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Listen
Preventing Suicide and Deliberate Self Harm
Laying the Foundations: Identifying Practice Examples
Project Report
13. Streetwork, Edinburgh
Target Group
Streetwork works with people in Edinburgh who are at risk on the streets - young people and rough sleepers, both in the city centre and the outlying housing schemes.
Issues
The project was set up in 1992 following concern about the numbers of young people at risk in the city. The aim was to provide informal education plus work with young people in a severe crisis.
In 1997, the project was expanded to tackle the wider issue of street homelessness, with funding from the Rough Sleepers Initiative. The project now consists of the Youth Services Team and a Homeless Services Team, which is split into two smaller teams (the Streetwork Service and the Complex Needs Service which works with people with multiple issues who are in a rough sleeping environment). The project also runs a coffee stall training and education project. This part of the project helps people gain self-confidence as a step towards other employment opportunities.
Around half of the rough sleepers who use the project have been identified as having mental health difficulties. A big problem for people is not being able to access psychiatric services - for example, people not being admitted to hospital because they haven't got a 'mental illness'. If a person needs counselling or support it is also often not available.
Suicide and self-harm are big issues for the project, and there have been several serious suicide and self-harm attempts on the premises. Self-harm amongst young people is frequent. The project often gets people in crisis who are self-harming, and young people involved in high risk behaviours, such as hanging - whether or not it is a suicide attempt or not is irrelevant as the outcome can sometimes be death. And, in terms of drug over-doses it is sometimes difficult to know the extent to which drug-taking is accidental, deliberate self-harm, a suicide attempt or something else, such as to access services.
Services/approach
The philosophy behind the project is that it undertakes 'detached' work - 'detached' meaning an open agenda - 'you tell me where we should start'. The same principle of detached work is undertaken with every age group - the project workers find out what people want from the project and then provides it.
Streetwork works with people who do not easily fit into existing provision or meet service expectations - people who may not be seen as the responsibility of any one agency and who may remain on the margins of, or be excluded from, a number of agencies and services. People who use the project are also often disconnected from their families.
The project workers work (and walk) around the centre of town to find people who may need a service. People also access the service themselves and can be referred by other agencies. The project refers people onto other services, and provides support in accessing their services.
The project starts by helping people with basic needs such as a place to stay, but also helps them with a sense of belonging - group activities with other people and staff - both in the youth work and work with older people. The workers often see immediate improvements - people taking more care of themselves. Streetwork will start to help someone straight away as it is easy for people to get into a cycle of depression and for their problems to escalate. The aim is to be patient and accepting of people, and allow them to take small steps. The project doesn't just focus on one aspect of a person but tries to work holistically.
People often self-harm because they are bored and isolated - on their own with nothing to do. The Project gives them things to do, people to meet, informal counselling and an opportunity to talk about self-harm, but also structured activity which is important in that it reduces self-harm. The project sees that it is important not to encourage people to self-harm, but at the same time to operate a climate in which it is OK for people to tell the workers that they are struggling. Streetwork doesn't exclude people for doing something like cutting themselves, which can be a reason for exclusion at some projects.
The project is able to respond to people who sometimes need a service, but who are also sometimes OK. It is also important for people to know that they don't have to be in a crisis in order to use the project - this knowledge also helps people to stop self-harming.
The project works with 'fluidity around structure'. For example, the project runs a recreational group one afternoon a week for young homeless people. The project expects that they will have to remind people about the arrangements, and be flexible with meeting times in order not to exclude people. Many people that the project works with live very impulsively from day-to-day. The project helps people get out of this way of thinking and to realise that, for example, it is normal to have a good morning but a bad afternoon. This way of working helps people to reduce their self-harming.
The project has recently published 'The Homeless and Hungry Guide to Surviving the Streets' which is a practical advice book which includes sections on self-harm and mental health problems.
Key features
Fluidity around structure
Active engagement of people who are not reached by other services
Acceptance and tolerance
Providing a sense of belonging
For further information, contact:
Tam Hendry and Katie Owen
Streetwork
Castlecliff
25 Johnston Terrace
Edinburgh, EH1 2NH
Tel 0131 622 6660
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