We must continue to learn from each other
Projekt UDENFOR has
over the past two years participated in the SMES-European
project 'Dignity and Well-being', a European project
that aims to exchange experiences, explore barriers and
strengthen and develop new methods in social and social
psychiatric outreach work for people who are homeless
and have complex social and psychological problems.
One may ask if it all makes sense to participate in
pan-European cooperation on homelessness. Is there,
after all, not too large differences between cultures,
traditions and social legislation in European countries
despite all are members of the EU community? Some would
probably even say that we in the Nordic countries with
our well-established welfare state is particularly
privileged and therefore (says many colleges in my
country) are the ones that are best suited to inspire
others to do as we do, while we have nothing to collect
from the outside.
That I dare to state is nonsense!
In projekt UDENFOR,
we have 20 years experiences in sharing knowledge and
cooperation with organizations around Europe for example
through the organization SMES Europe, and through
participation in SMES Europe's pan-European projects.
Our experience is that it gives even very good sense to
see and hear how others work, and both to pass knowledge
on and receive new knowledge back. It is quite true that
there is much done differently, and there are situations
in other countries, as we contend with in Denmark. But
there are indeed areas where we have lagged behind. For
example, have they in London as well as in Bruxelles
been much earlier in the process of highly qualified
outgoing and outreach services for the homeless living
on the streets than we were - and they are still ahead.
The 'Dignity and
Well-being' project was implemented in the period 2015 -
2017 in the form of three seminars, a report and a final
conference. The seminars were held respectively in
Warsaw, Athens and Copenhagen. The report “European
Exchange and Inter-vision project on Homeless Pathways
and Interventions with Homeless and Mentally Ill People”
was written on the basis of the material and the
knowledge that was gathered at the seminars. The final
conference was held in Lisbon, d. 16, 17 and 18 March
Seven European countries, from north to south and east
to west, participated in the three seminars; further
some countries attended the conference.
The report brings
together the experience of the three seminars in which a
number of anonymous 'case studies' was presented in
workshops. The report's findings are based on analysis
of the 50 cases across all participating organizations
and countries. The cases are distributed with roughly
equal numbers of male and female homeless, mostly aged
30 to 60 years, and about a third of migrants. The
homeless, which was described in the cases were divided
between those in their outer lived up to the
performances of living on the street, "dressed in a long
skirt and strange hat walking around with bags full of
clothes and whatever else she need to live on the
street" and those who have not got anyone to think it
was a homeless person who was responsible for one: "Neat
and well satisfied with his life as a homeless person,
usually in a good mood and welcoming."
It is of course the interventions that are of particular
interest to the investigation and thus the report.
Whether the analyses of the cases that are largely
agreeing that the first meetings is essential for
further work - which requires that there is a good time
to be there and to have good time with the homeless and
a good amount of patience. As a social worker wrote in a
case study: "When I visit him, it seems as if he wants
to talk, but he builds a wall of words that it is
impossible to penetrate."
The analysis of the cases shows that, even for those who
initially solid reject contact is a gradual change,
often imperceptibly and only visible over a space of
time. But it does not means, say the analysis, that the
improvements in the state just comes by itself.
Professional social workers, robust organizations, both
voluntary and public, good cooperation between
organizations with different approaches, which "form a
network that is able to implement processes that not
only relate to solve the acute problems", is necessary.
Based on the cases
of the three seminars, we managed to achieve an
increased awareness of the choice of methods in the work
out in the streets, and we got a shared recognition of
how the work not only requires professionalism, but also
have to involve humanity. In the series of workshops
were talk a lot about the daily challenges; the feelings
that affect you when you go out and meet people in such
a vulnerable position; about when you are rejected and
most want to give up; on the difficult cooperation
between the various sectors. And we talked about how we
again and again recognized each other's experiences at
work on the street whether you work in Athens,
Barcelona, Bruxelles, in Copenhagen or one of the other
cities that participated in the project.
On 14 SMES-Europe
conferences held in Lisbon on Friday 17th and Saturday
18th March 2017. We were four who attended from projekt
UDENFOR and a total more than 100 people from nine
different European countries. During the two conference
days, it was not the cases that stood in the centre, but
the experiences and challenges that we had learned from
the discussions of the cases.
