Real Life Stories: How First Base Day Centre helped Joe off the streets

Many of the people we are seeing are new to rough sleeping, like Joe who was helped by First Base Day Centre.  This is his story:

“When Joe first came into our service, he had never before been in the position of rough sleeping.  He was 45 years of age, had worked fairly consistently and always had friends or partners he could rely on if work dried up and he found himself in between jobs.  The recession had meant that he had faced a longer period of not working, his relationship had succumbed to stress and he found himself sleeping on the beach.

“Joe had made a claim for Job Seekers Allowance, but had not received a payment after several weeks.  He had eaten nothing for two days and was embarrassed, he said that he had not washed or changed his clothes for a week.  We made sure that Joe had a hot meal, a change of clothes and was able to use the shower at First Base.

“Joe was assigned a caseworker who met with Joe every day for the following week and it became clear that he was feeling overwhelmed by his difficulties, ashamed and hopeless about his future.   He said that he had visited a railway bridge on several nights in the previous month and had considered throwing himself under a passing train.  Joe disclosed the difficulties that he experienced throughout his life and that these experiences were re-visiting him on a nightly basis and tormenting him.

“Joe’s caseworker referred him to the Mental Health Team, a multi-agency team providing mental healthservices for homeless people, contacted his GP and made Joe an emergency appointment.  The Doctor was sympathetic and offered medication and follow-up visits.

“It was obvious that Joe was in no position to be actively seeking work and he needed a new claim for a sickness related benefit.   Joe was very anxious and physically shaking while he spoke with the Department for Work and Pensions on the phone so his caseworker supported him with the call.  It was a further two weeks and many phone calls later that Joe received any benefit payment.

“Joe met with the Mental Health Team at First Base and they agreed to offer some on-going support, seeing Joe fortnightly, alongside regular contact with his GP and daily support from his caseworker.

“With the support of his caseworker, Joe arranged an appointment with a BHT housing adviser who suggested that he make a homeless application.  His application was rejected due to lack of medical information supporting his case.  As Joe did not have a local connection to Brighton and Hove it was not possible for him to be referred into one of the City’s hostels, so we began to explore the possibility of privately rented housing with support from another BHT project, Firm Foundations.

“Throughout this time, Joe was continuing to sleep on the beach and his mental and emotional state would fluctuate greatly on a daily basis.  Joe made very good use of services at First Base, including volunteering and on good days was able to plan the direction of casework himself.

“Over time, we collected letters from his GP and from mental health specialists involved in his care and re-submitted his homeless application.   With the additional evidence gathered Brighton and Hove City Council accepted Joe’s application for housing.

“Joe is now living in BHT supported accommodation for people experiencing mental health difficulties.  He has key work support from this project alongside specialist mental health support for Complex Post Traumatic Stress Disorder.  He is engaging with alcohol support services and still calls in periodically to let us know how things are for him.”

First Base operates in the centre of Brighton and is the main centre for the provision of support to assist people who are homeless or vulnerably housed in Brighton and Hove to move on from the streets or insecure accommodation and realise their aspirations.  First Base operates client-centred specialist services to support people who are sleeping rough in the city to get off the streets, start realising their aspirations through work, learning and leisure and find a place they can call home. Several services run from First Base including a Healthy Lifestyles Project (comprising the Catering Training Project and Fitness 4 All), PASH (Promotional and Awareness of Sexual Health), First Impressions (CV and Employment Service), Culture (Heritage and Cultural Activities), and Dine, our catering Social Enterprise company.  

Inspiring accounts of recovery from addiction

I sometimes think that, after over 30 years at BHT, there is little more that could surprise me. But two things this evening have impressed on me how wrong I can be.

This evening (17th January 2017) I went for dinner at our Addiction Services, something I like to do every couple of months. It is an experience that never fails to move me. The accounts of how clients are determined to overcome their addictions is humbling, their courage awe inspiring.

One resident moved me to tears. He said that he is sixty and that this Christmas was the first in 50 years that he hasn’t been drunk. He spoke of his gratitude to the service because his gaining sobriety means that his eight year old son will never again have to see him drunk.

Another client was so determined to gain a place in the project that, in order to attend the pre-admission drop-in session, he had walked from Eastbourne (where he was in temporary lodgings) to Brighton, a distance of 22 miles.

i can’t imagine what these two clients must have gone through to achieve what they have. It is far too easy to dismiss those in active addiction. About twenty years ago I heard a worker in a drug prescribing service write off the prospects of recovery and abstinence by using the grotesque expression “once a junkie, always a junkie”. Thank goodness such attitudes have (largely) disappeared. And thank goodness that there are people in recovery who show just what is possible.

Brighton and Hove City Council Budget: My Reaction

brighton-hove-council-logoBrighton and Hove City Council published its budget at 3pm yesterday (30th November). I have reviewed it from BHT’s perspective and have a few observations.

