Tag Archives: mental health

Abri partnership preventing homelessness for people in mental ill health recovery

Homes for Cathy member Abri – a 35,000 home housing association operating in the south of England – has partnered with Southern Health Foundation Trust (SHFT) and homelessness charity The Society of St James (SSJ) to provide the ‘Step Out Pathway’, housing and support for people discharged from acute mental health services.

With one in four people in the UK experiencing mental health problems each year, mental health services are becoming increasingly stretched. Part of this is a lack of move-on accommodation support for people in mental ill health recovery, which is becoming a growing crisis for the NHS. Across Hampshire, this is resulting in substantial housing need as well as cost pressures for the NHS.

SHFT reported that limited spaces were being blocked by people who could return to the community if there was supply of appropriate accommodation. Around 60 people (many from Southampton) were, as a result, being housed in temporary accommodation in cities such as Manchester, Bradford and Liverpool at an average cost of £600 per day.

In partnership with SHFT, Abri provides access to a portfolio of 15 properties to help alleviate the issue. Situated on the outskirts of central Southampton, the Mansbridge location encourages independence and helps people in recovery to be close to community facilities, while distancing from other negative influences. These properties are granted through a lease agreement to The Society of St James (SSJ), a Southampton-based homelessness charity, who take on full housing management and landlord responsibilities. Abri has a good working relationship with SSJ, established over many years of working together on other initiatives.

The Keep Well Collaborative was instrumental in the conceptualisation, design and development of this ‘Step out’ pathway, facilitating the approach as part of their wider commission by the Hampshire & Isle of Wight Integrated Care System to address health inequalities through a focus on the home.

Abri now has eight leases in place and the partnership is looking to explore more opportunities. It has been a challenging process, with people moving from acute inpatient units with long-term mental health issues, but the partnership is proud there have been no hospital re-admissions and there are signs of the residents establishing themselves within the local community.

The longer-term leases (seven years) also provide time and space for people to think differently. Removing the timeline for people moving out of the properties reduces pressure and enables them to focus on making the changes they need to make in their lives.

Avril Ansell, Abri’s Partnership Living Manager, said, “It’s been such a positive piece of partnership working and is such a clear fulfilment of our strategic aim around community, as we’re building on our relationships with both the NHS and also a specialist housing management provider to help people to move on with their lives in a really clear way. I know that my team has really valued seeing the smiles on people’s faces when they’ve seen the properties that they are about to move into, knowing that they are hopefully turning another significant corner to improved health and wellbeing.

“Having a place to call home, establishing roots and finding opportunities for personal development can make a significant difference to people’s lives. We’re excited to continue working in partnership to provide these homes for years to come.”

Jon Pritchard, Associate Director of Housing & Community Inclusion at Southern Health NHS Foundation Trust added, “This collaboration between Abri, Society of Saint James, and Southern Health NHS Foundation Trust provides an excellent discharge solution for people who, traditionally, haven’t had many/any accommodation options at the point of discharge.  With the support of our partners, Abri and SSJ, we are discharging people from our inpatient care much sooner than we would be able to do otherwise. 

“Using a consistent person-centred approach across all of our organisations we can ensure that the property is right for the individual (close to support/family networks/transport links, and meets their accessibility requirements etc).

“The individuals receive intensive, time-limited support from the Southern Health Community Rehabilitation Team when they move in to their new home, which transfers to the Community Mental Health Team over time.  This structured support really helps to make the discharge sustainable.

“Our partnership brings the constituent strengths of each organisation together, delivering the greatest impact for our service users.  We very much look forward to continuing to grow this innovative approach.”

The supported housing scheme offering a lifeline to vulnerable women

A traumatic past and mental health challenges are a common factor for many people at risk of homelessness.  However, women in particular are often at greater threat of living with complex, multiple disadvantages that can lead to them becoming homeless, especially where dependent children are involved. 

Homes for Cathy spoke to North Star Housing Group, one member organisation that is committed to offering a lifeline to vulnerable women to support them away from homelessness.  North Star’s Hestia Service provides accommodation with intensive support to women in Teesside. In the two decades since the service’s inception, it has helped around 120 women gain the opportunity for a more positive future, with a secure, settled home for life, the cornerstone of its philosophy.

North Star’s Pauline Byrnes, Hestia manager, says, “Our USP is that once our service users no longer require support, they can remain in their home. If they want it to be a home for life, that’s exactly what it can be. Once support is no longer required, the property reverts to general needs property. This provides service users with the stability they’ve never had and from there they can start to address the other issues they may be facing.  All we ask is that they fully engage in the support offered at the outset.”

Hestia’s service users are referred from a range of agencies including the local authority’s homeless service, mental health services, social care and probation and all are classed as homeless.  Some have experienced failed private rental tenancies because of their mental health problems, while others have fled domestic violence or forced marriages.  The service has also supported women with mild learning difficulties, as well as women whose children have special needs, many of whom receive no support from their families. 

Properties from general needs stock

New service users are offered a property from North Star’s general needs stock which becomes a supported tenancy (Assured Shorthold).  These are properties dispersed throughout the local area, rather than located in one dedicated block. They are usually terraced houses with a small back yard, typical of Middlesbrough’s traditional town centre housing stock.  The properties are hand-picked to ensure they are located in areas where tenants can feel safe and come equipped with furniture, soft furnishings, white goods and kitchenware, ready for tenants to move into.  Every property offered is newly decorated to a high standard, ensuring a homely and welcoming environment where tenants want to stay.

Pauline comments, “Our service users take an enormous pride in their new home, often adding their own finishing touches such as cushions and pictures to really make it their own.”

