The Assertive Case Management Team (ACMT) is a multi-agency project, stemming from the ‘Better City for All’ report which was published in October 2012 by key stakeholders in the city centre who had been tasked by the Lord Mayor to investigate issues of public drug use and perceived anti-social behaviour in Dublin.
The project was established in September 2014 based on a Memorandum of Understanding (MOU) between: the Health Service Executive (HSE); Dublin City Council (DCC); An Garda Síochána (Garda); and the Ana Liffey Drug Project (ALDP). The project overview states that the parties will work together to provide a multi-agency team focused on addressing the needs of a cohort of people with complex and multiple needs in Dublin City Centre. The team provides intensive case management support to people identified as members of the target cohort.
Core funding for the team is provided by the HSE, with management and employment responsibilities taken on by the ALDP. The ALDP employ a team leader and a project worker using the HSE funding, and provides management and volunteer support from existing resources. The two paid ALDP staff are the only members of the team who carry cases. They receive regular supervision from the ALDP head of services. The Garda have two members, one from each side of the city, allocated to working with the team. They give up roughly a quarter of their time each to the project, amounting to half a full-time input. DCC provide the team with rent-free office and meeting space and resources.
The HLG is made up of senior management from: HSE; DCC; Garda; and Dublin Region Homeless Executive (DRHE). The HLG meets every four-six weeks with the ALDP director in attendance to give an update on the project. An interagency case management team meeting takes place every week with the ALDP team leader and project worker, the Garda members and a Housing First representative. This meeting updates information and reviews all cases and identifies actions to progress cases. The team also has regular informal and/or structured communication with a range of other statutory agencies and community/voluntary charity/non-governmental organisations (NGOs) providing services in the homeless and addiction sectors (see Appendix 1).
The team focuses on conducting assertive case management in the city centre area by identifying, approaching, engaging with, and assisting those individuals with complex and multiple needs. The needs of the target group spans four key areas: addiction and public injecting; homelessness and rough sleeping; anti-social behaviour, begging and criminal behaviour; and mental health. The total target group is estimated to be somewhere between 100 - 150 people. Exact figures are difficult to quantify due to transience and the changing make-up of the group, which also includes some migrants, particularly from Eastern European countries. Many of the target group are well known to the Garda and justice systems as well as statutory and NGO services.
The team takes a proactive approach to outreach, supporting clients at locations and times that are suitable to them. The team works to either supplement existing case management structures for these individuals, where such is in place, or will take on the case management role where none exists.
In order for a person to be case managed under the ACMT, they must first sign a Consent Protocol - agreeing that information on their case can be shared across key agencies - including the Garda. An individual may receive an incentive in the form of a mobile phone top-up if they agree to case management. When an individual agrees to be case managed, they benefit from having direct access to a range of supports from a variety of agencies. There is a case load of 20 per project worker, totalling 40 by both ACMT workers at any one time. Where Housing First take on a lead role in managing certain cases through the weekly interagency meetings, the ACMT worker may adopt a key working role and the case load may increase beyond 40, e.g. in October 2015 it was at 47.