The CLASH Wellbeing Guide Version 1.8 1 This version published: … This guide was compiled by clinical psychologists Phillip Kelly and Toby Newson, using information from a range of sources including: NHS England, National Ugly Mugs, Beyond the Gaze, Talk to Frank. It was produced for the CLASH and SHOC sexual health clinics at the Mortimer Market Centre in central London. Other contributors: Caitlin Kiddy Kaylee Linton Del Campbell Naomi Adams A number of people with lived experience of the sex industry also contributed to the development of this guide. The authors have tried to ensure that all information is correct at the time of release. Copyright © 2020 Central and North West London NHS Foundation Trust. All Rights Reserved. CLASH/SHOC Mortimer Market Centre Capper St, Bloomsbury London WC1E 6JB Go to: Introduction - Main Menu - Wellbeing and Mental Health - Safety - Physical Health - Drugs and Alcohol - Male, Trans and Non-Binary Sex Workers - Legal Issues, Police and Tax - Exiting Sex Work - Useful Organisations 2 Introduction This guide was created to help sex workers improve their wellbeing, work safely and know their rights. It was developed with the support of people with lived experience of the sex industry in order to try to make it as relevant and useful as possible. The guide is designed for people living near London, but it may also be of use to people living elsewhere in the UK. Being a sex worker is a legitimate job. Sex workers have the right to work in safety without facing abuse, harassment or injustice, just like everyone else. Sex workers also have the right to access support to ensure their health and wellbeing. We know that sex work can often involve feeling lonely and isolated. If you’ve been feeling like this, you aren’t alone. The good news is that there is help out there, from public services like the NHS, from charity and community groups, and from other sex workers. When writing this guide, we have tried as much as possible to make it for all sex workers. We know that every sex worker works differently, but we didn’t want to exclude some kinds of sex-workers, or prejudge what kinds of information would be useful. As a result, some of the topics may be relevant to you, and some may be less so. Go to: Introduction - Main Menu - Wellbeing and Mental Health - Safety - Physical Health - Drugs and Alcohol - Male, Trans and Non-Binary Sex Workers - Legal Issues, Police and Tax - Exiting Sex Work - Useful Organisations 3 Main Menu Wellbeing and Mental Health Safety Physical Health Drugs and Alcohol Male, Trans and Non-Binary Sex Workers Legal Issues, Police and Tax Exiting Sex Work Useful Organisations Go to: Introduction - Main Menu - Wellbeing and Mental Health - Safety - Physical Health - Drugs and Alcohol - Male, Trans and Non-Binary Sex Workers - Legal Issues, Police and Tax - Exiting Sex Work - Useful Organisations 4 Wellbeing and Mental Health Sex workers can face lots of challenges in their lives. Lots of sex workers feel worried, low, or isolated at times. If you’ve been feeling like this, then you aren’t alone. The following sections contain some suggestions about how to manage these issues. In this section: Feeling Low, Worried or Anxious Sexual Assault Back to Main Menu Go to: Introduction - Main Menu - Wellbeing and Mental Health - Safety - Physical Health - Drugs and Alcohol - Male, Trans and Non-Binary Sex Workers - Legal Issues, Police and Tax - Exiting Sex Work - Useful Organisations 5 Feeling Low, Worried or Anxious We all feel low or worried sometimes. However, if those feelings don't go away or are stopping you from carrying on with your normal life, you may need to make some changes or get some extra support. Here are common signs that you may be experiencing difficulties with low mood: • low mood lasting 2 weeks or more • not getting any enjoyment out of life • feeling hopeless • feeling tired or lacking energy • not being able to concentrate on everyday things like reading the paper or watching television • comfort eating or losing your appetite • sleeping more than usual or being unable to sleep • having suicidal thoughts or thoughts about harming yourself Go to: Introduction - Main Menu - Wellbeing and Mental Health - Safety - Physical Health - Drugs and Alcohol - Male, Trans and Non-Binary Sex Workers - Legal Issues, Police and Tax - Exiting Sex Work - Useful Organisations 6 Here are common signs that you may be experiencing difficulties with anxiety or worry: • Feeling nervous, restless or tense • Having a sense of impending danger, panic or doom • Having an increased heart rate • Breathing rapidly, sweating, or trembling • Feeling weak or tired • Trouble concentrating • Having trouble sleeping • Regular stomach problems The good news is that there are things that can help us manage or cope with these feelings. Lots of sex workers find talking to other sex workers or people with knowledge of the industry can help with these problems. You could do this in person by attending events run by charities or community groups, or through online sex worker groups. To find out more click