Experience of volunteering at St Mungo’s during the pandemic

    We recently celebrated our Heroes of the Pandemic Volunteer Awards, which recognised the hard work and dedication of our wonderful volunteers over the last year.

    In this blog, one of our award winners, Sara Ramos Pinto discusses her role with Mulberry House in Bath, the impact it has had and how she has had to adapt in response to COVID-19.

    Role and why to volunteer

    I volunteer with Mulberry House (a supported housing service for people living with and recovering from mental health issues) as a walking group facilitator.

    On the walks, we literally just walk and talk. We talk about anything and everything, and along the way we’ve got to know each other more. Sometimes we share worries, sometimes we share goals or interests and sometimes we don’t share at all – sometimes people don’t want to talk and that’s okay too.

    I decided to volunteer with St Mungo’s because I am a strong believer in community and now that I had settled in Bath I wanted to actively participate in the community of Bath. I am also acutely aware that we all have a tendency to live in our own bubbles, only spending time with people who are similar to us. I looked around me and realised everyone was a university lecturer (like me!), and I thought there’s something not right about this. I wanted to burst that bubble and have contact with new people who had different experiences, different backgrounds and different lives.

    I reached out to a friend who worked at Mulberry house and she told me about the volunteer opportunity, which thankfully worked out!

    The impact of the Covid-19 pandemic on volunteering

    When lockdown first hit, we weren’t able to meet up due to the restrictions, so during these times I have kept in contact with everyone in the house over email instead, sharing pictures and challenges to keep us going.

    When we have been able meet up, for example during the summer, everyone was really excited and we had even more people involved in the walks than usual. Everyone has been indoors and more isolated than usual, so walking in a group and enjoying the astonishing nature of Bath was exactly what we all needed and a rare moment of normality!

    Sadly, due to the latest lockdown, our walks had been on hold again, but now that we are easing out of this we’ve been able to start them up again and enjoy the spring! The next step would be to organise a longer walk, maybe doing the skyline walk, or a longer walk with a picnic in the middle.

    Highlights of volunteering during a challenging year

    During one walk, a client expressed hopelessness about their prospects of getting employment due to them having dyslexia. The client was new to the group, so I decided to take the opportunity to disclose that I also had moderate dyslexia. The client was really taken aback as he couldn’t believe that I, as an academic, had dyslexia! He had lots of questions and we talked openly about it, breaking down the assumptions and misconceptions. It was truly special!

    The impact of volunteering

    I think through sharing information about our lives, we have made connections which has helped people to feel safe and open up. As a result, I have seen the group grow in confidence. For some, this has meant talking more on walks, whilst others have even started volunteering themselves and considering further education options.

    The staff at Mulberry House say that the walks are doing a ‘world of good’ and are a ‘lifeline to clients’ but I often think it has benefited me more than them!

    I’ve learnt and shared so much and it’s helped me to put my own life in perspective. When you are in your own bubble, sometimes things that aren’t that significant can seem really big and important. But when you hear about other people’s experiences and establish a connection with that person, you start to realise what really matters. In addition to now knowing a lot more about plants, animals, the city of Goa in India or the new lingo of generation Z, this experience has only reinforced my belief in community and how important it is to have connections with people who have different life experiences to you.

    Find out more about volunteering with St Mungo’s here and our current volunteering opportunities here.

    A Mental Health Act that works for vulnerable people

    This week we submitted our views to the public consultation on reforming the Mental Health Act. Emma Cookson, our Senior Policy and Public Affairs Officer, outlines what we want the legislation to remember about people who are homeless experiencing mental ill health.

    How many people who are homeless do you think suffer from mental ill health?

    From October to December 2020 our data showed that 72% of people accessing St Mungo’s housing-related support services had a mental health support need.

    The Mental Health Foundation (2015) found that depression rates are more than 10 times higher in the homeless population, and Office for National Statistics data for 2019 shows suicide rates 14 times higher than among the general population.

    But all too frequently people tell us they can only access help when they reach crisis point. And then even once they receive help, they can often be disempowered and not treated with dignity and respect.

    The role of complex needs and multiple layers of disadvantage – like homelessness – in people’s mental health and access to mainstream services is also completely under-acknowledged. Research carried out by St Mungo’s in 2016, for example, revealed that 68% of areas where 10 or more people sleep rough on any one night do not commission any mental health services actively targeting people sleeping rough. There has been some positive progress with the £30m in NHS funding to enable specialist homeless mental health services to be set up in some parts of the country. However, there is still plenty more to do.

