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Off Road
Territorial Road Units
SUMMARY
The project Off Road (Territorial Road Units) funded by the Lazio Region, is linked to the work done over several years in the territory of Asl RM 1. The basic objective of the project is the contact in the meeting places of drug addicts and is aimed at improving the quality of their lives. The intervention strategy is for ‘Harm reduction’ (i.e. needle exchange, distribution of condoms, interventions in the case of overdose, information on substances and sexually transmitted diseases, medical advice, legal advice, dispatch services, lunch, shower facilities……).
The low threshold intervention, especially that in the Road Unit, is characterized by the way in which it operates, which is within a different framework from the institutional one, in a non-therapeutical context in the traditional and institutional,sense in the scope of everyday life. In fact, the team contacts the specific recipient, directly in his/her area and in the meeting and consumption areas, in an informal and non-judgmental manner and tries to get the most out of the meeting, whilst keeping it short.
NAME OF THE PROJECT
‘Off Road’ – Daytime mobile unit for preventing diseases
RECIPIENTS
Direct recipients: people with drug problems.
Indirect recipients: social-territorial and health structures. Citizens in general.
METHOD OF FINANCING
Funded by: the Lazio region
Legal reference: National Fund for Combatting Drugs (DPR 309/90)
AREA OF INTERVENTION
ASL RM 1 City of Rome
BRIEF HISTORY
The first interventions of ‘Harm Reduction’, aimed at drug addicts in the area of Rome, was established in the early 90s arising from the crucial need to provide services and support to addicts who continued to use psychotropic drugs, particularly by injecting heroin (i.e.active drug users). In fact, the main objectives above all were: health, and reducing the spread of HIV and deaths from overdoses. A new policy of access to low threshold services was promoted, so that people can use the services offered by the Road Unit and the Day and Night Centres, regardless of their state of abstinence or use of abusive substances and without any major bureaucratic process. During that time, Parsec was a pioneer in this field and favoured this new philosophy for intervention, primarily addressing and aimed at those most in need and ostracized. Since 1994 a Road Unit, in addition to looking after other low-threshold services, is also taking care of drug addicts in the ASL RMA area.
OBJECTIVES
The main objective of the work on the streets is concerned with the protection of health and the quality of the social life of drug addicts. In fact, the general objectives of the project are to encourage a greater awareness about their socio-health; assessing their needs in relation to substance use; facilitating access to the system of services and opportunities offered by the territory; promoting a culture of citizenship by supporting and enhancing the social skills of the recipients involved; monitoring changes in consumer behaviours and market dynamics. An additional objective is to promote consensus on intervention and its aims and practices in order to enable network and synergies with agencies in various capacities - either through direct or indirect contact with the targeted recipient of the intervention - through mapping and the knowledge of the area.
METHODOLOGY OF INTERVENTION
‘Harm Reduction’ and low threshold intervention, especially the one of the Road Unit, is characterized by an operation that is placed in a different setting to that of a classic therapeutical and institutional intervention. This scope is defined everyday in that of social and interpersonal relations related to substance use; social life, to the relational maps, both social and interpersonal, that users themselves are following. The work on the road originates from the choice to stop and be present at the places where the people live and where they are suffering under hardship conditions and to promote and foster interventions for care.
The operators are in the areas, either in mobile vehicles or on foot, in order to observe, intercept, go to users and be in contact with the target groups in the places where they meet, purchase and consume substances.
The road then becomes the setting, the context of work and the operator on the road must be readily available to work in situations with unclear limitations,with no room, no shirts, no protection, -except that of his/her position – and his/her professionalism will have to adapt to a context that is so strongly deconstructed.
So the operator on the street can fit in as a privileged interlocutor who offers the chance of help and encouragement not only to individuals but also to groups and to the community in general.
This work thus requires a new perception of the helping relationship that becomes an offer of prodigious solutions to an intervention aimed primarily at promoting awareness and responsibility with regard to the social and health conditions of the addict population.
TOOLS AND ACTIVITIES
If the ability to establish meaningful relationships with a weak bond, non-regulatory or judicial, is the heart of a road team, prophylaxis materials, together with the mobile unit itself, become the real face of the offer, the objective that more than any other, lends itself to feedback, reactions and appreciations from the users.
The resources offered, with the progress of the road work, also take on other meanings, in addition to the immediate prevention, self-care and risk reduction. There are more symbolic meanings and objects of media relationships that stand between the operator and the user and become instruments of exchange (a sterile syringe, a used syringe) that create a space and a definite time in which the interaction between the subjects allows and contributes to the construction of the bond.
The services offered are:
• Needle exchange;
• Distribution of condoms;
• Intervention in the case of overdose;
• Information about substances, HIV, hepatitis;
• Social health counselling;
• Dispatch services;
• Medical advice;
• Legal advice;
• Advice and guidance on identifying needs and managing therapeutic projects;
• Psychological support;
• An escort to the local services, in specific and appraised cases;
• Small snack refreshment.
NETWORK AND TERRITORY
The service has been available in the area for nearly two decades. It is, by nature, a discreet and barely visible service, if not for the targeted population, yet it is strongly established and recognized. In this regard, a rich network of relationships has been built over time that represents the everyday dialogue of the service. With the public and private institutions that deal with addiction (Ser.T., Municipalities, Hospitals, Day and Night Centres, Therapeutic Communities, Social Services ...) dialogue is continuous both for the management of patients and for the sharing of cultural thought linked to our activities, both for social, political and cultural, territorial initiatives. Of equal importance are the contacts with a local network, more informal by nature, (i.e. the committee of the district, citizens’ associations, Banca del Tempo, leisure centres ...). These contacts have been built up over time and have often become an additional resource for the project. The Road Unit is also constantly monitoring the area and the services.
CONTACTS AND PROCEDURES FOR ACCESS
The outputs of the Road Unit is done with at least two operators, in the areas of I, II , III and IV districts; given the vastness of area, the mobility team is divided into macro and micro shifts – five hours a day for five days a week.
The mobile unit travels aound the indicated areas in order to carry out mapping, making and stabilising initial contact and offering all the activities listed in the specific objectives of the project.
The client can, of course, use the service freely and it is not necessary for people to provide their personal details (especially at the beginning of the acquaintance); a fictitious name can also be used. Privacy is guaranteed.
The car that is used is a Hyundai Athos
Contact: Mobile phone: (0039) 347.73.85.870
ORGANIZATIONAL STRUCTURE
The Road Unit team intervenes by way of a shared and integrated workspace and uses the expertise of professional psychotherapists, psychologists, doctors, professional educators/trainers.
It consists of a manager, a coordinator, four operators, a supervisor, and consultants for training and evaluation.
EVALUATION
The assessment is made by the client through a system of quantitative (numerical evaluation boards) and qualitative (reports with achieved objectives) monitoring. Periodical checks are also carried out through internal monitoring-on the expected objectives achieved between the team, the service manager and the contact area.
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