helping young people with drug addiction problems
DESCRIPTION
Presentation given by Aleksandra Lukasiewicz, MONAR Association (PL) at the 2013 FEANTSA Conference "Investing in young people to prevent a lost generation: policy and practice in addressing youth homelessness" http://feantsa.org/spip.php?article1596&lang=enTRANSCRIPT
Helping young people with
drug addiction problems
Warsaw experience
Aleksandra Łukasiewicz, The MONAR Association
Investing in young people to prevent a lost generation in Europe:
key policy and practice in addressing youth homelessness
8th November 2013, Prague, Czech Republic
The MONAR Association
a non-governmental organisation offering
a wide range of services to drug users and
the homeless in Poland;
the largest network of treatment services:
out-patient, residential and outreach (135);
founded in 1978;
Situation of the Young
Homeless in Warsaw Survey „Situation of Homeless People in Warsaw: opinions by the homeless
and social workers”, conducted in 2005 by CBOS – Public Opinion Research
Centre - commissioned by the City of Warsaw
Findings:
30,5% of respondents became homeless before 30 y.o.
including 27,3% - 19-30 y.o.
3,2% 18 y.o. and below
According to respondents, the most frequent reasons for homelessness are:
51,3% family desintegration (including economic migration of parents:
phenomena of „Euro-orphans”)
20,7% violence in families, especially towards young people (in the
age group below 35 y.o. 41% indicated violence in family
as a reason for homelessness)
33,2% own addiction (including 30% of alcohol addiction,
3,2% drug addiction)
Situation of the Young
Homeless in Warsaw
The question on addiction was regarded by researchers as sensitive,
therefore the data could be considerably underestimated.
Researchers also pointed out the strong correlation between alcohol and
drug addiction: data shows that these addictions often co-exist.
Situation of the Young
Homeless in Warsaw
24,8% of respondents – homeless people – look for
assistance in shelters and nightshelters.
Only 2,3% of respondents turn to different types of out-
patient services, including addiction treatment,
psychological assistance and other.
The homeless do not want, cannot or do not know how to
use generally accessible services, and because of such
feelings as shame, fear, or embarrassment associated with
deprivation of basic needs (hunger, hygiene, safety etc.)
Outreach for the homeless
All-season outreach program conducted by
MONAR in Warsaw.
Aid and motivation.
Based on harm reduction principles in work with
the homeless.
Conducted in places not suitable for living where
the homeless live, working or spending time:
parks, canals, garden/summer houses, railway
stations, stairways, squats, etc. (ETHOS:
roofless 1.1 i 2.1, inadequate 11.2, 11.3, 12.1).
Outreach for the homeless
Systematic activities
Education on safer drinking, drug use,
living in not suitable places (risk of fire,
hypothermia, etc.), system of the welfare.
Waiting for the client’s decision.
Work with a person according to his/her
rate and rules, in his/her environment, and
based on the plan accepted by him/her.
Outreach for the homeless 30% of the outreach program clients – young
people;
Frequent use of drugs, criminal activity, sexual
services;
Usually the young homeless stay at their
acquaintances, in squates, railway stations,
shopping malls;
Outreach is a link between a client and the
services;
Allows to react and be flexible to the needs of
the homeless;
Gap in the system
The data collected in 2005 by the MONAR Drop-in
for the Homeless in Warsaw showed that the
system was not ready to help young people who:
had limited access to treatment services due to
their specific situation (lack of documents,
insurance etc.);
needed instant intervention;
Gap in the system..
previously dropped out from the treatment system, as
they did not regard themselves addicted and at the same
time were excluded in much more spheres than the rest
of addicted patients:
lack of income,
lack of family support,
neglect of health and social situation etc.
did not accept staying in shelters for the homeless, as
they did not identify with the rest of clients;
needed specialised but low-threshold offer.
Shelter for the young homeless To respond to the needs of this group, in 2005, the
MONAR Association established a shelter for
disadvantaged young people at the age of 18-30 in crisis
situation in the framework of the Centre for Humanitarian
Aid MONAR-MARKOT in Warsaw;
The program offers a comprehensive and contemporary
approach to solving a number of co-morbid with
homelessness disorders;
The Shelter also implements the indicative prevention
program for young people at risk of drug addiction
(financed by the Drug Prevention Agency of the Ministry
of Health – the state recognises the young homeless as
a group which is vulnerable to drug addiction and co-
morbid disorders);
Shelter for the young homeless Our goal:
to motivate clients to change their current life situation
and modify their attitudes and behaviour connected with
drug using practices;
Activities:
conduct individual assessment of reasons for
homelessness,
choose relevant intervention,
develop new life skills (conflict solving, job preservation,
personal budget management etc.),
cooperate with other organisations and institutions which
may contribute to our clients’ welfare,
work with families of the clients, if possible.
Shelter for the young homeless
Team: addiction therapists, social workers, a
psychiatrist,
6-months contract with a prolongation option
Individual programs to exit homelessness
developed together by clients and their key-
workers
Our clients Polydrug users
The most popular drugs often mixed with alcohol:
Amphetamine
Cannabis
Mephedrone
Heroin „brown sugar”
Since 2008 so-called „smart drugs”
Pharmaceutic over-the-counter drugs in doses
exceeding medical indication (syrups, pills and other
containing benzidamine, codeine, pseudoephedrine,
dextromethorphan)
Our clients
Every year, a number of clients of the Shelter vary from 150 to 200.
In 2011 - 190 clients
In 2012 - 177 clients
Until 31/10/2013 – 184 clients
Clients declared at admission (via special questionnaire):
Problematic use of drugs or alcohol
115 persons (2011)
95 persons (2012)
104 persons (2013)
However, we know that 90% of our clients have experienced drug
use but choose to conceal this fact in the begining, due to different
reasons.
Our clients
Young adults (18-30 years old)
Men and women
Found themselves in the crisis situation due to different reasons and
cannot stay in their previous place of residence any longer – the
young homeless.
Main reasons for their homelessness are:
Conflicts in the family,
Domestic violence,
Addictions,
Mental health problems,
Release from prisons, institutions for minors,
Leaving orphanages and foster families.
Therapeutic Community Method
Why TC?
Tradition of the MONAR Association (the first TC
in Poland established in Głosków in 1978 by
Marek Kotański);
Suitable for work with people having different
problems (addictions, mental disorders, street
children and other);
Therapeutic Community Method..
Partner relations between staff and clients.
Developes social skills.
Allows to observe clients in different daily life
situation.
Atmosphere of openness encourages personal
development.
Therapeutic Community Method..
Participation in decision-making and creating
rules, as well as possibility to express his/her
opinion is especially useful in work with street
children who do not easily resign from their
freedom;
Clear structure, rules and traditions give sense
of security.
Shelter effectiveness
Emancipation: 18,6%;
Undertaken therapy in out-patient or day
treatment centres: 54%;
Undertaken therapy in residential
treatment centres: 2,9%;
Vocational training: 27,4%
Shelter effectiveness
Employment: 49,5%.
Education: 15,9%.
Received entitlement to social pensions:
3,5 %.
Established contacts with family members:
61,1%.
Social housing – 1 %.
Readaptation flats – 1,8 %.
Conclusions
We recommend short-term programs focused on
the needs of the young homeless and
considering their specificity:
Short-term homelessness: usually early stage – below 2
years, or warning phase – 2-4 years of homelessness;
Drug use;
High aggression level – street behavior and culture;
Higher activity;
High mobility level (experienced homelessness abroad);
Need to identify with their peer group.