. They do what they say they are going to do and only make promises they can keep. They are in it "for the long haul" and continue to persevere. Commitment: Outreach workers are both consistent and persistent in their dealings with clients. They do what they say they are going to do and only make promises they can keep. They are in it "for the long haul" and continue to persevere.

Less is more. At the outset of intervention, there is less application of intensive and costly treatment, less professional distancing, less rigidity, less intrusiveness, and less directive ness. Services offered are purely voluntary. Less is more. At the outset of intervention, there is less application of intensive and costly treatment, less professional distancing, less rigidity, less intrusiveness, and less directive ness. Services offered are purely voluntary.

Sense of humour: the ability to use humour at appropriate times, as well as maintaining as sense of humour during difficult times is essential. Sense of humour: the ability to use humour at appropriate times, as well as maintaining as sense of humour during difficult times is essential. Creativity & resourcefulness are strengths that outreach workers tap into daily. Creativity & resourcefulness are strengths that outreach workers tap into daily. Cultural competency: Workers demonstrate competence across ethnicity, gender, transgender, lifestyle, and age spectrums. Cultural competency: Workers demonstrate competence across ethnicity, gender, transgender, lifestyle, and age spectrums.

Resilience: Workers are resilient and patient in a work environment marked by high turnover, difficulty tracking clients, high stress, lack of resources, and lack of immediate improvement in the clients they serve. Effective workers are able to continue working despite the difficulties endured by their clients, without personalising them. Resilience: Workers are resilient and patient in a work environment marked by high turnover, difficulty tracking clients, high stress, lack of resources, and lack of immediate improvement in the clients they serve. Effective workers are able to continue working despite the difficulties endured by their clients, without personalising them.

Mobile or Fixed? Outreach may be mobile or fixed depending on the needs of the target population. Our Outreach takes place on the streets, as well as in shelters, drop-in centres, hospitals, and prisons But an option is do both……………

NEON & LTMP NEON – Needle Exchange Outreach Network Low Threshold Methadone Programme

NEON Streetwork and Backpacking With HOP Outreach with SCOTPEP Van Based Exchange in Landward Areas

LTMP Same stances as Outreach despite the fixed nature: Client Centered Client Centered Open access Open access Works At Clients Pace Works At Clients Pace Short Term Achievable Goals Short Term Achievable Goals

Our Service Streetwork in Central Edinburgh 7 days a week Streetwork in Central Edinburgh 7 days a week Backpacking 5 shifts a week Backpacking 5 shifts a week Drop in duty system Drop in duty system Evening and Weekend Service Evening and Weekend Service Needle Exchange 365 days Needle Exchange 365 days Multidisciplinary Team Multidisciplinary Team

But……….. Not a complete solution in itself Can be a lengthy process And without joined up working ? Think of it as a tool…

Some Examples Client P and accommodation Client P and accommodation Client C and exchange Client C and exchange NEON Figures NEON Figures

With Paraphernalia Especially Water With Waiting Lists…. With Flexible Services Including Opening times.. Help