# Presentation: 532599

## Outreach workers

- Burnout and relapse

## Basis for Outreach

- From institution based care to community led services in order:
- To bring services to people using drugs
- To ensure easy access to care and services (low-threshold)
- To facilitate ownership by affected communities
- To address needs in a day to day situation of people using drugs
- To create a supportive environment

## Qualification of an outreach worker

- “People don’t care what you know until they know that you care”.
- An outreach worker is someone who is:
- Able to gain acceptance of people and communities he/she serves
- Non threatening and adaptable to change
- Open minded and without prejudice – non judgmental
- Sensitive both to street/community and organizational needs
- Able to maintain boundaries

## Disqualification of an outreach worker

- Someone who is:
- A know it all attitude and unwilling to learn
- Un willing to listen
- Playing God
- Liable to compromise on principles – drug use/trafficking; discrimination; exploitation; mis-utilisation of resources
- Talking down and inflexible
- Not recommended by peers

## The environment

- Discrimination and stigma - mistrust
- Hostility – only form of defense
- Manipulation – to access resources
- Resistance by community and law enforcement
- Strong negative emotions – NGOs
- You represent an opportunity for exploitation
- Instant gratification will be sought by people using drugs

##  Vulnerability of outreach staff

- Psycho social processes and environmental factors
- Nature of work – attracts adventurous people
- Constant access to drugs
- Injection becomes demystified after a while
- Solidarity with sub culture
- Isolation of outreach workers from other agency staff
- Often go to absurd lengths to share common reality with clients
- Undervalued – underpaid – disempowered – isolated

##  Vulnerability of outreach staff

- Psycho social processes and environmental factors....continued
- Outreach workers are often accountable to management with conflicting views
- Glamorized by media/others – leads to envy from agency staff
- Isolation often results in missing out on professional development opportunities
- Anti drug use attitudes at work leads to concealment of drug use – fear, shame and guilt
- Insufficient training and skills to cope with such stressors
- Often insufficient monitoring/accountability

##  Vulnerability of outreach staff

- Personal factors
- Early recovery
- Poor economic status
- In experience of working environment and work ethics/attitude
- Over confidence
- Disturbed family relationships
- Poor social interaction outside of clients/staff
- Fewer de-stressors in daily living

##  Minimizing relapse and burnout

- Organizational level
- Involve outreach staff to develop strategies to minimize relapse and burnout
- A clear friendly policy to protect the work integrity and health/well being of staff
- Realistic and clearly defined criteria for selection of outreach staff
- Tailored and needs based on going training
- Inter department shuffling to avoid boredom and burn out and minimize isolation from agency staff

##  Minimizing relapse and burnout

- Organizational level...continued
- Re-visit salary/incentive structure and should be at par
- Provide support / counseling
- On going on site monitoring and feed back
- Involvement of out reach staff in organizational activities / processes – ownership
- Specialized support in case of chronic / drug use
- Encourage alternate social networks

## Examples of disciplinary action

- Requires a warning...
- Lending money to clients and service users
- Looking sleepy and incoherent during office hours (not including side-effects of script medication)
- Failure to attend a shift without calling in advance

## Requires temporary suspension...
Purchasing drugs from clients 
Borrowing money from clients 
Coming to work inebriated 
Nodding out during office hours 
Being consistently late for work
Failure to attend work several times without calling in 
Doing drugs with clients 

- Purchasing drugs from clients
- Borrowing money from clients
- Coming to work inebriated
- Nodding out during office hours
- Being consistently late for work
- Failure to attend work several times without calling in
- Doing drugs with clients

-  Examples of disciplinary action

## Requires dismissal...
Selling drugs to service users 
Violating confidentiality of users and dealers
Injecting drugs into the veins, skin, or muscles of service users 
Doing drugs with clients in the office 
Coming to work inebriated after several warnings and suspensions 
Failure to deliver service due to an outstanding debt(s) 
Threatening clients for not paying their debts 
Consistently being late for work after several warnings 
Consistently being absent from work after several warnings 

- Selling drugs to service users
- Violating confidentiality of users and dealers
- Injecting drugs into the veins, skin, or muscles of service users
- Doing drugs with clients in the office
- Coming to work inebriated after several warnings and suspensions
- Failure to deliver service due to an outstanding debt(s)
- Threatening clients for not paying their debts
- Consistently being late for work after several warnings
- Consistently being absent from work after several warnings

-  Examples of disciplinary action

##  Recommendation

- Organizational support to out reach staff is crucial in order to _minimize_ relapse and burn out.
- Involvement of out reach staff in developing strategies to _minimize_ relapse and burn out is crucial