1. Social Reintegration in Europe
Alessandro Pirona, Berlin, May

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

3. 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

4. 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

5. Social exclusion and drugs

6. Drug use among socially excluded groups (2002 data)
Prisoners: % 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 % use of drugs for children of users
Sex workers Alcohol, tranquillizers and illicit substances (e.g cocaine)

7. 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% ( estimated homeless drug users)
Women with one or more children 25000

8. 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%

9. Social reintegration

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

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

12. 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)

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

14. 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)

15. 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

16. 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?

17. 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)

18. 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

19. 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

20. 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

21. 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)

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

23. 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

24. 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

25. 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’ …