A recent EUDA webinar heard about what works best in delivering successful reintegration programmes without the need for abstinence, and with a focus on dignity, health and genuine opportunity. DDN reports.
‘Too often reintegration is treated as something people must earn, most commonly through abstinence,’ EUDA’s scientific analyst Eliza Kurcevič-Ramonė told the agency’s Care without conditions – housing-first and employment-first approaches webinar. ‘But when abstinence becomes the gatekeeper it can end up excluding the very people who most need stability, healthcare and safety.’ Social inclusion was not a ‘reward at the end of the journey’, she said. It was what made change possible.
‘People are not unfit,’ Cristiana Merendeiro of CRESCER told the webinar. ‘More often, it’s existing responses that fail to meet their real needs.’ CRESCER is a Lisbon-based organisation committed to both housing-first and employment-first approaches and believed that genuine solutions always began with participation and listening. This meant ‘creating spaces where people’s voices are heard and valued, and integrated into project design and implementation’.
Paid participation
Around 30 per cent of CRESCER staff were people with lived experience, she said, and peer workers were involved in every project it delivered. The organisation had developed a training and labour market integration programme, partnering with Lisbon hotels and a tourism school alongside official employment and training bodies. It also ran successful restaurants as well as canteens located in the headquarters of large companies.
The programme consisted of a one-month theoretical element and five months of on-the-job learning, followed by either a professional internship or direct entry into the labour market. All participants were paid, she stressed, with around 50 per cent who completed the on-the-job training successfully entering the job market.
CRESCER’s housing-first programme also took a ‘fully individualised’ approach, with the aim of promoting genuine autonomy. Tenants were the drivers of the project, she said, setting their own goals and housing rules, while those with an income contributed 30 per cent to the project. ‘These are individuals who’ve been living in extreme vulnerability, often with multiple co-morbid conditions’, and the project imposed no preconditions regarding abstinence or treatment. ‘In fact the most complex and vulnerable cases are the ones that are prioritised.’ Providing stability allowed the project to then work on health, safety and social integration from a ‘place of trust and dignity’, she stated.
Reframing use
The programme had grown from seven to more than 150 houses over the course of a decade and now operated in three cities, with 90 per cent of those supported not returning to homelessness. It took the approach of ‘reframing’ substance use, she explained, recognising that it was a complex phenomenon. The aim was to understand the role it played in that person’s life without moral judgement, and ultimately to co-create realistic alternative pathways aligned with the person’s goals, capacities and circumstances. ‘Change isn’t imposed, it’s built collaboratively,’ she said. ‘We’re not just talking about providing a roof here, we’re talking about security, autonomy, privacy and the sense of ownership’ that came with having a home.
‘Our mission is to be there for everyone who’s struggling and has nowhere else to turn’ said Els van Koeverden of De Regenboog Groep, an Amsterdam-based organisation that supported people facing marginalisation by providing low-threshold, harm-reduction based services. The organisation had around 400 employees and 1,500 volunteers, and operated day shelters, drop-in centres, consumption rooms and street-sweeping teams alongside restaurants and cafes, offering more than 350 paid work reintegration places.
‘We try to offer opportunities in places near where people are, and participation is unconditional,’ she said. ‘People are always welcome regardless of mental health problems, drug or alcohol use or housing situations’, and the organisation also did its best to offer a genuinely diverse range of work. ‘Wherever someone is in his or her life, we try to offer something that fits’. The focus was on the positives, she said. ‘It’s a progress-oriented approach, looking at what people can do, their capabilities, skills, motivations and desires. If someone doesn’t want to do something we try to motivate them, but we’d never force.’
Strong networks
The organisation was part of a strong and diverse network in the city, collaborating with other mobile outreach teams as well as a range of social enterprises and companies – including a major bank – for external placements and internships. One innovative scheme was a successful Amsterdam walking tour conducted by people who who’d been formerly homeless.
The first connection was often made through a drop-in centre based in a bus, she said. ‘It’s a place where people can use, and it’s where people come who are never in contact with any social work, healthcare or any other kind of institution at all. So we can get to know them there – it’s a first step to motivate them to a new direction.’
‘The introduction of lived and living experience in the sector may have been seen as tokenistic before, but it really isn’t now – there’s a real culture change,’ said Lewis Boddy of the Scottish Drugs Forum (SDF). SDF had launched its award-winning national traineeship as a small pilot in 2004, with the aim of breaking down barriers to entering the workplace. ‘The traineeship is a unique combination in terms of the quantity of training, the bespoke support, the practical element and the paid element,’ he said.
Many of the trainees came from backgrounds of intergenerational unemployment and areas of multiple deprivation, he said, with the project giving them an element of financial independence they’d never experienced before. ‘They show up as real role models within their family, their local community, their peer groups, and it’s really tackling that stigma around employing people who have a history of substance use.’