    It’s been two years since the Independent Review of the Mental Health Act, led by Professor Sir Simon Wessely, which recognised the need to give people more say in their own treatment; to require stronger, transparent justification for using compulsory powers; and to improve services.

    It also highlighted the huge race inequality in the use of the Act: black people, for instance, are more than eight times more likely to be subjected to Community Treatment Orders than white people.

    In response, the Government has now published its long-awaited White Paper on reforming the Mental Health Act and held a public consultation on it. This is a huge opportunity to reflect the needs of St Mungo’s clients and ensure that people who are homeless are not forgotten in the reforms.

    Here are the main points we put forward in our submission:

    • We need more focus on prevention, rather than only being able to access help once someone has reached crisis point. Many homeless people are not engaged with statutory mental health services (for reasons including a lack of trust in services and barriers in access). This lets problems escalate. Specialist homeless mental health services are an invaluable means of overcoming the inaccessibility of mainstream health services. But these teams have been subject to major funding cuts during the past decade.
    • Wherever possible, successful community-based interventions are much more preferable to the situation where people are held in a secure, medicalised setting with other people who are also very unwell, with huge restrictions on their choices and freedoms, and where treatment may be administered against their will. Sometimes detention is necessary – but we want it to be a last resort.
    • Housing needs are too often forgotten in both prevention and recovery from mental ill health. Homelessness is toxic to mental wellbeing. To stop a cycle of discharge, re-admittance and worsening mental health, we need more Supported Housing and Housing First which can play a big part in improving mental ill health.
    • People who are homeless face significant stigma, including from ‘professionals’ in positions of responsibility. We need to make sure that there are checks and balances in place to prevent this. We also need more awareness of complex needs amongst mental health professionals to understand the complexities of being homeless with mental health needs.
    • Many people who are homeless with mental ill health have complex trauma. It’s crucial that detention – and other responses to mental ill health — do not re-traumatise the individual, exacerbating mental ill health and creating more difficulties in addressing other, intertwined problems – such as homelessness, substance use, chronic physical, health problems and crime.
    • Even though there is National Institute for Health and Care Excellence (NICE) guidance in place to prevent it, people are frequently pushed into individual treatment pathways. Mental health, homelessness, and drugs and alcohol services are all designed and funded as if people fit into one box, rather than the reality that people’s problems are complex and interwoven. They cannot be addressed one-by-one but need to be approached holistically.

    It’s so important to have a Mental Health Act which works for vulnerable people – like our clients — who find it difficult to engage in mainstream services and who need person-centred care which takes into account their complex needs.

    Just changing the law won’t be a magic switch. Money is needed for chronically underfunded mental health services and we need attitudes towards mental ill health to shift, although there’s been some good progress. Overhauling the Mental Health Act 1983 is a good place to start.

    Our Putting Down Roots programme

    Image: Putting Down Roots

    Matt Woodruff, Horticulture Skills Manager, shares his work supporting St Mungo’s clients through Putting Down Roots.

    Before joining St Mungo’s, Matt had a variety of jobs including garden designer and horticulture teacher – he believes his current role is the most rewarding so far.

    What is Putting Down Roots?

    Putting Down Roots is a horticultural therapy and training project, using gardening as a tool to help people in their recovery. It has been taking place for 21 years – we had been due to celebrate 20 years in 2020!

    How does Putting Down Roots help clients* in their recovery journey?

    Putting Down Roots helps to build people’s self-esteem, confidence and sociability.

    It establishes a routine by asking participants to commit to attending regular sessions, and taking responsibility in caring for plants. Learning to nurture something else helps people to learn to nurture themselves, and there is a parallel between the growth and development of plants and the growth and development of people.

    Putting Down Roots can be an up and down journey, with set-backs and recovering from things going wrong. The cyclical nature of gardening can teach a wider message about positive outcomes coming after cold spells.

    How do clients find out about Putting Down Roots?

    A client may be told about Putting Down Roots via their key worker or another client who has been involved. Clients fill out an application form, and the Putting Down Roots team then make an assessment to ensure the client would be suitable and safe to participate, and at the appropriate stage of their recovery journey to do so.

    Clients can take part in Putting Down Roots for up to two years, before being encouraged to move on to another activity to make space for someone else. This can be difficult as people enjoy the programme so much!

    Is Putting Down Roots an accessible programme?

    It is very accessible! Putting Down Roots is open to all clients and we can assign tasks depending on physicality, for example a participant can sow seeds or do digging, and we have raised beds for people who can’t bend over.