But first, I want to recognise the huge challenges facing councillors. They are trying to cope with unprecedented reductions in funding from central government. I would start by paying tribute to the work of councillors. They will get a lot of criticism, personally and collectively, as well as some personal abuse for making tough decisions caused by circumstances for which they are not responsible. That is unfair.

Of course I am most concerned about homeless people and other vulnerable groups, be they people with mental health and/or substance misuse problems, those escaping domestic violence, and so on.

There are other things that will impact of council budgets, again over which councillors have no control. Welfare reform, not least the benefit cap of £20,000 on households, will see more families losing their homes in high cost areas like Brighton and Hove. There will be greater demands on homelessness services, and the City Council will have statutory responsibility to house many of these households.

All this means that homeless prevention services, like those BHT provides through our advice centres in Brighton, Eastbourne and Hastings, become ever more important. Last year we prevented 2,055 households from becoming homeless.

Can you imagine what would happen if we were not there?

The Council has produced a detailed 98 page summary of its budget proposals. It details cuts, the risk arising from funding reductions, and an assessment of the impact and outcomes of doing so.

There are things I welcome:

  • There are no further cuts proposed in hostel accommodation for homeless people on top of the cuts already announced.
  • There are no reductions in homelessness prevention.
  • There is no reduction proposed in the excellent Mental Health Team for Homeless People.
  • And there is no further reductions proposed in funding for specialist support services given the considerable cuts made in recent years.

There is recognition that recommissioned services are supporting the delivery of the City Council’s Rough Sleeping Strategy to which BHT is an enthusiastic signatory.

Savings of £356,000 proposed from the cost of providing temporary accommodation for homeless households out of Brighton and Hove is ambitious and not without risk and not without its problems such as loss of support structures, disruption to schooling, and so on, but I am reassured that the Council is looking at positive inducements for people to agree to these placements.

A further saving of £550,000 is proposed by prioritising households in temporary accommodation for social housing. If this can be achieved, then it will be good news for families, especially those of the 1,800 children in temporary and emergency accommodation. Inevitably, though, if one group gets greater access to social housing, others will lose out, but from a social and financial perspective, this is a proposal I support.

I do have some big concerns.

There is a proposed £470,000 reduction in funding to the third/charity sector through the new Third Sector Investment Programme. Many small community groups might struggle to survive without this funding. These cuts might also be a false economy. For example, cuts to BHT’s Brighton Advice Centre might see a reduction in the prevention of homelessness resulting in much more costly interventions that the City Council will, by law, have to provide.

First Base Day Centre currently receives a modest £20,000 from this source.  It is essential funding that allows us to continue to provide the services we do to those sleeping rough of our streets.

I was encouraged that the Council is looking at ways of reducing these savings.

I have a mixed reaction to proposals to save £600,000 from community substance misuse services.

The main provider of the Pavilions Partnership, Cranston, has negotiated a reduction in its funding in return for a longer contract. This is commendable.

The proposed £138,000 cut in funding for residential rehab services could be a decision the City might come to regret. If it is to reduce out of area placements I would be quite relaxed about that given that these are rarely effective and a lot of money has been wasted in the past. (People achieving abstinence out of area have limited prospects of remaining abstinent if they return to the City without support structures that are provided in abundance and voluntarily for those who achieve abstinence through a Brighton/Hove based service).

If there is a reduction in funding to the two local residential rehab services provided by the St Thomas Fund and through BHT’s Addiction Services, then I would be very, very worried.

BHT’s Addiction Services are amongst the most effective anywhere in Britain. It is no exaggeration to say that if this service was to be compromised, there will be an increase in drug-related deaths.

I hope that councillors are being well advised regarding this.

Why I strongly disagree with Caroline Lucas over drug consumption rooms

(This item first appeared in the Brighton Argus on 10th November 2016.  For more about my views on drug consumption rooms, please see here and here).

I am really disappointed that Caroline Lucas MP is suggesting that Brighton and Hove introduce drug consumption rooms.

When it was first proposed by the Brighton and Hove Independent Drugs Commission, it became a complete distraction from the much needed debate about treatment and recovery from addiction. It did not enjoy support within professional circles.

img_3827When I spoke at the Drugs and Alcohol Today conference of drug workers at the Amex Stadium in 2013, my uncompromising rejection of consumption rooms was given a very warm reception by those present. (See the Argus report here).

Consumption rooms might have a place in areas with high concentrations of street injecting. Brighton and Hove has its problems, but we do not have anywhere near the same scale of the problem associated with street injecting behaviour as they do in Glasgow.

I rarely, if ever, hear those who advocate this costly measure calling for more funding to go to abstinence-based treatment service. There is plenty of evidence that abstinence-based residential treatment is the most effective way of helping people to come off and stay off drugs, thereby allowing them to make the transition to normal living: accommodation, training and employment.

