Cabinet Office Social Exclusion Taskforce
Last updated: 15 November 2008
The following exercise is designed to demonstrate the needs of the ACE client group and the practical difficulties in offering support to someone who is vulnerable with multiple problems. It is a group exercise designed to bring the reality of working with chronic exclusion alive to commissioners and policy makers.
With thanks to the Revolving Doors Agency for devising this document.
Lynne is a 33-year old divorcee who, until recently, lived alone in a local authority flat. She was sexually abused by her father from the age of three, when her mother died. Lynne ran away from home at 12 and has been selling herself for sex since the age of 14 in South East London, when her then boyfriend persuaded her to ‘go on the game’. He had introduced her to drugs shortly before that suggestion. Lynne has been raped several times by punters and also by acquaintances of her then boyfriend.
Lynne suffers from depression and self-medicates with alcohol and crack. She often expresses suicidal thoughts. She also suffers from a number of physical health problems including an ulcer, bronchitis, a urine infection, an abscess and major surgery to her bowel, which required a temporary colostomy. Her lifestyle is highly chaotic.
Well known to the police, Lynne had been frequently fined for soliciting – fines which she paid through further prostitution. However, more recently, the Police have been attempting to stop her street work through Anti Social Behaviour Orders. She has several and has been to prison 4 times for breaching their conditions. Her first sentence was in 2005.
Lynne does not like prison but feels that, at least, it gives her a chance to stabilise, stop taking crack and have a break from street work. The sentences are all less than a year long which means she is released from prison without supervision or a Probation Officer.
In March, the housing association where Lynne lived, evicted her with a possession order following reports that she had pushed melted butter through the letterbox of the flat above, left a pile of vomit outside the door and poured glue on the handrails in the stairwell, in addition to generally banging and shouting when drunk or on drugs. She returned to prison 4 weeks later and is due to be released on October 20th.
She will be homeless, barred from her local GP and will not receive any benefits. Lynne has told Prison Staff that she is scared to leave prison and wants to sort out her mental health and stop being on the game. She is particularly afraid of her Pimp, Paul, who has visited her in prison and has told her he will, ‘look after her’ on release.
Today, Lynne has been referred to Revolving Doors Agency by a Prison Officer.
Occupation: Link Worker, Revolving Doors Agency
Age: 40
Income: Mid 20k.
Based: North London
Job Description:
Working as part of a team to engage with, and offer support to, people with mental health problems who fall through the gaps of current service provision. Maureen and the team take referrals from Police Station, Courts and local Prison from staff who are concerned about the mental health or behaviour of a suspect or charge, but who have been unsuccessful in finding appropriate support.
Tasks include: GP registration, Benefits applications, Housing Tenancy preservation and acquisition, advocacy, organising healthcare assessments, managing financial crises.
Personal Qualities: Primarily to engage, long term, with a chaotic group of people and link them into services that will offer appropriate support. Tools include; working with offenders in prison, at release, and in the community; offering several more chances to engage when a client initially refuses; meeting clients where they feel comfortable (and is safe); shared caseload between team members who will have a range of skills from advocacy to benefits knowledge.
Challenges:
Aim: To work with Lynne pre and post release.
Occupation: Pimp
Age: 40
Income:
Two primary sources, both dependent on the number of men and women ‘staff’, on his books. Staff generate income through:
Accommodation:
Privately rented flat – home/workspace.
Outgoings: Highly variable
Profit – £25(bad week) – £3,000 (Christmas and New Year)
Motivation:
Paul lives in a world of fear and violence. He is not rich, but the potential to make money is his key motivation and reaching his goal requires drug dependent staff, who will see as many clients as possible. Paul is willing to do whatever it takes to retain his staff. Many go to prison, which is disruptive. Paul will phone them while they are there, meet them at the gate on release and, if required, take them to the GP to sort out their medication so that they are fit for work. Paul also has a flat where Lynne can stay for rent she will pay through prostitution. He is not afraid to use violence or manipulation to secure what he wants. He has beaten-up friends of Lynne who refused his offers of ‘help’. Lynne also owes him £250 in drug debt which she must pay off.
Aim:
Paul wants Lynne to return to work for him. He does not want anyone else involved in her life.
Notes
You have 15 minutes to work in one of three groups.
Lynne's Group: Please can you describe what you feel you need in terms of support, today. You want to change your life, but this is frightening. However, so is returning to the streets.
Please be as specific as possible.
Following your feedback, you will hear from Maureen and Paul who will ‘pitch’ to you on the support that they can offer. You will be asked to decide what you intend to do on release day.
If you are in Maureen's Group: Please devise a pitch that describes what you can do to help Lynne. You must use your collective knowledge of policy to ensure that you only offer Lynne things that you can deliver on. For example, were you to offer her a GP appointment, you must show how you would do this given she is unregistered with a GP and homeless. Your approach should mirror that of a Link Worker – supportive, constructive, honest and promising what can be delivered. You will not be able to help every aspect of her life, so please prioritise.
If you are in Paul's Group: Please devise a pitch that describes what you are willing to offer Lynne on release from prison. This can include arrangements for pick-up, housing, money and healthcare. It must also make the case for working for Paul in return. You should attempt to incorporate Paul's approach to persuasion in convincing Lynne to come home with you. This includes dishonesty, bribery, guilt and shaming.
Where does Lynne Go?