    In addition to our permanent sites in Bristol and London, we are doing in-reach work in hostels to encourage new recruits who may not feel comfortable travelling to a project site. People may feel comfortable participating in the garden of their accommodation project initially, to build up their confidence.

    What outcomes do you expect to see from Putting Down Roots?

    The small things can be the biggest achievement. Simply leaving a room or quitting a substance can be a subtle way in which people have turned their lives around.

    Everyone has a unique recovery journey, and therefore will have different outcomes from Putting Down Roots. For some people, employment or retraining may be the ultimate goal. For others, it may be feeling comfortable and confident in joining another community group as a volunteer. For others, it is regaining confidence and managing to work as part of a team.

    We build our own community within St Mungo’s and seeing the change in people’s outlook is very powerful.

    What has been the impact on the Coronavirus pandemic?

    There has been a massive impact – the initial lockdown in March 2020 meant that the programme could not run and the gardens quickly became out of control. Again, there can be an analogy between people’s lives spiralling due to the pandemic in the same way as the gardens.

    We were allowed to resume at the end of summer, and it has been a start-stop process since then. Putting Down Roots has recently resumed however the rule of 6 means that only four clients and two trainers can participate in a session at the moment. We are looking forward to welcoming more clients back when it is safe to do so.

    We always encourage new recruits and are currently seeing massive demand for Putting Down Roots with a waiting list of clients wishing to take part. I think lockdown has contributed to this – people want to be taking part in a physical activity in new surroundings.

    What is the most rewarding part of your job?

    The most rewarding part is getting to see a tangible difference in people in a very short period of time. In about six weeks you can really notice a person’s confidence increasing, and the feedback we receive from clients is great – they wouldn’t keep coming back if they didn’t enjoy it.

    The transformations are amazing and it feels like a privilege to be part of that.

     

    *Clients are people who use our services, for example, some are residents in our hostels and/or use our Recovery College to gain skills and confidence after homelessness. 


    Putting Down Roots is funded by our generous supporters including corporate partners Barratt Developments and Jo Malone London. Find out more about our partnerships and how you can get involved here


    Donate to help us fund more programmes like Putting Down Roots.

    Housing First in action: Camden

    One of the largest Housing First services St Mungo’s provides is in Camden, which we began running in 2014 with 20 clients. The service has since expanded four times, mostly through Rough Sleeping Initiative (RSI) funding, although its most recent expansion was through the Next Steps Accommodation Programme, increasing its capacity to 72 clients.

    The power of choice

    Housing First staff have small caseloads. They work intensively over long periods with clients, whose trust and belief in the model is key to its sustainability. Staff in Camden begin by asking a client “do you want to work with us?” It seems a simple question, but the most vulnerable clients may feel that past decisions have been made for or to them. Having choice put firmly in their hands from the outset provides a bedrock of empowerment at odds with past experience. Small caseloads have been consistent throughout expansion, with the service maintaining the necessary staffing to support this through partnership working with Camden Council.

    The service works with a range of housing providers, affording choice to clients on where they want to live. This cements their power over their journey and provides a physical platform for recovery in the right environment. The service works with Camden Council and providers such as One Housing and Notting Hill Genesis with whom the service has negotiated service level agreements. These ensure that housing providers understand the Housing First client group, and streamlines processes to prevent clients being overwhelmed. Staff use personalisation budgets to purchase items clients choose which they feel will turn their tenancy into a home.

    The right support

    Housing First is based on clients’ strengths and aspirations, with no requirement for them to engage with support services. Recovery is not linear and, for many, the rigid structure of statutory services, with fixed treatment programmes and methods, can be difficult.

    When clients are ready to engage, challenging the status quo of a treatment programme is important. Staff support clients to engage with these services but also support the services to engage with a client group that they may be unfamiliar with, attending multi-agency meetings to advocate on a client’s behalf.

    As a result, 96% of clients in Camden Housing First are registered with a GP*, and 100% of clients with a mental, physical or substance misuse issue who need to engage with services are doing so*.

    Camden Housing First provides an Occupational Therapist, Rosemary, supported by Homeless Link’s Housing First Fund, to work with clients who have the most difficulty engaging. Using her specialist healthcare knowledge Rosemary works alongside Housing First staff to ensure that clients can access services, especially where those rigid structures and methods have proved insurmountable in keeping clients within treatment and care programmes. Rosemary is able to assess, establish and evidence their clinical requirements and needs. This includes ensuring that capacity is assessed accurately, that adequate care is provided and stepping in when this is not the case.

