Helping people sleeping rough from Europe and beyond
Petra Salva is St Mungo’s Director of Rough Sleepers, Migrants and Criminal Justice Services. She has been working directly with people sleeping rough in London for over 20 years and heads up St Mungo’s rough sleeper and outreach teams across London boroughs and south east England. Petra also represents St Mungo’s on a pan European network which shares best practice and ideas across Europe to help reduce street homelessness. In a blog first published on the Huffington Post, she explains how we work to help destitute non-UK rough sleepers to move away from the streets for good, with the right support in place to rebuild their lives. Every week I hear stories and get updates about people who St Mungo’s outreach teams are trying to help off the streets. I also try as much as possible to meet people myself so I can see first-hand how things are working and understand more about the issues that homeless people face, and the challenges for our outreach colleagues. Peter’s journey Recently I heard about Peter*, a 45 year old man from Poland. Peter had lived and worked in Poland and then the Netherlands with his partner for many years before moving to London with hopes of work and a better life here in the UK. However, once in London things didn’t work out as he hoped. After working in construction as a machine operative, his life was turned upside down when the relationship with his partner broke down and she returned to the Netherlands. Peter dealt with his sudden loneliness by drinking and then moved on to using cocaine. Eventually he lost his job and soon after his accommodation. He, like many others in a similar situation, ended up sleeping rough on the streets of London. Our outreach team met him on the streets and offered support. Initially Peter refused to engage with us. We didn’t give in though and kept visiting him on a regular basis. Eventually as winter and freezing temperatures set in he became more willing to talk and think about what to do. Peter began to talk about returning to Poland and getting help with his alcohol and drug use. He realised he could not “get clean” without support and that he couldn’t access treatment in the UK. He hadn’t considered that he might be able to get the treatment he needed in Poland. Through our supported reconnection service, we worked with Peter to make this option a reality. Getting the right help My colleagues told me that Peter completed his treatment in Warsaw and is now in full time skilled employment assembling electrical components. Just days before my outreach colleagues met up with him again in Poland he had finally been helped into his own flat. Peter was proud to tell us about his work and show us pictures of his flat where he enjoys having his friends and sister visit him. As they chatted, he reflected on the moment he arrived at the treatment agency in Warsaw and was met by his sister who had gone there to welcome him back. You might wonder why we couldn’t help Peter to get the help he needed in the UK? The simple answer is he, like many others, had become stuck on the streets. Government policy meant he wasn’t eligible for housing or publically funded support services in the UK. This situation has led many people to become destitute and eventually very unwell on our streets. We know of some who have died. In London about 57% of people sleeping rough are non-UK nationals. That means their options are legally limited when it comes to accessing housing, treatment services and any other welfare assistance that is possible for UK citizens. Our Routes Home service, funded by the Mayor of London, works with vulnerable people like Peter. Last year, the team helped over 60 people who had really complex and high support needs to voluntarily return to their home country into accommodation and treatment with the support and assistance they needed. Why couldn’t Peter get help in the UK? When we met Peter he didn’t have many choices. We didn’t want him to die on the streets of London. We wanted him to have a second chance. That meant persevering with him, and working with many different agencies and being realistic about the legal and practical limitations he faced. When our outreach teams meet people who are sleeping rough but have no support needs and are able to work, our focus is on helping them to find a job as the only way to stay in the UK and resolve their homelessness. Where people have physical or mental health needs or have issues around substance use, we work with partners in the UK and in people’s home countries to ensure they can receive appropriate housing and support, often through our Routes Home service. When they have complex immigration issues, we also support people to get legal advice through Street Legal, our partnership with migrant charity Praxis and Refugee Action UK. Working with migrants who are sleeping rough is challenging and complex work. We often get asked about the approach we take and the partners we work with, in particular what our relationship is with the Home Office in such cases. Supporting and advocating for our clients In terms of our approach, our first response to non-UK nationals sleeping rough is always to offer help and support, ensuring people understand their rights and entitlements and, where possible, are provided with assistance to take up options in the UK including work and housing. Where this is not possible, and people are not eligible, St Mungo’s will offer services to provide treatment and housing options in home countries through supported reconnection like Routes Home. In areas where local authorities have decided to engage the Home Office to take action against individuals or groups of rough sleepers, St Mungo’s outreach teams work alongside the Home Office teams to provide support and advocate on
Outreach on the streets of Connecticut
