The street-based substance abuse work project covering the central city district was started based on an idea submitted by Helsinki residents through OmaStadi in late 2022. Experienced registered nurse Saara Lappeteläinen was appointed as the full-time project worker. For two years, she did substance abuse work on the streets, mainly in Sörnäinen, Alppila, Alppiharju, Hakaniemi and Kalasatama. During the project period, substance abuse and the resulting increase in malaise were increasingly visible in the streets of the area.
“From the very beginning of the project, it was clear that there were many clients in need of help and support in the area, and that they needed more and more assistance. This could be seen as an increased level of unrest and a decreased sense of security in the neighbourhood,” Lappeteläinen confirms.
She was partnered with many street-based substance abuse workers from various organisations and the city. During the project period, Lappeteläinen encountered a little over 1,600 clients, and her work tasks ranged from emergency first aid to the assessment of the need for care and the provision of advice on the street.
“While on the streets, I could talk to the clients, assess which kind of care they needed, arrange future appointments, make referrals to detoxification or be involved in the initiation of an assessment process for opioid replacement therapy, for example. In many cases, my task was getting messages to clients about matters such as upcoming appointments, social work issues or housing decisions. The regular outreach work also made it possible to monitor the clients’ state of health, assess which kind of care they needed and refer them to services.”
Developing different forms of work with different actors
According to Lappeteläinen, the development of various cooperation networks and collaboration between actors and workers have played a decisive role in her street-based substance abuse work. The activities of the city and organisations complement and support each other in many ways – for the benefit of the clients.
“Networking was key to the success of the project. The network meetings and continuous discussions between workers helped to form a common understanding of functional working methods that take into account the clients’ needs. In the autumn of 2024, the total number of cooperation partners and individual workers in the network was more than 120,” Lappeteläinen says.
However, outreach work cannot replace fixed units, nor do the operations of the fixed units correspond to the street-based work.
“In future, we should focus on developing cooperation between street-based substance abuse and mental health work and the fixed services while boosting and developing the cooperation between the different operators.”
One-third of respondents to a substance abuse survey live in the central city district
All Helsinki residents aged 13 and over were encouraged to respond to the nationwide substance abuse survey between 23 September and 13 October 2024. The aim of the survey was to find out what the substance abuse situation looked like in the residents’ own neighbourhoods. A record 10,271 Helsinki residents responded to the survey, of whom 7,913 were aged 18 or over and 2,358 were aged between 13 and 17.
Some 35% or 2,770 of the adult respondents live in the central city district. Nearly 31% of them had seen drugs and 16.5% alcohol passed on to persons under the age of 18 in their neighbourhood over the past twelve months. Nearly 60% of respondents living in the central city district had witnessed persons under the age of 18 drinking alcohol, nearly 61% vaping and 68% using cannabis or other narcotics in the past twelve months.
The restlessness of the area is reflected in the residents’ responses. A total of 65% of adult respondents and 40% of young respondents stated that they had been afraid of intoxicated people in a public place during the past year. Fears had been raised by the unpredictable, aggressive and chaotic behaviour of intoxicated people.
Lessons from the project to be used by the cooperation network
The progress and content of the OmaStadi project that is now coming to an end is described in the project’s final report published on 5 November 2024. Saara Lappeteläinen will continue her work as a registered nurse in the Mobile Symppis health advice service, which provides health and social counselling to clients across the city on weekdays.
“The lessons learned and experiences gained during the project period will be utilised and the project practices continued in the network doing the outreach work. For example, the service and needs assessments on the streets can be continued,” says Mikko Tamminen, Director of Housing, Crisis and Substance Abuse Services.
A project discussion event was arranged on 5 November 2024. It brought together network partners from the central city district, representatives of the City of Helsinki, representatives of organisations and local residents. A recording of the event is available on the Helsinki Channel for two weeks from the date of publication, i.e. until 20 November 2024.
OmaStadi is Helsinki’s way of implementing participatory budgeting. This means that residents can suggest improvements that they would like to see in their neighbourhood. Helsinki spends EUR 8.8 million on implementing the residents’ proposals during each OmaStadi round.
