1. What more can we do for rough sleepers? Setting the Scene Harm Reduction What’s missing? Tracey Hughes – East Kent Substance Misuse Team

2. Setting the Scene – the Strategy No one should have to sleep rough. In this strategy we now signal our intent to work with our partners to end rough sleeping by 2012. To make that happen we want to make sure that in every part of the country people get the help they need, so no one has to sleep rough. Services will act to prevent rough sleeping, or to bring people in as quickly as possible. People who have slept rough will be supported to improve their health, consider employment options and rebuild their lives. No One Left Out - Communities ending rough sleeping. CLG November 2008

3. No One Left Out Key Principles: Preventing people sleeping rough – tackling the flows of new rough sleepers onto the streets Diverting people from the streets as quickly as possible – so no one needs to stay sleeping rough and to avoid people becoming entrenched and developing or exacerbating problems such as poor mental health, substance misuse and physical health Sustaining people in accommodation and their communities to prevent them returning to the streets in the future.

4. The Numbers…………… In June 2009: 464 people were sleeping rough on any single night in England. 263 of these were in London &110 were in Westminster. Outside London: Bath 10 Bedford 10 Chester 9 Liverpool 9 Manchester 9

5. The Local Picture On Wednesday 25 November 2009 Total found Evidence of how rough sleeping many more? East Kent (incl Swale)1314 West Kent 5 12 Medway 5 5 Total 23 31 25.11.09 75 people were accessing Kent Outreach Service 25.11.09 123 people on waiting list for Porchlight’s rough sleeper support

6. What is harm reduction? Harm reduction is a term that defines policies, programmes, services and actions that work to reduce the health social and economic harms to individuals, communities and society that are associated with the use of drugs (Newcombe 1992)

7. Working together Social EconomicHealth

8. What is Harm Reduction? Advice and information for all – substance users, family, friends, carers Safer injecting & needle and syringe exchanges Overdose prevention BBV testing and vaccination Sexual health Gateway to services

9. Maslow’s Hierarchy of Needs Self- Actualisation growth & fulfilment Esteem achievement, status, responsibility Social needs friends, family, relationships & affection Safety needs protection, security, stability Physiological needs air, food, water, shelter, warmth, sleep

10. A useful model? Abraham Maslow introduced the hierarchy of need in his paper 1943 paper A Theory of Human Motivation. We all have 5 levels of need: physiological – air, food, water, shelter security – a feeling of security (money & housing etc) social – friends, family and relationships self esteem – status, position, confidence self actualisation – reaching your full potential

11. The Mystery Shopper Experience “It felt a bit like a computer game where you had to get to the different levels and you get through to the second level and you might get through to the third level but ultimately, on a number of occasions, I’ve been able to get up a few levels but you still can’t get any kind of help” A mystery shopper from “No One’s Priority” Crisis July 2009

12. Where Do We Go From Here………