To Dance With GraceTo Dance With Grace

Outreach & Engagement To Drug Outreach & Engagement To Drug Users On The StreetUsers On The Street

Outreach is viewed as a process rather than an outcome, with a focus on establishing rapport and a goal of eventually engaging people in the services they need and will accept

Outreach work is based on a foundation Outreach work is based on a foundation of strong values, principles and unique of strong values, principles and unique worker stances worker stances

Engagement is the key in Outreach Engagement is the key in Outreach The outreach is designed for are those The outreach is designed for are those

who are unserved or underserved by who are unserved or underserved by existing agencies and who aren’t able or existing agencies and who aren’t able or are service resistant to seek services are service resistant to seek services from those agencies from those agencies

The goals of outreach are to develop The goals of outreach are to develop trust, care for immediate needs, provide trust, care for immediate needs, provide linkages to services and resources, and linkages to services and resources, and to help people get connected to to help people get connected to mainstream services and ultimately into mainstream services and ultimately into the community through a series of the community through a series of phased strategies phased strategies

Effective outreach has been Effective outreach has been demonstrated, with positive outcomes demonstrated, with positive outcomes

Peer based outreach and the use of the Peer based outreach and the use of the expertise of homeless and formerly expertise of homeless and formerly homeless persons and consumers are homeless persons and consumers are valued and should be actively sought outvalued and should be actively sought out

Discrimination and marginalisation are Discrimination and marginalisation are

part of the experience of both outreach part of the experience of both outreach clients and workers; as a result, clients and workers; as a result, advocacy must take place at all levelsadvocacy must take place at all levels

Outreach services cannot exist in Outreach services cannot exist in

isolation isolation

Values & Principles Of OutreachValues & Principles Of Outreach

A person centered orientation: a A person centered orientation: a philosophy which aims to restore dignity, philosophy which aims to restore dignity, dealing with clients as people dealing with clients as people

A recognition of clients' strengths, A recognition of clients' strengths, uniqueness, and survival skillsuniqueness, and survival skills

self-determination: facilitated by self-determination: facilitated by presenting options and potential presenting options and potential consequences, rather than solutions , by consequences, rather than solutions , by listening to clients rather than "doing" for listening to clients rather than "doing" for them, and by ensuring a balance of power them, and by ensuring a balance of power between individuals and outreach workers between individuals and outreach workers

Goals of OutreachGoals of Outreach

Our main goals of outreach are:Our main goals of outreach are:

Firstly to care for immediate needs, Firstly to care for immediate needs, including to ensure safety, provide crisis including to ensure safety, provide crisis intervention, refer to immediate medical intervention, refer to immediate medical care, and help clients with immediate care, and help clients with immediate needs. needs.

To develop a trusting relationship To develop a trusting relationship To provide services and resources, To provide services and resources,

whenever and for as long as needed whenever and for as long as needed To connect clients to mainstream services To connect clients to mainstream services

Worker StancesWorker Stances

These characteristics are critical These characteristics are critical because successful engagement will because successful engagement will largely be determined by the largely be determined by the relationship between clients and relationship between clients and workers. We have found effective workers. We have found effective worker characteristics include:worker characteristics include:

Good judgment, intuition and street sense: Good judgment, intuition and street sense: this includes safety for themselves and the this includes safety for themselves and the client-being observant and vigilant, as well client-being observant and vigilant, as well as using good common sense. Strategies as using good common sense. Strategies include going out with a partner, avoiding include going out with a partner, avoiding closed, remote or dangerous areas, closed, remote or dangerous areas, developing a relationship with local police developing a relationship with local police dressing appropriately, and assessing dressing appropriately, and assessing situations before actingsituations before acting

Non-judgmental attitude Regardless Non-judgmental attitude Regardless of the worker's personal beliefs, no of the worker's personal beliefs, no behaviour on the part of the client is behaviour on the part of the client is judgedjudged

Team player: Workers must know Team player: Workers must know when to ask for help, from getting when to ask for help, from getting backup on the streets to a second backup on the streets to a second opinion in clinical assessments. opinion in clinical assessments. Outreach staff must have a strong Outreach staff must have a strong commitment to the "team" approach commitment to the "team" approach to service delivery to service delivery

Flexibility: Outreach workers are Flexibility: Outreach workers are flexible in reassessing daily work flexible in reassessing daily work priorities, in setting work schedules, priorities, in setting work schedules, and in the treatment planning and in the treatment planning process, and contentprocess, and content

Realistic expectations: Workers Realistic expectations: Workers have an "expectation of non-have an "expectation of non-results." They understand that they results." They understand that they will not be able to "cure" or "save" will not be able to "cure" or "save" clients, and at the same time clients, and at the same time continue to persevere. continue to persevere.

