Working with Homeless People with Alcohol Problems

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Working with Homeless People with Alcohol
Problems
16th July 2009 Community Alcohol Nurses Homeless
Team Birmingham
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Who We Are Homeless Alcohol Team Based at The
Health Xchange, Primary Health Care Centre for
Homeless People 3 Community Alcohol Nurses 2
Community Primary Care Nurses 2 Support
Workers GP Sessions daily-appointments and
drop-in Access to Podiatry and Dentist
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Client Group- Anyone over 18 years old who is
homeless or vulnerably housed
Source of Referral Routes-self, intra-agency,
hostel workers, GPs, discharge liaison staff, day
centres, police, probation, prison, etc

The service covers the whole of Birmingham 3
PCTs- HOB, BEN South
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Services Provided

• Referral received
• Offer appointment for Initial Triage Assessment -
• approximately 2 week wait
• 2 Appointments offered, either
• attend and taken on OR
• 2 DNAs then discharge and re-refer

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2 clinics week-Monday and Thursday mornings -4
appointments each day, 1 hour assessment Fast
track/Priority referrals e.g. from hospital or
identified health needs
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Physical Needs Complex and multiple health issues
identified, either through primary health care or
at assessment Physical assessment completed at
Initial appointment ie Baseline obs, and blood
tests-UEs, FBC, LFTs, GGT, weight loss, diet,
assess for vitamin therapy Close links with
GPs Pathways for referral to secondary services
i.e. gastroenterology, hepatology and neurology
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• Mental Health
• There is a close relationship between alcohol
  problems and mental health.
• People with Mental health problems are at raised
  risk of alcohol problems and vice versa.
• Personality Disorder-large proportion of
  clients have Anti-Social Personality
  Disorder-sexual/physical abuse in childhood, time
  in care
• Depression
• Anxiety

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Mental Health Pathways

• Assessment by Gateway Worker
• Managed in Primary Care eg anxiety or mild
  depression OR
• Referral to Secondary Services CMHT for severe or
  enduring mental illness
• Close links with Homeless MHT
• Joint working at weekly clinic at Health Xchange
• Weekly meetings- Gateway worker attends

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Treatment Option Following initial assessment
needs and goals identified Work around safe, slow
reduction-harm minimisation around continued
drinking Motivational work Auricular
Acupuncture Access to Counsellor Referral to
Detoxification and Rehabilitation
services Referral to Dry Houses in Birmingham
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Outreach Early Morning identified 18 months
ago entrenched alcohol rough sleepers, numbers
up, people coming in and staying in
Assertive Engagement-where and when people need
to be seen that suits them/their drinking-
opportunistic engagement/interventions
Partnership Working- voluntary sector, City
Council Homeless Multi Agency Meeting-
monthly Day Services Norman Imlah
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• Thoughts for the Future
• Alcohol Strategy
• Raise awareness of hazardous drinkers
• Prevention Early intervention
• Pilot Brief interventions

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Contact Details
Health Xchange William Booth Lane Birmingham B4
6HA Telephone [phone] Fax [phone]
3973 Monday Friday 9am 5pm Jacqui
Conaty April Stoneman