Beggars belief

Many of those begging on the streets are fighting drug, alcohol
or mental health problems. Recent government research found that
more than 86 per cent of beggars reported using drugs, with heroin
and crack prominent. Moreover, a study of beggars by Glasgow
University found that nearly half had been in council care. But is
the answer to force them into treatment?

The government thinks it is and has shown its hand by publishing a
white paper, Respect and Responsibility. Among the
proposals are one to make begging a recordable offence and another
to coerce drug users into treatment. Although not included in the
Antisocial Behaviour Bill the proposals could yet be
introduced.

But evidence from homelessness charity Centrepoint’s work with
chaotic drug users suggests that coercion and rigid regimes are not
effective. Young people entrenched in drug use are unlikely to
respond well to the enforced treatment proposed by the white paper.
Services must allow them to work at their own pace.

Rather than an initial approach based on reduction and abstinence,
there is a need to take a step back and begin the slow process of
building a young person’s trust as a basis for increasing their
motivation to address their drug use and complex inter-connected
issues. Centrepoint workers suggest it can take three months to
help someone stop using additional drugs on top of a prescription
for methadone, let alone to start to address deeper issues. By
using the criminal justice system as a gateway to coerced
treatment, the government is in serious danger of setting
vulnerable people up to fail. This may reinforce their exclusion
and could make it more difficult for them to remain motivated in
the future.

It is true that some young people will benefit from treatment, but
appropriate drug treatment services are scarce. Centrepoint has
found a lack of detoxification, rehabilitation and stabilisation
units and waits of six months or more to enter detoxification
programmes. Drug use often masks other underlying problems which
may need a far wider response than treatment alone. The lack of
appropriate supported housing for drug users continues to be a
major flaw in the system. The reality is that young people who use
drugs are often excluded from homelessness services and given the
message that they are “too difficult” to work with.

Even when young homeless people do complete treatment programmes
the problems continue. In the foreword to Labour’s Updated Drug
Strategy 2002, home secretary David Blunkett admitted that
accessing after-treatment services “can be a lengthy and difficult
process”. At this stage supported move-on accommodation is needed
for progress. But all too often, the good work is undone because
people end up in inappropriate hostel accommodation, surrounded by
chaotic drug users and lacking support.

The government’s decision to refocus the drugs strategy on
problematic drug misuse (specifically heroin and crack) and harm
reduction is welcome. But the basis for accessing treatment is
still weighted towards the criminal justice system. More than
11,000 drug treatment and testing orders have been handed out since
their introduction in October 2000. Yet evidence suggests that they
are not an effective response to offenders deeply entrenched in
drug use who often need an intensive period of therapeutic work
before they are ready to begin to address their issues.

Interventions need to be made a lot earlier than at the point of
arrest if the cycle of homelessness, drug use and offending is to
be broken. In addition, a range of support services for homeless
young people is needed; not just when crisis point is reached but
when they first become homeless and before drug use
escalates.

Arresting and coercing someone into treatment for begging will
further alienate them from society. For this we need early
intervention, immediate and flexible treatment services and
appropriate supported housing.

Ellie Lewis is a policy and research officer at
homelessness charity Centrepoint. Contact her at
elewis@centrepoint.org