1. Access to Safety: Housing Women with Multiple Disadvantages The tragic irony is that women who sustain the most damage are those for whom the least support and services exist. They, and their lives, are complicated, difficult and do not ‘fit’ into the way services have developed. (Kelly & Lovett, 2005)

2. Working with people affected by domestic and sexual violence and problematic substance use [Presentation title here] www.avaproject.org.uk | twitter.com/AVAProject AVA and the Stella Project AVA (Against Violence & Abuse) is a national second tier service working to end all forms of violence against women and girls. AVA’s Stella Project is the leading UK agency addressing the overlapping issues of domestic and sexual violence, problematic substance use and mental health.

3. Working with people affected by domestic and sexual violence and problematic substance use [Presentation title here] www.avaproject.org.uk | twitter.com/AVAProject Addressing Multiple Disadvantage? Multiple Disadvantage Domestic & or sexual violence Substance Use Mental ill- health HomelessOffending

4. Working with people affected by domestic and sexual violence and problematic substance use [Presentation title here] www.avaproject.org.uk | twitter.com/AVAProject Substance Use Humphreys & Regan research for the Stella Project in 2005, with data from 99 perpetrators and 75 survivors of domestic violence: 63% of men accessing perpetrator programmes self-reported problematic substance use 44% of survivors accessing domestic violence services self-reported problematic use 51% of survivors accessing domestic violence services were affected by own/someone else’s use  Study of 318 drug users in treatment in Scotland: 35% of women reported physical abuse and 10% reported sexual abuse from a partner (McKeganey, 2005)  UK study of 60 women using crack: 40% reported being regularly physically assaulted by a current partner and 75% by a current or past partner (Bury et al, 1999)  Prescribed psychiatric medicines are the most frequently misused substances.

5. Working with people affected by domestic and sexual violence and problematic substance use [Presentation title here] www.avaproject.org.uk | twitter.com/AVAProject Key: Substance Use as a Coping Strategy for Women “The doctors just want to put you on drugs. Doctors they just give you anti-depressants and you’re out in five minutes, they don’t want to talk about anything, they don’t want to talk about the cause, they don’t really deal with referring you somewhere, you have to get all of that help yourself.” - Stella Project research (2012)

6. Working with people affected by domestic and sexual violence and problematic substance use [Presentation title here] www.avaproject.org.uk | twitter.com/AVAProject Lifetime prevalence of mental health problems Rees et al 2011. “Lifetime Prevalence of Gender-Based Violence in Women and the Relationship With Mental Disorders and Psychosocial Function.” Journal of American Medical Association, Vol. 306, No. 5, pp. 513-521.

7. Working with people affected by domestic and sexual violence and problematic substance use [Presentation title here] www.avaproject.org.uk | twitter.com/AVAProject Access to Safety?  3 year project  Improve housing options for women with multiple-disadvantage Key Aims: 1.To implement key recommendations from ‘Case By Case: Refuge Provision for London survivors of domestic violence who use alcohol or other drugs or have mental health’ 2.Improve pathways for homeless women who are experiencing abuse, problematic substance use and mental health problems 3.To provide a pan-London support network for professionals based in the substance use, VAWG, mental health and homelessness sectors

8. Working with people affected by domestic and sexual violence and problematic substance use [Presentation title here] www.avaproject.org.uk | twitter.com/AVAProject Refuge: Case-By-Case Rational:  Clarity on the criteria of referrals accepted by refuges for women with multiple/complex needs. Aims:  Identify the extent of domestic violence refuge provision currently available in London to women who use substances problematically or have mental health problems  Identify examples of promising practice in relation to the provision of domestic violence refuge accommodation for these women  Develop recommendations for commissioners and service managers to improve access to domestic violence refuges for these women.

