I read Simon Hattenstone’s article in the Guardian about the tragic death of Joe Black in a London hostel with mounting horror, frustration and sadness.
Both the subject – and the journalist who wrote it – reminded me of my own journey in the world of drugs and housing and why it matters so much.
Many moons ago, I was a young outreach worker in central London, working with people sleeping rough in the West End. All too many of those young people were trapped in the drugs/homelessness catch 22 – need to be in treatment or off drugs to get into housing, but can’t get into treatment or off drugs while unhoused.
The one treatment service that would take people who were homeless would only sign up the first three people in the queue on a Wednesday morning. For everyone else it was the roundabout of hostels where use was covert, ignored or detected and you were back on the streets. In this environment there was a grim but inevitable tally of drug-related deaths – overdoses, suicides, neglect, injuries.
Two deaths that changed my view of the work and the situation were those of two young men who were fatally stabbed by a local bar-worker when they slept rough in Soho. It affected me deeply at the time. The lads in question were Big Issue vendors, and Simon Hattenstone was, at the time, a journalist there, learning his trade. He wrote a piece about their lives and death after they were killed. I have a clipping of it still – the only published memorialisation of two lives cut short.
A NEW MODEL
For me, it was the start of a piece of work that has carried on now for almost three decades – working with housing providers to form drugs policy and practice which is lawful, as safe as possible, and fit for purpose. It has seen the emergence of a model which has been adopted by Shelter and Homeless Link, and Martin Powell at Transform worked extensively with a range of agencies to expand take up. Housing providers from Cornwall to Scotland have adopted and adapted the models developed 30 years ago to provide inclusive housing where the needs of residents are properly addressed and appropriate.
Based on Hattenstone’s article about the death of Joe Black, and stressing that I don’t know the provider involved and had no input into their policy or practice, it stood out as a startling throwback to the problems we have seen numerous times in supported housing – a catastrophic mismatch between policy and provision.
There is a need for a wide spectrum of housing provision. Drug-free housing is essential for some people looking to sustain abstinence. High-tolerance housing is equally essential for people using – especially in ways that may be hazardous – to provide an environment which is safer, can provide stability and offer the start of a journey which may include change.
IMPOSSIBLE SITUATIONS
Where it goes wrong is where the policy of one is applied to the other. This creates two impossible situations. One is where people who believe they are moving into drug-free housing are exposed to unacceptable risk, as the practice doesn’t ensure the housing is in fact drug free. The other outcome is where people who are known to have ongoing substance-related support needs are housed in a service where the policy doesn’t acknowledge or respond to those needs, again leading to unacceptable risks.
In the case of Holmes Road, about which Hattenstone writes, the policy starting points were all the tropes of a classic ‘zero tolerance policy’:
‘Residents had to promise not to take drugs on the premises – and, ideally, not at all’ and ‘Holmes Road management said any drug dealing on the premises was immediately reported to the police.’
The problem is – and has always been – that such policy and practice is unworkable and unsafe, where the provision is working with people who still use. At best it displaces the activity.
The mismatch creates all the ambiguity and confusion that Hattenstone’s piece illustrates, and is best summarised by this statement in the article, quoting the service manager for adult safeguarding in Camden:
‘It is noted that people may continue to use both legal and illicit substances during their stay. In light of this, staff extend advice and support, striving to mitigate potential risks and helping those who wish to cut down or quit entirely. Staff are also conscious that for some, drug use may be a means of coping, often due to past traumas or ongoing personal struggles. It’s crucial to mention that any illegal activities identified within the hostel are immediately reported to the police and could result in eviction.’
Therein sits the contradiction and the failure. On the one hand the recognition of the need for a harm-reduction approach while simultaneously clinging on to a zero-tolerance ‘illegal activities will be reported to the police.’
LEARNING POINTS
Looking at the list of ‘key learning points’ (see box), these aren’t new and it’s deeply depressing that they even need to be restated. But the evidence from Hattenstone’s article is they must be restated.
All the tools needed to shape good, lawful, progressive and safer provision are available for use and have been implemented for years by a variety of organisations, including those in the London Borough of Camden.
The piece was a salutary reminder that amongst the shining examples of good practice that do exist in the UK, there are others that do not – and their failures lead to fatalities.
Kevin Flemen runs KFx which has offered training and resources on drugs and related issues since 2003. Email kevin@kfx.org.uk