Don’t look now

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.