here. You can also talk to your GP about what help they can offer and what other services are available. Sexual health clinics may also be able to tell you about special support services for sex workers. Another option is to get help from the NHS. You can find your local talking therapies service here. Go to: Introduction - Main Menu - Wellbeing and Mental Health - Safety - Physical Health - Drugs and Alcohol - Male, Trans and Non-Binary Sex Workers - Legal Issues, Police and Tax - Exiting Sex Work - Useful Organisations 7 Making small practical changes can also help. Here is a list of ideas: • Speak to someone you feel supported by about how you’ve been feeling (friends, family, supportive and like-minded sex-worker) • Try to get some regular exercise • Aim to get a good night's sleep • Keep to a healthy diet • Reduce your drug or alcohol intake • There are certain apps that may help in the NHS App Library. Here are some tips from other sex workers: • Eat something, anything. Ignore the balanced meal and eat what makes your soul happy- I suggest using Ubereats. Finding it hard to face food? Try something easy like yogurt or a banana, or drink something with calories. • Call a friend who ‘gets it’. Other options include venting online, especially in sex worker only spaces. • Changing the format I work in often helps me. If I need routine and structure I head to a parlour. If I need to be at home as much as possible I offer shorter services to reduce the number of hours spent with clients. • Three things I do: bath, wine and a good book. This is my time; no one can interrupt this. Go to: Introduction - Main Menu - Wellbeing and Mental Health - Safety - Physical Health - Drugs and Alcohol - Male, Trans and Non-Binary Sex Workers - Legal Issues, Police and Tax - Exiting Sex Work - Useful Organisations 8 • I also do something to tune out of the world. For me, I reread a favourite book, watch my favourite TV show or eat my favourite food. • Sometimes you might feel like you are backsliding, but if you are trying to fix all your unhelpful habits at once it can be very hard to stay grounded. Its ok to not be perfect, especially if that’s the best way to get through a hard day. You don’t need to try to fix everything at once! Go to: Introduction - Main Menu - Wellbeing and Mental Health - Safety - Physical Health - Drugs and Alcohol - Male, Trans and Non-Binary Sex Workers - Legal Issues, Police and Tax - Exiting Sex Work - Useful Organisations 9 Sexual Assault Sexual assault means an unwanted sexual experience: when someone does something sexual to someone else without their agreement or consent. Everyone has the right to work without threat of abuse or assault, whether they are a sex worker or not. Sexual abuse is never acceptable, and is not an ‘occupational hazard’ of being a sex worker. Sex workers do not ‘leave consent at the door’ when they go into a sexual encounter with someone. If a sex worker has been sexually assaulted or raped, it is not their fault in any way. The responsibility always lies with the attacker, not the victim. UK law recognises this. If someone is raped or sexually assaulted, they might experience the following: • feel ashamed or even guilty about what happened • feel depressed or suicidal • have flashbacks • have difficulty focusing or sleeping • feel numb and in shock • be tearful, angry or irritable. These are all normal human reactions and might last for some time. It’s important to remember what happened is not your fault and you’re not alone. Go to: Introduction - Main Menu - Wellbeing and Mental Health - Safety - Physical Health - Drugs and Alcohol - Male, Trans and Non-Binary Sex Workers - Legal Issues, Police and Tax - Exiting Sex Work - Useful Organisations 10 If you have been sexually assaulted, you don't have to have a forensic medical examination. However, it can provide useful evidence if the case goes to court. The following services will all provide treatment or support depending on your preference: • The Havens, a specialist centre in London for people who have been raped or sexually assaulted. Telephone - 02032996900 • You can find the location of your nearest NHS Sexual Assault Referral Centre here. • You could see a nurse or GP at your local surgery. • Alternatively you could attend a sexual health clinic, a contraception clinic, or an accident and emergency (A&E) department. For telephone support, you could contact: • The Rape Crisis national freephone helpline: 0808 802 9999 - 12-2.30pm and 7-9.30pm • The 24-hour National Domestic Violence Helpline 0808 2000 247 – 24 hour • NHS 111 – 24 hour The following charities also offer support: • Women's Aid • Victim Support • Women Against Rape • The Survivors Trust Go to: Introduction - Main Menu - Wellbeing and Mental Health - Safety - Physical Health - Drugs and Alcohol - Male, Trans and Non-Binary Sex Workers - Legal Issues, Police and Tax - Exiting Sex Work - Useful Organisations 11 • Survivors UK (for male victims of sexual assault) If a someone close to you has been raped or sexually assaulted: • Don't judge them, don't blame them.