Helping young people with

drug addiction problems

Warsaw experience

Aleksandra Łukasiewicz, The MONAR Association

Investing in young people to prevent a lost generation in Europe:

key policy and practice in addressing youth homelessness

8th November 2013, Prague, Czech Republic

The MONAR Association

a non-governmental organisation offering

a wide range of services to drug users and

the homeless in Poland;

the largest network of treatment services:

out-patient, residential and outreach (135);

founded in 1978;

Situation of the Young

Homeless in Warsaw Survey „Situation of Homeless People in Warsaw: opinions by the homeless

and social workers”, conducted in 2005 by CBOS – Public Opinion Research

Centre - commissioned by the City of Warsaw

Findings:

30,5% of respondents became homeless before 30 y.o.

including 27,3% - 19-30 y.o.

3,2% 18 y.o. and below

According to respondents, the most frequent reasons for homelessness are:

51,3% family desintegration (including economic migration of parents:

phenomena of „Euro-orphans”)

20,7% violence in families, especially towards young people (in the

age group below 35 y.o. 41% indicated violence in family

as a reason for homelessness)

33,2% own addiction (including 30% of alcohol addiction,

3,2% drug addiction)

Situation of the Young

Homeless in Warsaw

The question on addiction was regarded by researchers as sensitive,

therefore the data could be considerably underestimated.

Researchers also pointed out the strong correlation between alcohol and

drug addiction: data shows that these addictions often co-exist.

Situation of the Young

Homeless in Warsaw

24,8% of respondents – homeless people – look for

assistance in shelters and nightshelters.

Only 2,3% of respondents turn to different types of out-

patient services, including addiction treatment,

psychological assistance and other.

The homeless do not want, cannot or do not know how to

use generally accessible services, and because of such

feelings as shame, fear, or embarrassment associated with

deprivation of basic needs (hunger, hygiene, safety etc.)

Outreach for the homeless

All-season outreach program conducted by

MONAR in Warsaw.

Aid and motivation.

Based on harm reduction principles in work with

the homeless.

Conducted in places not suitable for living where

the homeless live, working or spending time:

parks, canals, garden/summer houses, railway

stations, stairways, squats, etc. (ETHOS:

roofless 1.1 i 2.1, inadequate 11.2, 11.3, 12.1).

Outreach for the homeless

Systematic activities

Education on safer drinking, drug use,

living in not suitable places (risk of fire,

hypothermia, etc.), system of the welfare.

Waiting for the client’s decision.

Work with a person according to his/her

rate and rules, in his/her environment, and

based on the plan accepted by him/her.

Outreach for the homeless 30% of the outreach program clients – young

people;

Frequent use of drugs, criminal activity, sexual

services;

Usually the young homeless stay at their

acquaintances, in squates, railway stations,

shopping malls;

Outreach is a link between a client and the

services;

Allows to react and be flexible to the needs of

the homeless;

Gap in the system

The data collected in 2005 by the MONAR Drop-in

for the Homeless in Warsaw showed that the

system was not ready to help young people who:

had limited access to treatment services due to

their specific situation (lack of documents,

insurance etc.);

needed instant intervention;

Gap in the system..

previously dropped out from the treatment system, as

they did not regard themselves addicted and at the same

time were excluded in much more spheres than the rest

of addicted patients:

lack of income,

lack of family support,

neglect of health and social situation etc.

did not accept staying in shelters for the homeless, as

they did not identify with the rest of clients;

needed specialised but low-threshold offer.

Shelter for the young homeless To respond to the needs of this group, in 2005, the

MONAR Association established a shelter for

disadvantaged young people at the age of 18-30 in crisis

situation in the framework of the Centre for Humanitarian

Aid MONAR-MARKOT in Warsaw;

The program offers a comprehensive and contemporary

approach to solving a number of co-morbid with

homelessness disorders;

The Shelter also implements the indicative prevention

program for young people at risk of drug addiction

(financed by the Drug Prevention Agency of the Ministry

of Health – the state recognises the young homeless as

a group which is vulnerable to drug addiction and co-

morbid disorders);

Shelter for the young homeless Our goal:

to motivate clients to change their current life situation

and modify their attitudes and behaviour connected with

drug using practices;

Activities:

conduct individual assessment of reasons for

homelessness,

choose relevant intervention,

develop new life skills (conflict solving, job preservation,

personal budget management etc.),

cooperate with other organisations and institutions which

may contribute to our clients’ welfare,

work with families of the clients, if possible.

Shelter for the young homeless

Team: addiction therapists, social workers, a

psychiatrist,

6-months contract with a prolongation option

Individual programs to exit homelessness

developed together by clients and their key-

workers

Our clients Polydrug users

The most popular drugs often mixed with alcohol:

Amphetamine

Cannabis

Mephedrone

Heroin „brown sugar”

Since 2008 so-called „smart drugs”

Pharmaceutic over-the-counter drugs in doses

exceeding medical indication (syrups, pills and other

containing benzidamine, codeine, pseudoephedrine,

dextromethorphan)

Our clients

Every year, a number of clients of the Shelter vary from 150 to 200.

In 2011 - 190 clients

In 2012 - 177 clients

Until 31/10/2013 – 184 clients

Clients declared at admission (via special questionnaire):

Problematic use of drugs or alcohol

115 persons (2011)

95 persons (2012)

104 persons (2013)

However, we know that 90% of our clients have experienced drug

use but choose to conceal this fact in the begining, due to different

reasons.

Our clients

Young adults (18-30 years old)

Men and women

Found themselves in the crisis situation due to different reasons and

cannot stay in their previous place of residence any longer – the

young homeless.

Main reasons for their homelessness are:

Conflicts in the family,

Domestic violence,

Addictions,

Mental health problems,

Release from prisons, institutions for minors,

Leaving orphanages and foster families.

Therapeutic Community Method

Why TC?

Tradition of the MONAR Association (the first TC

in Poland established in Głosków in 1978 by

Marek Kotański);

Suitable for work with people having different

problems (addictions, mental disorders, street

children and other);

Therapeutic Community Method..

Partner relations between staff and clients.

Developes social skills.

Allows to observe clients in different daily life

situation.

Atmosphere of openness encourages personal

development.

Therapeutic Community Method..

Participation in decision-making and creating

rules, as well as possibility to express his/her

opinion is especially useful in work with street

children who do not easily resign from their

freedom;

Clear structure, rules and traditions give sense

of security.

Shelter effectiveness

Emancipation: 18,6%;

Undertaken therapy in out-patient or day

treatment centres: 54%;

Undertaken therapy in residential

treatment centres: 2,9%;

Vocational training: 27,4%

Shelter effectiveness

Employment: 49,5%.

Education: 15,9%.

Received entitlement to social pensions:

3,5 %.

Established contacts with family members:

61,1%.

Social housing – 1 %.

Readaptation flats – 1,8 %.

Conclusions

We recommend short-term programs focused on

the needs of the young homeless and

considering their specificity:

Short-term homelessness: usually early stage – below 2

years, or warning phase – 2-4 years of homelessness;

Drug use;

High aggression level – street behavior and culture;

Higher activity;

High mobility level (experienced homelessness abroad);

Need to identify with their peer group.