9. Working with people affected by domestic and sexual violence and problematic substance use [Presentation title here] www.avaproject.org.uk | twitter.com/AVAProject Methodology: Refuge Providers Between January and April 2012, we made contact with 30 refuges to ask them to complete a questionnaire, providing more detail about how women’s access to their refuge is assessed. What we asked:  A table of the most commonly used drugs / mental health problems, with a simple tick box of “yes” or “no”  Current cross-sector partnership agreements  Conditions to acceptance  Eviction criteria based on mental health problems and the use of any alcohol or other drugs if women disengage with support services;  Acceptance of women with a dual diagnosis of substance dependency and mental ill health

10. Working with people affected by domestic and sexual violence and problematic substance use [Presentation title here] www.avaproject.org.uk | twitter.com/AVAProject Methodology: Local Authorities In April 2012, Freedom of Information (FOI) requests were submitted to 32 London local authorities.  What refuge provision do you fund for women fleeing domestic violence?  Do your service specifications for any of the refuge provision that you fund require service providers to provide access for women who have (a) problems with alcohol or other drugs; and (b) mental health problems (either diagnosed or undiagnosed)?  In the past 12 months, how many women (with needs listed above) have accessed the refuge provision that you fund?  In the past 12 months, how many women have been refused access to the refuge provision that you fund? The same FOI request was submitted to each London Borough (excluding the City of London) in August 2013 to identify any changes in refuge provision since the first request.

11. Working with people affected by domestic and sexual violence and problematic substance use [Presentation title here] www.avaproject.org.uk | twitter.com/AVAProject Findings: Refuge Providers

12. Working with people affected by domestic and sexual violence and problematic substance use [Presentation title here] www.avaproject.org.uk | twitter.com/AVAProject Findings: Refuge Providers

13. Working with people affected by domestic and sexual violence and problematic substance use [Presentation title here] www.avaproject.org.uk | twitter.com/AVAProject Findings: Refuge Providers  Exclusion of survivors who were currently using opiates, including methadone  Survivors must be engaged with a substance misuse service prior to taking up a place in the refuge  Exclusion of survivors with autism, dementia and schizophrenia  Risk assessment completed on a case by case basis  Extent of refusals unknown – lack of paper trail  Low levels of partnership working

14. Working with people affected by domestic and sexual violence and problematic substance use [Presentation title here] www.avaproject.org.uk | twitter.com/AVAProject Findings Local Authorities  Limited requirement to specifically support this group of survivors  Limited ability to provide the requested data

15. Working with people affected by domestic and sexual violence and problematic substance use [Presentation title here] www.avaproject.org.uk | twitter.com/AVAProject Aims of project: Refuges  Support 6 refuges over three year – at least two BME  Clear, up to date policies and procedures  Comprehensive risk assessments  Improved partnership working  Training  Better contract monitoring  Create service-user led focus groups to feed- into policy, procedure and training

16. Working with people affected by domestic and sexual violence and problematic substance use [Presentation title here] www.avaproject.org.uk | twitter.com/AVAProject Housing St Mungo’s Rebuilding Shattered lives Homeless women have different needs to men but these have not always been met Women’s needs

17. Working with people affected by domestic and sexual violence and problematic substance use [Presentation title here] www.avaproject.org.uk | twitter.com/AVAProject Women’s Homelessness Trauma and Abuse –Experiences rooted in traumatic childhoods Complex and interrelated needs –Found with women across sectors/services Relationships with children –Loss and separation key barriers to recovery Stigma and Shame –Judged by societal expectations of women Access to Services –Missed opportunities

18. Working with people affected by domestic and sexual violence and problematic substance use [Presentation title here] www.avaproject.org.uk | twitter.com/AVAProject Aims of project: Housing  Work with two housing providers over three years  Implement St Mungo’s model and Stella Project lessons: a gender, trauma informed service  Improve policy and procedure  Improved partnership working  Training  Create service-user led focus groups to feed- into policy, procedure and training

19. Working with people affected by domestic and sexual violence and problematic substance use [Presentation title here] www.avaproject.org.uk | twitter.com/AVAProject Services for Women?  Have things changed since last round of FOIs?  Pathways for multiple disadvantage  Training needs?  Key Project Aim: More services for women with multiple disadvantage that are trauma informed + gender responsive

20. Working with people affected by domestic and sexual violence and problematic substance use [Presentation title here] www.avaproject.org.uk | twitter.com/AVAProject Get in Touch Lucy Allwright: London Stella Project Coordinator and AVA Trainer Email: lucy.allwright@avaproject.org.uk Newsletter: www.avaproject.org.uk www.avaproject.org.uk St Mungo’s women’s strategy lead – Esther Sample - esther.sample@mungosbroadway.org.uk http://www.rebuildingshatteredlives.org http://www.rebuildingshatteredlives.org ​