This summer Ed Addison, Case Coordinator for St Mungo’s project Street Impact London, took part in an eye opening two week long cultural exchange programme, travelling to Connecticut in the USA to learn about their approach to supporting people who are sleeping rough. Ed explains more about the homelessness situation in New Haven, the challenges they face conducting outreach and what he has taken away from the experience. I travelled to the USA as part of the Transatlantic Practice Exchange run by Homeless Link, the national membership charity for organisations working directly with people who become homeless in England. I applied because I wanted to learn more about different approaches to engaging with and supporting people who are sleeping rough. Like much of New England, New Haven, a small city in Connecticut, has seen an unprecedented increase in rough sleeping. With long waiting lists for shelters and few other resources, my hosts, the Columbus House outreach team, have a challenge on their hands. Personal experience helps outreach work The outreach team explained to me that working with certain groups, like couples and people that don’t engage, can be challenging. They also told me about their own experiences of homelessness and how this helps them in their work. Recovery support specialist Stephanie said, “I too have been homeless and lived through this experience myself and used that experience to help others.” The team see a lot of people with mental health needs who also use alcohol or drugs, but place an emphasis on recovery. Stephanie explained that using lived experience to help others is a crucial part of the recovery programme, saying “[you] show them you can live through this experience and get to the other side.” Supporting others is its own reward What struck me is that, despite the challenges, the team were so motivated and passionate about their work. Their persistent and flexible approach provides a lifeline to those experiencing homelessness. As outreach worker Rhonda explained, “Someone helped me, so I am going to in return… It gives me a sense of satisfaction knowing that I am helping somebody to better their quality of life.” Applying learning in London The Street Impact London project I work for is all about supporting people who have experience of sleeping rough to sustain their lives off the street. I’ve been inspired by the multi-disciplinary approach in New Haven which brings essential services, including street psychiatry and healthcare, to people directly on the street. I’d like to highlight the challenges people have accessing support here in the UK and continue to ensure that St Mungo’s clients are given as much choice and decision making capacity in their recovery journey as possible. My time in New Haven has also highlighted the importance of a community based approach to working with rough sleepers. The experience is shaping the way I build relationships with people to encourage positive change in their lives. You can listen to an interview Ed conducted with the New Haven outreach team here. Find out more about Street Impact here. Homeless Link’s Transatlantic Practice Exchange is supported by the Oak Foundation and delivered in partnership with the National Alliance to End Homelessness. Placements are funded for five frontline homelessness staff to spend a fortnight in the United States, exploring different practice topics and sharing this learning on their return.
On a typical day…
“For me, if I can go home knowing I have helped at least one person away from the streets, or just one person away from the distress of mental health illness, I feel blessed.” St Mungo’s Mental Health Practitioner, Fatima, shares her experience of working in Outreach, helping people sleeping rough in the Tower Hamlets area. I’ve been a mental health nurse for 18 years. In 2011, I became and an approved mental health professional, which incorporates social work. I will work typical outreach shift in terms of going out early in the mornings and staying out late in the evening, as late as two or three in the morning, speaking to clients who are sleeping rough to try to form therapeutic relationships with them to help them move away from a life on the streets. ‘Blinded to homelessness’ I was one of those people who was blinded to homelessness. I could walk past a homeless person or rough sleeper and not really see them to understand what they’re going through. It’s been an eye opener for me and I’ve fortunately been able to influence others to see homelessness through what I do at St Mungo’s. It can take a week or months to be build a relationship with a person. Sometimes they are in denial – they have no insight about what is happening to them so I try and to slowly educate them. I take decisions out of people’s hands when they’re experiencing mental distress. I enjoy my work. I can get people registered with a GP surgery, then get them to start medication, stabilise their mental health illness and then help into accommodation whilst we support them. Many people may have been de-registered and have been turned away from Accident and Emergency (A&E) wards. They can go through those revolving doors three or four times a month, back and forth from A&E. I also work with the clients to ensure they engage with the process of recovering from homelessness. You cannot take someone off the streets and expect them to turn up for every appointment. I have to build that relationship, that rapport and that routine of them coming to see me to talk about their mental health, the medication and the side effects. ‘Long days full of drama’ My days can be very long and full of drama. Sometimes I get abused, which can be quite stressful. But my job is also fun and flexible. For me, if I can go home knowing I have helped at least one person away from the streets, or just one person away from the distress of mental health illness, I feel blessed. It’s brilliant to see someone who has been sleeping on the streets for five or six years leave that life behind. The kerb becomes their family so getting them into accommodation is not easy. When you put them in a room in a hostel it can be very lonely. The silence can be deafening for them because people out on the streets give them money and say hello – some people get to know them as they walk past them on their commutes. So they run back onto the street and people wonder why because they have accommodation. ‘Everybody is unique, everybody has a journey.’ A lot of clients can lose their accommodation in hostels because of poor mental health – some people cannot understand their journey. Everybody is unique, everybody has a journey. How you hold their hands to support that journey is what makes a difference. People might think, ‘go to housing and get a property, get off the road and get your benefits’, it’s a much longer journey, however. Different clients talk about their living conditions. Finances are a problem. People have not been used to managing money and paying bills. Universal Credit has also caused a lot of problems for our clients. I have one client, for example, who believes he has all his money invested in stocks and shares. He says when his investments mature, he’ll pay his rent. He has a diagnosis of schizophrenia with delusional disorder. I ask for my colleagues to work with him in terms of hand-holding to ensure he does not get evicted from his hostel. I’m working with this lady that I’ve known since I was a student nurse. Up to now she will not allow anyone else to work with her. She was sleeping in a bin shed. She became mentally unwell, and started using drugs to self-medicate the voices she was hearing. Her children were taken into foster care when they were young. I worked with her and got her a place in a hostel. He son got in touch after 15 years and they’re building a relationship again. ‘You cannot be judgemental’ Because of the nature of the people we work with, many with chaotic life styles, who are extremely marginalised, it’s very difficult to get through to the NHS. Even though I am that link between the NHS and homelessness services. Sometimes the nurses have no understanding or knowledge of homelessness. They’ll say, ‘he needs to go, he might bring drugs in here’. It’s a big challenge to get my clients treatment because of the way they look, or dress and their circumstances. Working in outreach, you cannot be lazy. I have gotten used walking everywhere. You must be able to multitask as you’re dealing with more than one client, sometimes up to seven a day, who are in crisis. I’ve jumped over six feet walls and walked along canals to help people – it’s part of what we do. You must have people skills, respect humanity, and you cannot be judgemental at all. It takes a lot of character to try and support people who are not ready to receive help. It’s a nice feeling to know you’ve helped someone from being a hermit to re-engage back into society and to be part of a community. I think that’s what
Five ‘giant evils’ of 1940s still exist for today’s homeless
The welfare state was established to fight the five ‘giant evils’ Lord Beveridge identified in his 1942 report. 70 years on, is the welfare state just as spritely when it comes to vanquishing those giant evils? Denis, from St Mungo’s client representative group Outside In, doesn’t think so: “The five evils are still evils in today’s society. They still continue.” Tanya English, St Mungo’s Executive Director of Communications, examines some client perspectives and considers our response… Giant evil #1: Squalor Beveridge wanted to break the cycle of poverty, where health problems caused by inadequate housing restricted people’s ability to work. Today, thousands of people still end up sleeping on the streets each year: “On many occasions I woke up and I’ve been covered in snow” Mark, 37 “When I woke up sometimes, my foot would be so frozen that I wouldn’t move it until it proper thaws out because it felt like I had frost bites and my hands were hurting because it was so cold” Michael, 31 Giant evil #2: Ignorance Beveridge thought that higher social classes were ignorant of the problems affecting communities. Our clients still experience this prejudice: “[Homeless people are] treated bad. Low life, dirty junkie, prostitutes, worthless dogs, but we’re not. We haven’t committed a crime; we’ve just had a bit of bad luck and made a terrible mistake, you know?” Linda, 52 “I think people who have problems with the homeless…whatever problems they’ve had, however they end up that way; I personally think [people] should consider them a bit more. Whether you’re homeless or not you’re still human beings at the end of the day. We are all still human beings.” Leon, 36 Giant evil #3: Want Beveridge was concerned with ensuring everyone in society had what they needed to survive. Unfortunately, many people who are homeless feel they have to resort to crime just to be able to eat: “[Homelessness] actually turned me to crime and…I’m a bit ashamed because I’ve caused a lot of damage to properties having to steal lead and that was just to survive… when you get your dole money if it doesn’t last or you get robbed, you’re going to find it very, very, very hard. I found that very, very difficult to, you know, to get a meal most days.” Stuart, 44 Giant evil #4: Idleness Beveridge called for training and work centres to be set up across the country to help everyone find a job. Although many people who are homeless would prefer to work, many still struggle with overcoming bureaucratic hurdles: “[When] you do go for a new job you say, ‘I’ve been homeless; this is why I’ve been out of work’, they just say, ‘What have you been doing?’” Michael, 30 “I was at the job centre. Loads and loads of work, but it was the same answer every time I picked the phone up, ‘We need proof of your address in London’” Jason, 39 Giant evil #5: Disease Beveridge believed that tackling health issues was central to helping people out of poverty. Health is a significant barrier to work for a number of people who we help: “I’ve nearly been killed three times doing [prostitution]. I’ve been raped doing it. I’ve… as a result of that I got HIV doing it.” Angela, 38 “Some people don’t understand [depression]… A lot of the time I have kept myself to myself. It’s only recently I’ve started to push myself out there a bit more. But even still there’s stigma. Any hint that you’ve got this, especially when I’ve been in the mental hospital, people think straight away strait jackets; nutjob.” Michael, 30 At a time of great financial uncertainty, Britain’s welfare system was set up to direct limited resources towards those who needed them most. Now in the middle of another financial crisis 70 years later, those who are most vulnerable are still tumbling through the gaps in the safety net to the streets below. Our response must be to strengthen the net, not cut more holes.
