News

The estimated 20,000 regular street drinkers in the UK are largely ignored by the public, and often by service providers as many of them do not fall under categories such as homeless. Gideon Burrows investigates.

Comedy can be a cutting observer of society. There is a Jasper Carrott sketch where a drunken man stumbles around a park lovingly clutching a nearly empty bottle of Scotch. After falling across a pathway, the tramp sings to himself and barks nonsense at passers-by as they walk the dog or hurry for a bus. Each one stares straight ahead, stepping over him and pretending he's not there. The joke is that whisky is a magic potion: it makes even the most conspicuous person invisible. And they continue to be invisible where service provision is concerned.

The Mental Health Foundation estimates there are up to 20,000 regular street drinkers in towns across the UK. Research shows they drink for the same reasons that many others visit pubs or open a bottle of wine at home: social contact, to help forget problems and to deal with addiction.¹

For many street drinkers inadequate housing, poverty and poor mental health hover around the root causes of their drinking, and their resulting drunkenness denies them opportunities for help.

The starkest example of this vicious circle is the lack of access to housing services. Most street drinkers do not sleep on the streets; they are often overlooked by statutory housing services because they do have a roof over their head. In addition, housing offices, like many others, often refuse to deal with people who are drunk. As a result, they are forced to remain in poor, often temporary accommodation. As Sue Millman, chief executive of the Alcohol Recovery Project says: "People often drink on the streets because home is not a very nice place to be."

The day-to-day health needs of street drinkers are rarely addressed and even the most severe mental health problems can be masked by intoxication. Indeed, many street drinkers' only contact with primary health care is hospital A&E departments after a fall or boozing binge.

Housing, health and social services, mental health services, benefits advice and legal advice are all cut off from street drinkers. Only the police have regular contact, but many drinkers are suspicious. The Criminal Justice and Police Act 2000 which became law on 1 September this year, gave officers the power to confiscate drink from people in the streets and arrest anyone who does not move on after being requested to.

Homelessness charity Crisis is concerned that the new legislation will criminalise an already vulnerable group, stating: "It is fine telling people to move on, but where are they supposed to go?"

The reality is that officers are reluctant to make arrests or pursue street drinkers through the courts. In Brighton, after a by-law banning street drinking was introduced, police struck an informal agreement with a local day centre to move street drinkers there instead of arresting them.

There is very little being done centrally to tackle the problem of service provision for street drinkers. The well-funded and high-profile government rough sleepers unit has a strict remit to help people who sleep on the streets at night.

Lynda Freimanis, formerly outreach service manager at the Drink Crisis Centre (Equinox) in London, and now a consultant for the Finsbury Park Street Drinkers Initiative estimates that one in three street drinkers is housed - and so missed by the rough sleepers unit.

"For groups of people who are street living, not rough sleeping, the situation has become worse in terms of accessing services," she says. "Previously we would have been able to plug street drinkers into homeless services, but because of the tight remit of the RSU, we're not now able to get them into those services."

The unit's remit is to reduce rough sleeping by two-thirds by 2002. A spokesperson told Community Care that they were now looking at how the government works with people who are socially excluded because of their drug and alcohol misuse. A recent survey by the unit, Looking for Change, revealed that half of all people who beg spend money on cigarettes and alcohol, while more than one in three spend most of their money on drugs.²

Sue Millman at the Alcohol Recovery Project says alcohol services are the "poor relation" of drugs services in central government strategy. Owing to a lack of central guidance for purchasers of alcohol services, she says, local responses are haphazard and depend on committed individuals to drive them through.

One of those committed individuals is Tom Preest, street population strategy co-ordinator for London's Camden and Islington councils. Front-line outreach with street drinkers is key to his strategy, and the boroughs share four dedicated workers to engage them.

"Street drinkers in the main are known to the homelessness sector. We want to make contact and key them back into services they may have fallen out of," says Preest.

In a Crisis survey, only half of all street drinkers said an outreach worker had ever approached them.³ Yet researchers assessing the issue of street drinking in Lewisham found that the drinkers crave company. One researcher was even invited to the funeral of a former client.

Outreach work does not, however, tackle the public nuisance of street drinkers. Some local authorities have taken the brave step of opening "wet" day centres. Brighton, Dundee, Leicester, Nottingham and Haringey in London all have wet centres where street drinkers can find the social contact they need, while still being allowed to drink. Each has workers who provide a range of on-site and referral services which don't depend on a client's commitment to tackle their drinking, although services are available if they do want to.

But wet centres do have to deal with the classic "not in my back yard" syndrome. "The objective of such projects should be to wean their clients off alcohol rather than turn loose an army of antisocial alcoholics on a neighbourhood that needs upgrading not downgrading," says an article in one Shepherds Bush residents' association newsletter. The Finsbury Park Action Group in Haringey had to move its own wet centre after complaints from residents and problems with planning permission.

Lynda Freimanis says that effective service provision for this most excluded of communities requires effective local partnerships between agencies, including those not normally associated with street life.

"The treatment of this group of people in primary health care is appalling, for example," she says. "We need to increase awareness and training around working with excluded communities. Services need to be made more flexible."

Street drinking is a local problem that requires local solutions, but services also require central guidance. The rough sleepers unit expects to meet its target of drastically reducing street sleepers while those working with street drinkers are hoping their clients will be next in line.CC

¹ Mental Health Foundation, Too Many for the Road, MHF, 1996

² Department of the Environment, Transport and the Regions, Looking for Change, Rough Sleepers Unit, August 2001

³ Simon Danczuk, Walk on By, Crisis, 2000. Available from 0870 011 3335

Leicester Council: A holistic approach

Leicester City Council realised as far back as the late 1980s that a "dry" policy in temporary hostels and day centres was resulting in people being forced to live and sleep on the streets.

In 1995, after residents called for a by-law banning street drinking, a working group drew up a strategy for dealing with street drinkers who would be affected. Plans included developing a "wet" day centre, an outreach team to address problem spots in the town centre, better community policing, limiting seating in public spaces, and designated drinking areas.

In 2000, the wet centre opened. It enjoys the services of a nurse or GP every day, a social worker two and a half days a week, housing staff once a week, and occasionally a community psychiatric nurse attends. A steering group from health, social services, housing, police and local traders, oversees progress.

Lisa Barker, service manager for hostels and community care at Leicester, says the integrated approach saves the city £114,000 a year in hospital admissions, arrests and unpaid rent.

An informal survey of service users was revealing. One in three said they drank less frequently; one in 10 had reduced the strength of what they drank; and nearly two-thirds said they drank less often outside.