Wrap around support
Trainees had paid employment with SDF for a period of nine months, as well as a practical work-based placement with another organisation – primarily drug and alcohol services, but also advocacy, criminal justice and homelessness services. There were also more than 30 pieces of bespoke training, he explained. ‘It’s a really intensive combination of professional and personal development, and this is all wrapped around with intensive pastoral and employability support. So at the end of the nine months they’ve got the qualification and the practical work experience, but they’ve also got the confidence and self-belief to be moving into mainstream employment.’
Rigorous procedure
However, the traineeship was like ‘applying for any other job’, he stressed, with a rigorous recruitment procedure. Spaces were limited ‘so we really need to make sure people know what they’re applying for, and that they feel ready for employment’, he said. But people who were still using drugs or were on medication assisted treatment were fully included, and there was extensive pre-employment support to identify needs and find out ‘where they’re at in terms of their own life, their family life, their recovery, and how to make sure they can fully make the most of the traineeship while they’re on it’.
The outcomes had been ‘fantastic’, he told the seminar, with 90 per cent of people successfully completing the traineeship and 85 per cent securing other paid employment by the end. Over the 20 years it had been running, many trainees had gone on to managerial posts and were now hosting and mentoring trainees themselves, he added.
On the question of getting the wider community’s buy-in for projects there were ‘different levels’ of engagement, said Merendeiro. ‘We do a lot of advocacy work, inviting decision makers to come and see the projects, visit the houses, and talk with people directly – the tenants are strong advocates.’ SDF’s traineeship project had been met positively, but there were inevitably still challenges, said Boddy. ‘Some of the stereotypes and stigma are still fairly prevalent, and part of our work is about challenging that.’
However, work and reintegration projects were a perfect opportunity to bring different worlds together, said van Koeverden. ‘It’s not just about the people, it’s also about what they make and what they deliver. We have several restaurants with nice food in beautiful environments – so people come to enjoy the place, but they also meet the people who make the food.’
Many of the SDF trainees had had interactions with the criminal justice system, said Boddy, and were having to navigate the ongoing barriers associated with that. ‘So it’s about supporting people in overcoming those challenges in getting the qualifications and skills and becoming employable.’
‘We’re very much on the same page,’ van Koeverden told the seminar. ‘But we treat people as normal employees, so if they create an unsafe environment for other people then that is a problem. But the second chance is always there.’
When it came to advice for any organisations looking to set up similar projects, engaging with the group you want to help from the very beginning in the design, implementation and assessment was key, said Merendeiro. ‘You also need to visit other organisations, see how it’s being done, and discuss the challenges with them.’
‘And take time,’ said van Koeverden. ‘It takes time to connect to people, to build something. Don’t be too impatient.’ DDN
Web Links
sdf.org.uk/work/lived-and-living-experience/sdf-national-traineeship/
We can work it out
SDF’s national traineeship is designed help people prepare for employment through a combination of supported learning and in-work placements over a nine-month period. Ninety per cent of participants complete the traineeship, with 85 per cent of graduates securing employment – most commonly in the drug, alcohol and wider social care sectors.
‘When I first heard about the national traineeship, I was volunteering with a service,’ says Mary*, a recent graduate. ‘My mentor there mentioned it, thinking it might be a good fit for me. That same day I went home and applied.’
Mary’s confidence was low at the start, she says. ‘I told myself I’ll give this a go, but deep down I wasn’t sure I had what it took. The interview process was another hurdle – I’d never done one before. Thankfully I got a lot of support, and when I got the call saying I’d been successful, I was over the moon.’
Starting the course was ‘amazing, but also a bit overwhelming,’ she says. ‘I didn’t even know how to turn a laptop on at first. My SDF coordinator helped me every step of the way – by the end, I’d become a dab hand with the laptop. I’m always telling people they should apply for this programme, it’s been such a game-changer for me.’
The traineeship combines structured training with hands-on placements, as trainees work towards gaining their SVQ2 in social services and healthcare. ‘I completed so many courses and earned loads of certificates, which have been so useful when applying for jobs,’ she says. ‘I also absolutely loved my placement. It gave me the chance to put what I’d learned into practice.
Every day, I had something new to write about for my SVQ. The staff and my mentor were so supportive, they made sure I felt capable and confident. I needed things explained a lot at first, but once I sat down, listened and put in the effort, I started to get the hang of it. You can’t just coast through, you have to want it and work for it.’
By the time she’d completed the traineeship Mary felt her life had been transformed: ‘It has completely changed my life. It’s made me more confident, resilient and self-aware, and it’s helped me feel settled in who I am and how I communicate with others. I talk about it all the time and always suggest it to people. If I could, I’d do it all over again.’
*Not her real name