IN APRIL 1993 I was 23 and had recently been made unemployed, so I started volunteering every Sunday night with a charity in London that ran a night shelter on Dean St in Soho.
The shelter provided emergency night-by-night accommodation for men and women between the ages of 16 and 25, people who were sleeping rough, many of whom were using drugs and alcohol to problematic levels and were often involved in other activities that were criminal or considered antisocial – shoplifting, begging, sex work and so on.
The approach taken by the team at the night shelter was one of acceptance and inclusion; we talked about and practiced being non-judgmental. From sex workers to pimps, from drug users to street dealers – we worked with anybody that needed our service, because we recognised the potential of each and every person we worked with.
Looking for help
One cold, dark and wet Sunday evening a young woman, about 18 years of age, banged on our door looking for urgent help. I went to the front door with the team leader and we talked to her at the door.
She was frantic, telling us her boyfriend had assaulted her and was going to make her go out into the streets that night to do sex work. As we spoke, her boyfriend appeared and the situation quickly became very dangerous. She did not want to go with him and at one point he grabbed hold of her arm and tried to drag her off.
She screamed for help and it ended in a tug of war between us and him – with us pulling her inside to safety. He tried to kick down the door but, thankfully, he left when he realised that the door would not give and probably for fear that the police may arrive following all the commotion.
Help and support
We got the first aid box, put the kettle on and sat down on the sofa giving the young woman help and support. She was well known to the staff at the shelter and we knew she had been on and off the streets since her early teens, that she had problems with drugs and that her boyfriend was understood to act as her pimp.
After thirty minutes she began to talk about how much she loved her boyfriend and how she needed to go to him. We talked with her, we tried to convince her to stay in the shelter for the night but the pull of the streets and the need for drugs was too great and she headed out into the night once more.
The following Sunday at the night shelter in the staff briefing, before the service opened, we learned that she had been booked into the night shelter during the week and that our team had successfully referred her on to another hostel – where she would have 24-hour access, be better able to stay away from the streets and get more help and support.
We were told that her now ex-boyfriend was booked into our shelter for the night. There was concern because only a week previously we had had a difficult situation to manage with him. However, whether he needed, or deserved, to be supported never came into the team’s discussion.
When he came in he was in a bad way – his drug use was off the scale, he had been beaten up that day, he was physically emaciated, he had an abscess in his groin from injecting and he hadn’t slept in a bed for months. We took him in, welcomed him, kept him safe and did everything we could to help him.
People at their lowest ebb
Ultimately, I don’t know what happened to either of them, but that is the nature of the work. That is, to work intensively with someone when they are at their lowest ebb, do your very best by them and then refer them on to another service that can meet their needs – detox, stabilisation, respite care, housing etc. Then support the next person who needs your help.
I learned very early on, from this experience and many others like it, that relationships on the streets are complex, that people often have very complicated health needs and that their associated problematic drug and alcohol use is a symptom of wider problems in that person’s life.
In 2000 I moved from London to Dublin and I’ve worked there ever since. For the last 12 years, almost half of my career, I’ve been CEO of Ana Liffey Drug Project and I am proud to say that our team carry out innovative work with people every day, people who remind me of those two young people I worked with in London.
Dublin is a small capital city by global standards and yet we have the types of street life problems that can be found in any megacity: begging, public consumption of drugs and alcohol, street homelessness, and so on.
Better outcomes
If we want better outcomes for people who have such complex and multiple needs, the single most important thing we can do is maintain engagement with them. This isn’t always easy for family and friends – because it’s not just a stressful life for the person caught up in these situations, it’s stressful for their loved ones too.
This is why inclusive services with very few rules are so important to develop and maintain. They keep the connection with people alive. They implicitly tell the person they are valued. They do the hard work that others can’t or won’t do. They are important, they provide the bed rock for people to make healthier choices in their lives.
If you were to end up isolated due to a spiralling problem with drugs or alcohol I hope you’re fortunate enough to have a ‘low threshold – harm reduction’ service in your area. The staff there will work to keep you healthy and alive, whilst seeking every opportunity to motivate you to make healthier choices.
25 years after that night in 1993 the need for ‘low threshold – harm reduction’ services remains and that will always be the case. For without positive engagement there is no meaningful connection and without that there is less chance of a positive outcome for people.
Tony Duffin is the CEO of Ana Liffey Drug Project a ‘Low Threshold – Harm Reduction’ Service, established in 1982 and currently working in Dublin and the Mid-west Region of Ireland. For more information about the Ana Liffey visit aldp.ie. You can watch the TEDx talk ‘Making the case for Supervised Injecting Facilities’ by Tony Duffin here.
To embed this post, copy the code below on your site
have your say