An interview with Mark, Team Leader at the West Lothian Assertive Outreach Service
What does the service do?
We are an assertive outreach service. That means we try to engage with service users who are classed as ‘hard to reach’ either because they are not engaging with services at all, or they are losing contact or disengaging with services before completing their recovery/treatment plan.
We provide a support package where we give harm reduction, safer injecting advice, brief alcohol and drug interventions, distribute naloxone kits to service users and family members and provide the training required to administer these potentially lifesaving kits. In addition, we offer psycho-social interventions and motivational interviewing techniques and support clients to and from appointments with other agencies.
Other services might give a client one opportunity to attend. As part of our persistent assertive outreach, we give clients as many opportunities as possible in order to make it as convenient for the client as we can. This could be meeting us in a car park, in a café, at their own home, in a community centre or health centre clinic, or at the job centre.
Most of our service users come to us via another agency or indeed self refer. For example, we receive referrals from the Scottish Ambulance Service, Scottish Prison Service, NHS, Criminal Justice Social Work, Children and Families Social Work, Job Centre Plus, Police Scotland and various partners within the West Lothian Addiction Care Partnership, of which Change Grow Live West Lothian Assertive Outreach Service is an active member.
As another part of our persistent outreach approach, we work in partnership with the Scottish Fire and Rescue service. They do a lot of work in the community, going into people’s homes to provide fire safety information and sometimes come across people who are struggling with substances. Therefore, with the person's permission a direct referral can be made to our service.
Why might a service user be ‘hard to reach’?
Sometimes the reason is geographical – we work over a very large area and there are lots of small villages and towns with varying levels of population. Therefore, it can be easy for people to become isolated.
Other times it’s due to a person’s religious beliefs, sexual orientation, minority group status, mental health issue(s), lifestyle. Sometimes they've had a poor previous experience in services and therefore they do not recognise their substance use as a problem.
How do you help service users to stay engaged?
At the initial meeting, we try and break down the power imbalance that can exist by having a conversation to not only explain our service and all the partner agencies that are available but very importantly, listen to the person’s narrative of their life, needs and expectations. This will hopefully allow us some insight and allow the person to get to know us as individuals - build up a rapport and a therapeutic alliance from the outset.
Service users are often taken aback that we will go with them to appointments with other agencies as part of their recovery journey. Where appropriate, we will pick people up at the prison gate on release and support them to pre-arranged appointments. Additionally, we will provide ‘gate pick-ups’ with a starter pack containing items of basic needs, for example, non-perishable foods, toiletries, socks, underwear, woolly hat, gloves, pocket diary/pen, and a list of important telephone numbers.
We are genuine, accepting and empathetic with a real understanding of where the service user is at and how difficult it is. We get it. We let them know that we are here to help but it is their journey, their life. Therefore, they direct their own recovery plan and we as workers help to facilitate this process.
What do you enjoy about this job?
Before this, I worked for myself for 27 years running a car valeting business. It served a purpose but I didn’t actually enjoy it, I was always looking for something more worthwhile. So, I decided to retrain and qualified as a psychotherapist and trainer.
My first placement was in an addiction service. I then progressed from student to full-time worker, to senior worker - and now I manage this service.
I really like the challenge of the work, meeting such a wide variety of different people and hopefully helping facilitate change in their lives. When something goes really well and you see the changes beginning to happen in someone’s life, see them moving on and getting on with their life – that’s why I do this job. I cannot save or rescue people, but I can play a supporting role in their journey of change.