A feasibility study to explore alcohol service engagement among Polish street drinkers in a London Borough

Note: This report was funded and/or written by our predecessor organisation, Alcohol Research UK (ARUK).

Agencies working with homeless people have expressed concerns about increasing numbers of Polish ‘new migrants’ who are homeless and who often have complex needs. Problematic alcohol use has frequently been reported among Polish migrants who are destitute and involved in street drinking activities. Agencies working with homeless people have highlighted the lack of engagement with services and the need for alcohol-related support for this client group. However, little is known about their existing support networks and their awareness of, access to and engagement with alcohol services. Research is needed to more fully understand the needs of this emerging and vulnerable group and to capture their experiences, attitudes and behaviours in this respect. The current study set out to understand the lived experiences of Polish street drinkers and their perspectives on approaching and engaging with alcohol services. Engaging with hard-to-reach groups called for a departure from traditional research methods and our study sought to explore the potential for using more innovative research methods to fully capture those lived experiences.

In this small-scale study we aimed to evaluate the use of two participatory interviewing techniques to explore Polish street drinkers’ lifeworlds. In addition, key aims of the research were to identify pathways to street drinking and to explore awareness of and attitudes to generic and alcohol specific services, and the barriers inhibiting Polish street drinkers from engaging with services.

The sample for the project comprised 12 Polish street drinkers living in, or in close proximity to, the London Borough in which the research was conducted. Recruitment was undertaken by a key worker at the specialist alcohol service provider collaborating in this research and with which all participants were in contact. This individual also acted as translator/co-researcher. As previously stated, one of the principal aims of the project was to evaluate the potential for participatory interviewing techniques to assist in engaging participants and enhancing disclosure. To this end, a combination of participatory mapping interviews and timeline interviews were deployed. The potential benefits of these methods were evaluated by the research team, but feedback was also sought from participants. The headline findings were that these research techniques worked effectively in engaging these hard-to-reach individuals and encouraged them to discuss relevant events, experiences and memories that may otherwise have been difficult to explore. Participants were enabled to feel a strong sense of ownership of the research process and, importantly, the techniques allowed people to reflect on their responses. Participant feedback on the techniques was consistently positive.

Pathways to street drinking

Our findings indicate that among our small sample, pathways both into problematic drinking and homelessness appeared to be diverse. A host of adverse life events often occurred prior to participants’ arrival in the UK, but they were not always tied to problematic drinking before individuals migrated, though they may have served to spur on migration. It was clear though that homelessness was rare before our participants left Poland and that they were to a large extent unprepared for life on the streets of the UK. Heavy drinking was often a feature of participants’ lives prior to migration and continued on arrival in the UK but some individuals began drinking problematically when they experienced troubles after migrating. Drinking problematically did not appear to be a direct cause of homelessness but, alongside other adversity, was linked to destitution. A lack of recourse to public funds appeared to play a critical role in triggering and maintaining their homeless state.

Resourcefulness

A resounding theme of participant’s accounts of the everyday pattern of their life on the street concerned ingenuity and resourcefulness, evident in each individual’s use of their wits, skills and social connections to cater for their everyday and long term needs and aspirations. Our participants were knowledgeable about which organisations to visit for their different needs and this required varying levels of planning and alcohol management during the day to be able to carry out what they needed to do.

Awareness and use of services

A range of factors informed the extent to which participants were aware, and made use, of various types of services and support. Prominent in participants’ accounts were reports of contact with health services, churches, the alcohol service collaborating in this research, and a local Homeless Advice Service. Some participants reported positive interactions with these and other organisations, with the specialist alcohol service in particular being valued by the great majority of participants, albeit for a diversity of reasons. However, significant constraints were also referenced which, in many cases, gave rise to considerable frustration and were seen to represent multiple barriers to participants achieving their aspirations, in both the short and longer term.

Barriers to service use

Significant barriers reported by participants included: inadequate Polish language provision among services; inadequate help with accessing lost or stolen identity documents and lack of a correspondence address. These, however, should be considered in tandem with statutory and legislative barriers – most significantly a lack of recourse to public funds – which also severely curtailed the extent to which participants were able to access a spectrum of support which they self-identified as potentially playing a transformative role in positively influencing their lifeworld situations.

A larger project, based on a mixed method, multiple case study research design, would offer significant potential to further develop this important, emerging area of social research. Firstly, a larger project would be conducive to comparative exploration of the lifeworlds of not only Polish nationals, but also migrants from the other A10 countries. Case study areas would be systematically selected to offer an insight into different parts of the country with significant A10 populations. Such a project, in addition to exploring the issues and themes that emerged during the course of this research in greater depth and detail, could also encompass a quantitative component augmented by key informant interviews. From the resulting evidence base, proposals to inform the evolution of alcohol services and interventions directed at emerging client groups could be offered.

We would like to thank the participants and the support workers who contributed to our research, especially the interpreter/co-researcher at the North London specialist alcohol service provider; and Betsy Thom for her advice. We are grateful to Alcohol Research UK for funding this study.