We surely want to do something far more positive about addiction and recovery than consumption rooms.

Brighton and Hove used to have the unfortunate reputation for being the drug-death capital of Britain. Through the work of many organisations, we have shaken off that sad reputation.  We should now be aiming to become the recovery capital of the UK.

Visible rough sleeping is a direct consequence of austerity

(This item first appeared in the Brighton Argus on 29th September 2016)

People living in tents in Brighton town centre should come as no surprise to anyone. It is a direct consequence of the housing crisis we are experiencing, not least in the south east.

The cost of renting a one bedroom flat in Brighton is now, on average, a little short of £1000 per month, well above the Local Housing Allowance of £612 per month, the amount that people on benefits can claim towards the rent of a one bedroom flat. The LHA has been frozen by central government making accommodation even more unaffordable

The rough sleeping situation in Brighton is more visible than ever before and, notwithstanding the excellent work of the City Council, several charities and others, the numbers on the streets can be expected to increase, an obvious and direct consequence of austerity.

Safety nets are under threat, and many have closed across the country. While those that remain work well for the lucky few, even they are now at risk from cuts and a government imposed cap on charges.

In the past I have been accused of scaremongering. However, the number and high-profile of those on our streets lends support to previous warnings regarding cuts to services and welfare benefits.

Needles in the parks is not something that should be confused with rough sleeping. Drug use impacts on people of all classes, housed or homeless, but needles disposed of carelessly should be condemned by all, as they pose a danger to all, not least rough sleepers.

Why East Sussex County Council is getting it wrong with drug rehabilitation

Last week it was reported that Hastings has the eighth highest rate of drug-related deaths in the country.  The Hastings Observer has carried the story in its online edition today (20th September 2016).  I have been quoted in the article, as has the Leader of Hastings Borough Council, Peter Chowney,and an unnamed person from East Sussex County Council.  (A basic lesson in PR is not to hide behind an anonymous ‘spokesperson’).

The County Council spokesperson is quoted as saying that the Council places people out of area.  Here is my response to the approach that is being taken by the County Council:

“I was very disappointed by the comments from East Sussex County Council on its policy to place people out of the county as it claims that people have a better chance of success away from any negative influences in their home area.

“That view harks back to the 1990’s. It is now widely recognised that in order to help people sustain abstinence and recovery, they need to do so in the area where they are already settled.  If someone does well out of area and then returns home, they have no support structures and are far more likely to relapse which is a tragedy for the individual and a waste of public funds.

“BHT Sussex’s Addiction Services only work with people from within the Brighton area. Since we made that change in the 1990’s, the long term success rate massively improved, and there is now a large and healthy recovery community in the City, partly due to the numbers who have gone through our rehabilitation services.

“The drop-in centres described, while sometimes reducing harm, tend to result in people remaining on substitute drugs like methadone for far longer than needed, and the majority of people on methadone continue to ‘top up’ with street drugs.

“The fact that Hastings has now such an acute drug problem and has the eighth highest rate of drug-related deaths in the country may well be to do with the out-of-date approach taken by the County Council and why, by contrast, the situation in Brighton has been improving.”


Hastings has the eighth highest rate of drug-related deaths in England and Wales

Many years ago Brighton and Hove had the unenviable reputation for being the ‘drug death capital of Britain’. Over the years, through some great work between partners including the charity Change Grow Live (CGL, formerly CRI), the heath service, the City Council, and Brighton Housing Trust, the rate of drug related deaths reduced.

There is still a major drug problem in the city, and still far too many people are dying, but the rate has reduced considerably.

naloxoneI am particularly proud of the contribution made by our Phase One Project (where with CGL we helped to pilot life-saving interventions such as Naloxone) and our Addiction Services (where large numbers of people put down the foundations for life-long abstinence and recovery).

Brighton has always had a higher rate of drug-related deaths than elsewhere in Sussex. But that is no longer the case.

Between 2013 and 2015, there were 7.5 drug-related deaths per 100,000 of the Brighton population. During the same period, Hastings had 9.1 such deaths per 100,000 of the population. I understand that this is the eighth highest rate in England and Wales.

Behind these tragic statistics are the lost lives of someone’s brother or sister, son or daughter, mother or father.

The tranquil gardens at the Recovery Project, part of BHT’s Addiction Service

As with Brighton fifteen years ago, these statistics should ring alarms and be a call to arms for East Sussex County Council, the NHS, Hastings Borough Council, and others.

Unlike Brighton and Hove where we have two first rate residential rehab services, East Sussex have none. Perhaps these deaths will provide the catalyst to rectify this.

(This is the unedited version of my latest Brighton Argus column, first published on 14th September 2016)