Support Services for Homeless Individuals with Substance Abuse in Northern Portugal
The spotlight in Northern Portugal is on homeless individuals facing substance abuse issues, particularly alcohol and drugs. The Health Service Network in Northern Portugal offers various levels of care, including mental health services, emergency rooms, and integrated response centers. The system includes inpatient treatment centers, alcohol treatment units, outreach services, and support from non-governmental organizations. The typology of people at risk of homelessness in Portugal sheds light on the varied challenges faced by individuals in insecure housing situations. Homeless individuals in drug and alcohol treatment units in Northern Portugal receive care in shelters, hotels, hostels, and other collective housing options.
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Homeless people who consume alcohol Homeless people who consume alcohol and/or drugs: and/or drugs: Spotlight on (Northern) Portugal Spotlight on (Northern) Portugal Kerstin Hoffmeister Drug and Alcohol Interventions Division of the Public Northern Health Administration (DICAD/ ARS Norte, I.P.)
HEALTH SERVICE NETWORK NORTHERN PORTUGAL Hospital Primary Health Care Unit CRI Braga CRI Viana CRI Bragan a CRI Porto Central CRI Porto Ocidental CRI Porto Oriental CRI Vila Real
LEVEL I LEVEL II LEVEL III MENTAL HEALTH SERVICES (HOSPITAL) EMERGENCY ROOMS INTEGRATED RESPONSE CENTRES (PREVENTION, TREATMENT, HARM REDUCTION AND SOCIAL REHAB) PORTUGUESE HEALTH SERVICE REFERRAL NETWORK FOR PEOPLE WITH ALCOHOL AND/OR DRUG CONSUME INPATIENT TREATMENT CENTRES/ THERAPEUTIC COMMUNITIES PRIMARY HEALTH CARE SERVICES ALCOHOL TREATMENT CENTRE OTHER MEDICAL SERVICES (HOSPITAL) INPATIENT DETOXIFICATION UNIT ALCOHOL TREATMENT CENTRE Outreach Services Non-residential services Other NGO and Assotioations HOMELESS PERSON (SICAD, 2014)
HOMELESS PEOPLE WITH SUBSTANCE ABUSE: PREVENTION, TREATMENT, SOCIAL REHAB AND HARM REDUCTION Planning integrated intervention of DICAD units/ teams
Typology of people at risk of homelessness in Portugal (ENIPSSA, 2018) Risk Typology No.of people Shelter for victims of domestic violence 475 Health service response without housing service 190 Incarceration without exterior housing 620 Other type of institution without housing service 322 Non conventional housing (i.e. caravan), alternative to absence of housing 4.549 Conventional housing at family or friends, alternative to absence of housing 3.701 HIDDEN HOMELESSNESS Insecure housing situation / warning of eviction 1.256 Total 11.113 ENIPSSA, 2018
Homeless people in Drug and Alcohol Treatment Units in Northern Portugal, 2018 350 300 250 200 150 311 291 221 100 87 50 0 Shelters Hotels, hostels and similar Other kind of collective housing Unsheltered Sistema de Informa o Multidisciplinar (SIM)
Ongoing Interventions 1. Supervised drug consumption facility in Porto (harm reduction) 2. Cofinanced outreach and residential services (harm reduction) 3. Training for professionals and peer groups (harm reduction)
Recommendations 1. Use of ENIPSSA risk typology for adequate and eficient referral to health services network (prevention) 2. Strenghthen articulation of health and social security services (bottom- up) to improve social reintegration and housing (residential services) 3. Give people with gambling and gaming disorders the same opportunities (prevention, treatment) 4. Joint Action Plan for Metropolitan Area of Porto (political and technical stakeholders)
Thank you! kerstin.hoffmeister@arsnorte.min-saude.pt http://www.arsnorte.min-saude.pt