One of the main
themes was the old trotter on cooperation - or more
often the lack of cooperation - between the social and
the psychiatric system. It is incredible that it can
continue to be a challenge!
There was also much talk about the outreach work. And
that it can´t stand alone. There must be something that
follows. It was a general attitude of the presentations
and the debate that in some countries, but not all,
shelters were to be rearmed, but that the Housing First
strategy, which most countries have adopted, should be
strengthened and maintained. Finally, the need for
rehabilitative interventions briefly mentioned.
At the debate at
the conference it has been pointed out the need to
maintain a demand for social justice and shared
responsibility to homeless people with a mental illness
who live isolated in the street. There is a need for
interventions that do not isolate them, but engages them
in community and civic life.
It could overall be conclude that social and health
workers working with outreach street work, still need to
gain experience and to learn more about the outreach
work. One can also conclude that both national and EU,
is needed to ensure the economy that is needed and to
ensure a liable policy on the social, the health, the
residential and employment areas that promote the
integration of not only the homeless who live on the
street, but all homeless.
The final word on
outreaching street work is not told by this. In
cooperation between SMES-Europa and the Portuguese
Centro Hospitalar Psiquiátrico de Lisboa and with
multiple partners, among them projekt UDENFOR, there
will, over the next three years, continue an exchange
and exploration of what good social outreach and social
psychiatric work in a project concerning cooperation for
innovation and the exchange of good practices and
partnerships - vocational education and training. This
project is financed by EU Erasmus+ program.
President projekt UDENFOR
1. What was the most useful idea or practice
you came across during the VISITS TO LISBON
on the Thursday 16th ?
Multi-disciplinary teams, working with the most
entrenched rough sleepers.
Foi importante ter conhecido as residências de
autonomização do H. Júlio de Matos, dá-nos outra
visão sobre o trabalho realizado visando a
autonomia dos utentes e o sua integração social.
The solidary lockers and the Health Quiosque.
Meaning of outreach team . Psychiatrist in
outrach team. Cooperation between institutions.
Use of patient potentials
The lockers on the street and the NPISA way of
Does not apply
Centro Hospitalar Psiquiátrico de Lisboa (CHPL)
ORIENTAR Association - Plastic arts and
recuperation of furniture and other materials as
reintegration and occupation for people. Their
Vintage Store which has the users contribution.
A importância do trabalho concertado e em rede
em prol da intervenção individual.
the group of dr. Bento
The open meeting for people with mental health
issues. The fact that the psychiatrists meet
with the people afterwards, based on their needs
not on the needs of the professional. Perfect
le mobilier urbains, "the lockers" and "ealth
J'ai beaucoup aimé l'idée des "lockers"
The networking of services (NPISA)
Work of continuity in mental health
to Know another experiences
About low threshold projects the most useful
ideas were the lockers and chiosco.
2. What was the most useful idea or practice
you heard about during the CONFERENCE DAYS
Friday and Saturday?
Auditing services for barriers to access.
importante dar tempo às pessoas para se poder
alterar hábitos de vida, respeitando a sua
condição psíquica e física.
Having the Maslow piramid of needs as a basic
framework , to work once the person is housed.
should heard the voice of homeless persons not
only in inside the institution, but also in
needs of the mind beyond the needs of the body.
Develop dreams and access to culture.
tool for an objective assessment of the social
integration of the participants
video infermieres de rue
Mungos/Mesa Redonda Migrantes/ Workshop Serviço
de Saúde e Saúde Mental
Cinema Debate - example from France
Direito inalienável do todos os seres humanos à
habitação condigna, aos cuidados, à saúde.
Respeito pela liberdade individual
interest for mental health for migrants
Particularly the theme about Housing - First
well-being of the homeless and Housing first
was mostly how what I heard sparked ideas in me.
In Dublin we have all the services for homeless
people, everything they need. What we do not
have is everyone working together, sharing
information and working for the betterment of
the homeless people.