Commitment: Outreach workers are Commitment: Outreach workers are both consistent and persistent in both consistent and persistent in their dealings with clients. They do their dealings with clients. They do what they say they are going to do what they say they are going to do and only make promises they can and only make promises they can keep. They are in it "for the long keep. They are in it "for the long haul" and continue to persevere. haul" and continue to persevere.

Commitment: Outreach workers are Commitment: Outreach workers are both consistent and persistent in both consistent and persistent in their dealings with clients. They do their dealings with clients. They do what they say they are going to do what they say they are going to do and only make promises they can and only make promises they can keep. They are in it "for the long keep. They are in it "for the long haul" and continue to persevere. haul" and continue to persevere.

Less is more. At the outset of Less is more. At the outset of intervention, there is less intervention, there is less application of intensive and costly application of intensive and costly treatment, less professional treatment, less professional distancing, less rigidity, less distancing, less rigidity, less intrusiveness, and less directive intrusiveness, and less directive ness. Services offered are purely ness. Services offered are purely voluntary.voluntary.

Sense of humour: the ability to use Sense of humour: the ability to use humour at appropriate times, as well as humour at appropriate times, as well as maintaining as sense of humour during maintaining as sense of humour during difficult times is essential. difficult times is essential.

Creativity & resourcefulness are Creativity & resourcefulness are strengths that outreach workers tap into strengths that outreach workers tap into daily. daily.

Cultural competency: Workers Cultural competency: Workers demonstrate competence across demonstrate competence across ethnicity, gender, transgender, lifestyle, ethnicity, gender, transgender, lifestyle, and age spectrums. and age spectrums.

Resilience: Workers are resilient Resilience: Workers are resilient and patient in a work environment and patient in a work environment marked by high turnover, difficulty marked by high turnover, difficulty tracking clients, high stress, lack of tracking clients, high stress, lack of resources, and lack of immediate resources, and lack of immediate improvement in the clients they improvement in the clients they serve. Effective workers are able to serve. Effective workers are able to continue working despite the continue working despite the difficulties endured by their clients, difficulties endured by their clients, without personalising them. without personalising them.

Mobile or FixedMobile or Fixed??Outreach may be mobile or fixed depending on the needs of the target population.

Our Outreach takes place on the streets, as well as in shelters, drop-in centres, hospitals, and prisons

But an option is do both……………

NEON & LTMPNEON & LTMP

NEON – Needle Exchange Outreach NEON – Needle Exchange Outreach NetworkNetwork

Low Threshold Methadone Programme Low Threshold Methadone Programme

NEONNEON

Streetwork and Backpacking With HOPStreetwork and Backpacking With HOP

Outreach with SCOTPEPOutreach with SCOTPEP

Van Based Exchange in Landward Van Based Exchange in Landward AreasAreas

LTMPLTMP

Same stances as Outreach despite the Same stances as Outreach despite the fixed nature:fixed nature:

• Client CenteredClient Centered• Open accessOpen access• Works At Clients PaceWorks At Clients Pace• Short Term Achievable GoalsShort Term Achievable Goals

Our ServiceOur Service

Streetwork in Central Edinburgh 7 Streetwork in Central Edinburgh 7 days a weekdays a week

Backpacking 5 shifts a weekBackpacking 5 shifts a week Drop in duty systemDrop in duty system Evening and Weekend ServiceEvening and Weekend Service Needle Exchange 365 daysNeedle Exchange 365 days Multidisciplinary TeamMultidisciplinary Team

But………..But………..

Not a complete solution in itself Not a complete solution in itself

Can be a lengthy processCan be a lengthy process

And without joined up working ?And without joined up working ?

Think of it as a tool…Think of it as a tool…

Some ExamplesSome Examples

Client P and accommodationClient P and accommodation

Client C and exchangeClient C and exchange

NEON FiguresNEON Figures

With Paraphernalia Especially WaterWith Paraphernalia Especially Water

With Waiting Lists….With Waiting Lists….

With Flexible Services Including With Flexible Services Including

Opening times..Opening times..

HelpHelp