Floating support is provided through a dedicated Hestia service coordinator, offering person centred support. This could include support with all aspects of managing a tenancy, budgeting and rent payments and liaison with North Star’s welfare benefits officer to ensure they are claiming any back-dated benefits they are entitled to.  Service users may also be supported to engage with other services, access recreational activities, education, volunteering opportunities and employment and build links in their local community.

Floating support to break homelessness cycle

Pauline adds, “From the point of referral, we work closely with all the involved agencies such as mental health and social care to identify any risks and draw up a risk management plan.  We also link in closely with other local support services in the area such as the CAB and credit unions.”

The approach certainly works, helping women rebuild their lives and gain hope for the future.  Says Pauline, “On average the support we offer is required for around 18 months but it’s enough to break the cycle of homelessness.  It’s wonderful to see our service users’ self-confidence and self-esteem improve to the point that they can move on in their lives and start to live independently.”

AB’s Story

AB was removed from the family home by Cleveland Police due to concerns regarding her safety. AB is of Pakistani descent, her marriage was arranged, and she moved to the North East to live with her husband and his extended family. During eight years of marriage AB was physically, financially and mentally abused. She was barred from using basic facilities such as the family bathroom and was told to bathe from a bucket of water, even after she gave birth to her daughter. She was beaten regularly by all the family with sticks, hands or pulling out AB’s hair and was made to cook and clean from 7am until 12 midnight every day of the week. AB managed to get to a phone one day and phoned 999, Police took immediate action, and AB was placed in a safe house. AB was unable to take her daughter, and it became clear that her signature had been forged on to numerous documents; one example is that AB’s signature was on a document which gave up her parental responsibilities, another was to claim carer’s allowance.  All documents were signed fraudulently by the husband’s family, without AB’s consent. AB did not have basic living skills, she had had hardly any communication with the outside world, lacked confidence and was unable to do the most basic of tasks. With support from Hestia, AB is now going to the shops, paying her bills and will soon be awarded full custody of her daughter who is now living with AB full-time. The final custody hearing is pending.

Helping homeless people access mental health support

Evidence shows that there is a significant link between homelessness and mental health problems.  According to Homeless Link, 80 per cent of homeless people in England reported that they had mental health issues, with 45 per cent having been diagnosed with a mental health condition.  Research by Homes for Cathy member Evolve points to childhood trauma as a contributory factor – its ‘Breaking the cycle of trauma report’ found that 80 per cent of homeless customers surveyed had suffered at least one childhood trauma. 

Mental health and homelessness can be a vicious circle, with homelessness causing mental health problems, and mental health problems often being the reason people become homeless.  Sadly, homeless people can face considerable barriers in terms of accessing the mental health services that could support them.  Many homeless people live with multiple and complex needs; this, combined with other factors such as the lack of a fixed address and even loss of confidence and self-esteem, can make it impossible for them to use traditional support systems.  

Research by another Homes for Cathy member, the homelessness charity St Mungo’s, reveals that many homeless people ‘fall through the gaps in legislation and local services’, the result of a shortfall in locally commissioned services that actively target their needs. 

Work is being done by Homes for Cathy members to address the issue.  Charity Evolve, which provides supported housing to homeless people across London, is raising funds to provide free, in-house, non-location specific counselling services to its customers, making mental health support easily accessible for those who need it.  According to its research, 76% of people who have accessed its service report better mental health and are more able to cope with life.   

Debra Ives, Head of Operations at Evolve, says: “Counselling is one of the best tools for dealing with trauma but it must be available quickly to have an impact. Our counselling is free, on site and available irrelevant of where the customer moves to.”

Evolve is putting clients’ mental health top of the agenda with in-house counselling services

Meanwhile, Hightown Housing Association’s Open Door homelessness service has partnered with local mental health providers Hertfordshire Mind Network and Hertfordshire Partnership University NHS Foundation Trust (HPFT), to deliver weekly support sessions direct to users of its shelter.

The scheme – announced to coincide with Mental Health Awareness Week (13-19 May 2019) – will give the shelter’s service users direct access to care for mental health issues without the need to register with a GP, travel to appointments, or provide a fixed address and phone number. 

Carla Watson, Open Door Scheme Manager, comments: “Imagine you lose your job, a loved one dies and you don’t have any savings. You are evicted from your home and lose most of your possessions. You’re now sleeping rough or staying in a homeless shelter. It feels like you are losing control of your life, your mental health is at an all-time low but you lack the confidence and self-esteem to seek help.  You give up and accept things may never get better.”

“I saw first-hand how often this happens to some of the most vulnerable people in our society. At Open Door we decided that if things were going to change, we needed to persuade mental health services to come to us. The services are bookable and available on a one-to-one basis, but without a waiting list or the need to have fixed contact details. 

“Another way people can fall through the cracks in services is if they don’t have a phone number, they can’t get an appointment. When the sessions are held at Open Door, we can encourage and refer residents on their behalf.”

Carla Watson, Hightown Housing Association’s Open Door Scheme Manager has implemented in-house mental health support sessions

Mental health charity Hertfordshire Mind Network is now offering mental health drop-in sessions at Open Door once a week to help service users with issues such as anxiety, loneliness and isolation, depression, anger and loss, while NHS provider HPFT will also run standalone mental health support sessions. 

Carla adds: “It’s still early days but the appetite from residents to improve their mental health is there – we have had good attendance every week.

“This exercise has taught us a valuable lesson. If things aren’t working, be proactive, look for a solution and work in partnership with other organisations. Ultimately, it’s the people who matter most and we’re committed to fighting for their right to have the same opportunities as others to access vital services and improve their life.”