Housing first: je ne connaissais pas bien ce
dispositif. Cela n'existe pas dans ma région ,
il est par ailleurs important pour moi de
constater que ce concept est largement partagé
dans d'autre pays d'Europe
working with embassy for foreign patients
combined pillars "Home & Housing and
Rehabilitation & Employment
experience of housing first in Ireland
Mungo's experience with her conclusions and the
experiences about housing first. On saturday we
have appreciated a lot the vision and imput
about immigration situations
3. How might these – or other things you heard
about – CAN CHANGE YOUR DAILY PRACTICE ?
the way , that it can be very useful to help to
plan joint action plans with the people I visit,
and not to propose, a " too high a need" or even
plan any, if the basic ones aren`t acheaved.
will try to do my best daily job with homeless
persons and will try to make best cooperations
with other institutions- hospitals, police and
must combine our forces to end homelessness.
Social care should not be discarded
Start with an objective assessment of the social
integration of the participants
Confirmação que o trabalho integrado, em rede, é
o caminho preferencial para intervenção neste
âmbito. Que se constrói em conjunto. Necessidade
de melhor capacitar os profissionais e as
instituições para isso.
Will definitely introduce some of these inputs
in the next year plan of actions of my project.
aceitar tudo o que existe. Agora sei que se pode
fazer diferente, há quem o faça e resulta logo
temos que insistir e não baixar os braços.
can change my practice about the housing for
severe mental hillness patients
way we "treat" and passion we must apply to help
Rather than focus on the gaps in services, I
will endeavour to build relationships and links
with services that already exist to provide the
support that the homeless people need.
souhaite me rapprocher de ma hiérarchie et
associations porteuses de "housing first" pour
communiquer sur le terrain
involve patients in their treatment, through
help to others (with psycotherapeutic group)
knowledge, experience in the field and
networking can make the daily practice more
effective, more interesting.
Networking works and influences public policies
It's always useful to think about another
most important concept is to be able to work
together actually. The private services and the
istitutional services having a real contest to
face to the real problems to discuss and giving
them pragmatic answers.
4. Do you have ANY SUGGESTION FOR PRIORITY
SUBJECTS - TOPICS for future SMES initiatives,
think we should develop a sort of basic profile
for the resources that we visit. A template ,
with different contents, to fill in, every time
we do a visit.
Night shelters, outrach teams methods.
Translation during the workshop :D
Reforço o que foi abordado na Conferência. SMES
e entidades exercerem capacidade de influência
para que as politicas correspondam às
necessidades. Exercitar capacidade de
influenciar a decisão das politicas. Dinamizar
rede de parceiros para intensificarem partilha
de conhecimento e experiencias
moment to share practices from different
countries with video and pictures. I think that
a better choice possibility is important on the
workshops, if possible organize them in a way
which we could take part in at least two in the
morning and two in the afternoon and not just
connections between the total interventions for
Continuity of Care, bridging the gap within the
professions; medical, social, addiction,
education and housing. Homelessness is not just
the lack of shelter it is a societal constraint
and early intervention is the key
j'aurais souhaité plus d'informations sur les
réalités de chaque territoire pour mieux
contextualiser le propos des différents
housing and follow-up in housing
Integrated services and user involvement (person
centred services and co-production of services)
What is social inovation in the projects for
Street work project
be more practice whit change experiences and
clinical and social cases
think would be interesting to have more
workshops to work together to create also new
interactive and international sinergic groups.
We think that this kind of organization is very
useful and we could make it more visible and
5. Any other free comments about the
really enjoyed it, and it was definitely very
motivating. And again I would like to
congratulate the organisation, specifically
Elias and Luigi
Thank you because it allowed me to meet field
actor and develop my practice.
Great organization and amazing ambient among
more little workshops and less plenary
the presentation was very important ant
interesting. The only thing i must point out was
the time not beeing respected, leaving few time
to the speackers talk about their themes.
thought it was very professionally run. Everyone
was so welcoming and knowledgeable. It has
inspired me greatly, thank you
soucis de traduction
L'intervention de Sergio Aires était
particulièrement intéressante et stimulante.
will be important to have the workshops
conference was very interesting and also the
climate was so good. Would be great to have more
occasions like that realizing and to constitute
a stable set of different professional roles