Abstract

Following an extensive process, spanning nearly two years, the Salvation Army Crisis Services was funded to establish and operate a primary health service in St Kilda for injecting drug users in accordance with guidelines set out by the Victorian Department of Human Services. On 1 September 2004, Access Health was officially opened in a large building adjacent to Crisis Services and the primary Needle and Syringe Programs Locked in Crisis Services. In this paper, we seek to provide an insight into the initial establishment phase of a primary care facility designed to meet the health needs of a particularly vulnerable population. It outlines early trends in client need and the service response developed to meet these needs. It also touches upon the relationships that service management has pursued, the structure of the service, and the processes that have been put in place to address the (relatively few) teething problems that have arisen in the facility's first months of operation. In doing so, it provides insight of relevance to all practitioners who encounter the issues that marginalised and vulnerable clients with complex needs often bring.

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