If you read my column last month then you will remember that two of our rough sleepers failed the Pereira Test since they were deemed, by the council, not to be any more vulnerable than “an ordinary homeless person”
It’s really rather ironic and devastatingly sad that one of those guys has since died. Which proves that he was actually really rather vulnerable after all.
And yes, it will be extremely easy for anyone to just write him off as being homeless and substance dependent but it is worth remembering that he was desperately trying to get help to not only come off the drugs but also to get treatment for hepatitis, find suitable supportive accommodation and get himself sorted.
Desperately trying to get help in what we, at Doorway, call the catch-22 fridge situation…
See, standard treatment for hepatitis C is only possible if you can store your medication (Interferon) in a fridge. And if you are homeless then you haven’t got a fridge. But you can’t get a fridge because someone has decided that you aren’t priority need and therefore the council doesn’t have a statutory duty to find you accommodation. But the fact of the matter is that you are unable to start treatment and therefore you are really rather vulnerable. It’s really not rocket science.
In 2012, Moses (a volunteer at Wiltshire Addiction Support Project) walked 200 miles around Wiltshire with a fridge in order to raise awareness of this very issue. Moses, who was a Falklands veteran and formerly homeless, suffered from the virus but was unable to access treatment since he was living in a caravan and didn’t have a fridge.
“There are a lot of people who are diagnosed with hepatitis C like myself that are homeless so they are missing out on treatment, and I wanted to raise awareness of it. I am hoping that it will do something towards the stigma.”
Three years later and not only is the condition still not recognised as being of a high priority, but there is still a huge amount of stigma attached to actually having the illness.
The bottom line is that K was extremely vulnerable. He had ongoing long term mental health issues which led to him being very fragile. But there is very little support for people who have a dual diagnosis – a mental health condition co-occurring with substance misuse. It is impossible to treat someone for these issues separately and yet there has been, in our experience, very little overlap within the two spheres of provision of support. He also had serious physical health issues that needed treatment. Basically K was on a crash course to developing serious long term medical conditions that could very easily be fatal.
Depending on other risk factors, such as alcohol use, between 10% and 40% of people with untreated chronic hepatitis will go on to develop scarring of the liver (cirrhosis). Around one in five people with cirrhosis will then develop liver failure, and one in 20 will develop liver cancer, both of which can be fatal.
So whilst people sat around making decisions about his levels of vulnerability they delayed him getting into a safe place, and forgot that he was a human being who was totally reliant on a stranger having a bit of compassion and just giving him a little bit of support when he needed it most.
And that bloody breaks my heart. Because I saw K week after week, year after year, and I sat and listened to him every time he broke down and sobbed. And we were just at the point where he actually had the chance to get a room in supported accommodation, he was engaging with the substance misuse services, and he was waiting for his hepatitis treatment. He walked out the door on that day and gave me a hug because he could see the light at the end of the very long dark tunnel and he knew that he had a chance to make everything okay.
And 5 days later he was dead in hospital.