Homelessness in the UK and the US: Translantic Practice Exchange Reunites

Last month the National Alliance to End Homelessness (NAEH) invited alumni from the Transatlantic Practice Exchange to gather and learn from one another as part of the NAEH Ending Youth and Family Homelessness conference.  The Transatlantic Practice Exchange, offered by the National Alliance to End Homelessness and Homeless Link in the United Kingdom, and funded by the Oak Foundation, aims to develop future leaders in the homelessness sector and establish transatlantic best practice connections.   Coming together this week with other Exchange participants was a rare opportunity for each of us to reflect on the lessons learned from our experience in the UK and look at ways we’ve implemented change locally as a result.  As a group, we discussed how a strong social safety net dramatically impacts the scope of “rough sleeping” (sleeping outside) in the UK.  We also observed how service users were far more integrated into provider operations and decision making in the UK, and how there’s more of a palpable sense of urgency around homelessness in the UK than here in the US.

During last month’s reunion, I also reflected on my participation in the Exchange three years ago.

The Exchange was one of the most important professional development opportunities of my career, and it has had a significant impact on the work we do at Avalon.  As the saying goes, “you can’t manifest what you can’t imagine.”  During my visit to the UK, I saw a window into what’s possible in the homelessness sector.   The team I worked with in the UK served individuals with complex needs whom they characterized as “chronically excluded adults.”  The team did not mince words when describing the epidemic of systems failure that led to, in their words, chronically excluding adults from silo-based systems of care.

When I walked into a health clinic in the UK, however, I saw a filing cabinet full of syringes for people to openly access. I watched a man come in off the streets and receive compassionate, professional care from a provider in a single payer healthcare system.   I learned about a broad spectrum of publicly-funded drug and alcohol treatment options and sat in on a legally mandated service user forum where “experts by experience” gave feedback on operations.  Nan Roman, Director of the National Alliance to End Homelessness, joined us for this conversation and reminded us that getting out of our community and learning what others are doing is a way to “twist your frame.”

banksy

British street graffiti courtesy of Banksy

Much of my Exchange experience has helped shape our work at Avalon. Our annual tenant pancake breakfast, where we ask tenants to give us in-person feedback about their experiences with Avalon, serves as our version of the service user forum I saw in the UK.  We now have peer supports, people with lived homelessness experience who support our tenants and improve Avalon’s operations with their expertise. We have a partnership with Packard Health Clinic to provide “backpack medicine” to our tenants, increasing primary care access and care coordination.

We’ve implemented concrete harm reduction strategies such as syringe access and Narcan distribution. We’ve also supported our local community’s efforts around advancing harm reduction, which include a harm reduction learning collaborative and an upcoming harm reduction conference.These are just some of the services now offered by Avalon that were inspired by my experience in the UK.

My colleagues at Avalon share a collective intent to better the lives of those we serve. What’s our philosophy for getting there? A core belief exemplified during the Exchange is that as care providers in the homelessness sector, we need to focus not on the impairment of the individual, but rather on the systems that fail to meet individuals’ needs. If we improve the systems for the clients we serve, then we improve them for everyone.

By Aubrey Patino