Developing a Range of Effective Responses

Una Munro

the

mungo

foundation

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Introduction

     

Who we are What we do A case study Key lessons New developments Conclusion

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Who we are

the

mungo

foundation 1st April 2004

Previously the Archdiocese of Glasgow Community Social Services

• 38 Projects/Services • 5 Service Areas : • • • •

Learning Disabilities/Sensory Impairment Mental Health Elderly/Dementia Young People Homelessness & Substance Misuse

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Young People, Homelessness and Substance Misuse

• Red Tower years +) - Residential 12 week providing detoxification, respite and short term rehabilitation (18 • De Paul House accommodation homeless (16 – Supported for – 25 years) young • Fairstart – Supported Accommodation for mothers with children aged 0 years (16 – 25 years) young – 10 • • • London Road – Rough sleepers projects (12 week) (16 – 25 years) A S I S T – Outreach support for vulnerable young people (16 – 25 years) Ar Caladh providing support – Residential facility to medical and vulnerable social young people experiencing with drug and alcohol use difficulties 4

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Red Tower Case Study Stage One (1990-1995) Approx

Context Client Profile Gender (mixed) IV Heroin use Average age 25 Criminal justice involvement Family support Targeted Outcomes Abstinence Return to the community Chaotic IV Drug Misuse Response to possible HIV epidemic Jointly registered: Nursing Home & Residential Social Care Programme Outreach 24-hour nursing care Visit-contracted GP Medically supervised detox Structured group work programme Key worker system Basic assessment 7

Context

Stage Two(1995-1999)

Recognition of underlying issues Introduction of comprehensive assessment Change in ethos (individualised) Formal referrals by local authorities Client Profile Average age 23 Polydrug use Hep C HIV education Co-Morbidity Mental health Homelessness No family support Programme Introduction of Europ-ASI Assessments Enhanced key worker system Individualised Detox Structured group work - phased approach One to one (workbooks) Community links Partnership working Targeted Outcomes Improved health Abstinence or stabilisation (linked with GP) Establish client’s links with community Aftercare/self-help groups/care manager Accommodation 8

Stage Three(1999-2005) Approx

Context Glasgow City Council/Greater Glasgow NHS Board joint review of purchased addiction services Capacity building Client Profile Drug and alcohol & stimulant misuse Most chaotic & vulnerable lifestyles Homelessness/mental health issues Recognitise parenting responsibility Programme Single shared assessment Individualised detox Child protection in projects Parenting interventions/equality issues Training & employment pathways Basic living skills in programme Treatment options for stimulant users Targeted Outcomes Drug-free or stabilised on prescription Positive relationship with partner agencies Understanding of care plan & development issues Improved relationships with family /understand child issues Next stage in care plan agreed i.e. rehab aftercare, supported acc 9

Key Lessons

Phased Approach More manageable Outreach Pre Entry Support Environment The importance of creating a positive socially inclusive culture, which includes mainstreaming equality as a core ethos of management and all staff Staff training Client Centred Approach - Working with individual at his/her own pace.

- Helping them to identify and work on their own identified issues to allow them to achieve positive steps forward in their lives.

Comprehensive Assessment motivational levels) The Vision that underpins all our services and all that we do This vision has developed as a result of our own experiences of working with vulnerable socially excluded people for over 20 years within Glasgow Communities - A holistic review of where the individual is at, using the SSA, and establishing where they wish to go (assessment of Partnership Working - Throughout all phases Medical/Health Psychiatric Employment and Training/Support Drugs Alcohol Family/Social Psychological Housing/Resettlement Support

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Young People, Homelessness and Substance Misuse

Supported Flats Red Tower

Drug detox Short term rehab 12 week programme

A S I S T

Outreach support 12-25 years

Ar Caladh

Assisted withdrawal residential care home 16-21 years 12 weeks

De Paul House

Housing support Care support Homeless young people 16-25 years

London Road

RSI Project 12 weeks 16-25 years

Long Term Drug Rehab

18+ years

Fairstart

Housing Support 16-25 years 11

Ar Caladh

Intensive Support for Young People

Provides For individuals with intensive support needs including the following:

• • • • • • • •

Residential treatment providing specific health related services Assisted withdrawal and an enhancement of mental health provision Short term rehabilitation Capacity to accommodate 8 young people Drugs and or alcohol issues Mental and/or physical health issues Homelessness issues Social instability

Importance – Alternative prescribing 12

Long Term Drug Rehab

Provides For individuals with a complexity of issues including:

• Mixed sex core residential settings for 10 service users • Severe drug dependency • • Gender sensitive, flexible therapeutic programmes and • Mental health issues • Length of stay determined by the individual’s progress between 6 – 9 months • • Currently homeless Risk of serious illness/death It will prepare individuals for the most sustainable accommodation appropriate services.

form and of into • Unsuitable for services more structured 13

12 Supported Flats

 Providing a stepping stone to independent living for service users from Red Tower  Provided throughout the Glasgow area  Offering housing support, relapse prevention and access to appropriate services for those individuals who can sustain themselves in the community with the necessary support 14

Conclusion

Developing a range of effective responses depends on 2 key factors

1 Getting the Basics Right

• Effective Assessment Tools • • • Safe secure environment • Flexible detox • • User involvement • • Appropriate interventions • Non discriminatory ethos Flexible tailored programmes Well-trained staff Gender sensitive groups User involvement 15

2 But it goes deeper than that. It is about the values and principles that underpin service provision

• The service needs to be client driven • It is about empowering the clients to take ownership and understanding of their issues and working through them • The atmosphere is crucial judgemental – it must be supportive and non • Staff have to work at clients’ own pace – measuring success in tiny steps • Service users must feel that they have long term goals which they can buy into 16

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The key is to develop relationships built on trust mutual respect.

and

•

Only then will an individual start to re-discover their self esteem and sense of worth, allowing them to start to tackle some of their issues.

FINALLY

If you have the basics and the right Values, Principles and Practices you can develop a whole range of services to meet the complexity of each individual’s needs.

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