Portsmouth City Council funds a project providing specialist support to rough sleepers with drug or alcohol issues and those at risk of rough sleeping. A multi-agency and multi-disciplinary team work in the community to help people access treatment, psychological support and accommodation.
The challenge
People who experience rough sleeping have some of the worst health and wellbeing outcomes in England. According to the charity Crisis, the longer someone experiences rough sleeping for, the more likely they are to develop additional mental and physical health needs, substance misuse issues and contact with the criminal justice system. The more complex someone’s needs, the more help they will require to move on from homelessness and rebuild their lives.
The number of people sleeping rough in England on a single night in autumn 2023 was estimated to be 3,898 (HM Government ‘Rough sleeping snapshot in England: autumn 2023’). The majority of rough sleepers are male, aged over 26 and from the UK.
Like many cities, Portsmouth has an ongoing issue with homelessness and rough sleeping. Between July 2022 and June 2023 there were an average of 19 rough sleepers per night, with another 100 people accommodated in the rough sleeper accommodation pathway at any one time. Portsmouth has an ambitious homelessness strategy, and in 2022 Portsmouth City Council was awarded funding through the Government’s rough sleeping drug and alcohol treatment grant.
Specialist support
Portsmouth City Council commissions the Society of St James (SSJ) to provide the city’s drug and alcohol treatment service, and additionally to provide outreach, day service and hostel accommodation for homeless people. The rough sleeping grant funding has enabled the creation of a new multi-agency and multi-disciplinary homeless drug and alcohol team.
SSJ acts as the lead agency and host organisation – providing recovery workers, life skills workers and peer mentors. Working alongside them is a Portsmouth City Council social worker, along with a psychologist and assistant psychologist from specialist voluntary sector partner Outcome Home.
The team is based in offices at Portsmouth Central Library but outreach is a key part of their work. In reality, that means they are integrated within existing services such as the SSJ outreach team, rough sleepers’ accommodation and other temporary housing projects across the city.
They work on a flexible basis between 6am and 7pm, seven days a week, depending on the needs of service users. A duty telephone line is available for service users and colleagues to contact for support and advice.
The team undertakes harm reduction work and supports people to access specialist treatment, enabling them to move along the supported housing pathway. Team members work closely with the council’s housing department and with hostel providers, who report that they find the support for residents very valuable.
In the first year of the project, support was available to people sleeping rough in Portsmouth or who had accessed emergency accommodation during the COVID-19 pandemic. In year two, this was expanded to include those at risk of returning to rough sleeping – people known to have substance misuse needs whose escalating behaviour meant they had received eviction warnings.
Sabrina Davis, Project Manager, said: “While we are a substance misuse service for those with co-occurring conditions and complex needs, we work in a holistic and trauma-informed way. This means that the priority is on building relationships of trust and working to understand what people want and need from us.
“Often what someone needs may not be in relation to their substance use. There may be areas to address such as their basic needs of shelter, food and safety.”
Impact and challenges
During 2022/23, the first year of operation, 60 cases were closed as either successful or transferred to the main support service (no longer rough sleeping or at risk of it). Twenty-seven people were supported to access detox and/or residential treatment. As of February 2024, the team was working with 125 people, with an average caseload of 15 per recovery worker.
Challenges encountered by the team include:
- Current housing provision (large hostel accommodation) does not meet the needs of everyone, and there are some complex cases with no housing plans available.
- The number of rough sleepers continues to rise.
- A lack of housing stock means it is difficult to move people through the housing pathway into self-contained independent accommodation.
- Grant funding (until March 2025) creates some uncertainty.
- The drug market is changing, with more potent substances such as synthetic opiates providing new challenges.
The team created a short service users’ survey to improve practice and service delivery and as a way to measure outcomes. By February 2024 there had been 62 responses. When asked ‘how would you rate your overall experience of our service’ using a scale of one (negative) to 10 (positive), 50 per cent of service users rated it as ‘10’, 26 per cent as ‘9’, 19 per cent as ‘8’ and five per cent as ‘6’.
The narrative responses included:
“Kept me sane and got me into treatment. Saved my life. Kept supporting me even though I made mistakes and encouraged me to continue with my recovery. Gave me hope for the future.”
“I felt that I had belief and comfort from them. When I was ‘triggered’, I was able to regain control of my emotions more quickly than ever before because my worker believed in me and remained a calm and reassuring presence.”
“You were there when I needed someone.”
“I was put on a script that day which supported me in my need to stop using opiates. I then very quickly accessed rehabilitation. I was kept informed and in the loop throughout my treatment…I got what I required.”
Contact
Sabrina Davis, Project Manager, Homeless Drug and Alcohol Team, Society of St James: [email protected] or Alan Knobel, Public Health Principal, Portsmouth City Council: [email protected]