    Rosemary also works with clients to make sure they have everything they need to meet their support needs within their homes and to access the community through digital inclusion. This has been particularly beneficial during covid, affording access to virtual medical appointments and learning opportunities.

    One client said, “Rose [the OT] is lovely. She gets things done, she don’t turn her back on nothing. She got a laptop for me. I get on fabulous with her and she does everything that’s required”.

    The ecosystem

    Staff also link clients in with other organisations, such as Groundswell, who assist clients through the entire process of attending appointments.  This can include getting ready and travelling to/from, ensuring access to vital medical care.

    During the pandemic staff have been working with services to ensure that medication is dropped directly to clients’ doors where possible. Necessary face-to-face contact has been carried out safely, and food delivered when needed.

    The service and partners in Camden Council identified a real need for a more trauma informed approach when working with female clients. They introduced a women’s worker to ensure a gender-informed approach: understanding and addressing barriers specific to women that they may face in accessing services.  A dedicated women’s worker also allows for more time to be spent building up trust with those clients.

    Support in Housing First services also includes practical things such as cleaning, shopping, and ensuring that the client is in receipt of the correct benefits. This helps people to develop skills which they can carry forward if/when they move on from the service. 100% of the clients at Camden Housing First have increased their ability to manage money as measured by an outcomes star*, and 100% are in receipt of the correct benefits with no sanctions*. The service also works with clients who are subject to court or Anti-Social Behaviour Orders, which staff support them to comply with, with a current compliance rate of 100%*.

    Being a St Mungo’s client also means access to services such as the Recovery College, the Lifeworks psychotherapy service or the Putting Down Roots gardening programme. The St Mungo’s Palliative Care Team have supported staff with hospital and hospice liaison and coping with a client death.

    Patience and persistence   

    It is these vital building blocks and wraparound support which help clients to maintain their tenancies – the ultimate goal of any Housing First service. In Camden, 50 out of 51 service users maintained their tenancies in the most recent quarter*.

    The ethos of Housing First has often been summed up as never giving up on a client. What is perhaps even truer is that clients, who may have every reason to do so, never give up on us.

     

    *Note: figures in this piece are from the reporting quarter 6th July – 4th October 2020

    Street Impact Brighton: successes and outcomes

    Street Impact Brighton Limited (SIB) was established to work with some of Brighton’s most complex rough sleepers; people with histories which involve prolonged and repeat episodes of rough sleeping as well as complex issues around alcohol, drug use and mental health.

    The project was due to start in 2017, however attempts to deliver a four-year multiagency, Sussex-wide SIB were unsuccessful. The following year Brighton and Hove City Council commissioned St Mungo’s to deliver Brighton SIB – a pioneering project to work with 100 people who were identified as being hard to reach, and the most difficult for our teams to encourage to engage with our support.

    The project officially started in March 2018 and is a Social Impact Bond which has social investors putting up the funds to meet the scheme’s running costs and is reimbursed on a 100% payment by results basis by Brighton & Hove City Council. This is backed by the Ministry of Housing Communities and Local Government (MHCLG).

    Fast forward three years and the project closes at the end of March 2021 with some wonderful outcomes. Paulina Drydra, former SIB Outreach Manager shares their journey.

    How does SIB work?

     Over the past three years we have been working with a cohort of 100 named individuals who have experienced long periods of time rough sleeping or who repeatedly return to the streets.  We have a dedicated team of four staff: one manager and three SIB workers. The SIB workers are assigned up to 30 clients each at any one time.

    We were not looking to replace or replicate services that people already had strong links to, but to support those services and fill any gaps with targeted personal support and funds to help people really sustain their recovery.

    The SIB models works because it relies on a great degree of trust between a person sleeping rough and a support worker who has the time and capacity to tackle the complex causes of someone’s homelessness and support them to recover in their own way.

    Optimism when all hope is lost

    Being a SIB worker is about carrying optimism when someone sleeping rough may have lost all hope, while at the same time being absolutely respectful of the individual’s choices and decisions – because it is their life after all. This takes time and focus, and the SIB model gave us that.

    The project essentially succeeds or fails according to how well the team are able to deliver a ‘throughcare’ service – the secret ingredient is providing a new way of working with clients and not replicating something that hasn’t worked before.

    What makes SIB different?

    The two differences that have enabled us to sustain long term outcomes for some of Brighton’s most complex rough sleepers have been consistency and freedom to innovate.

    We offer consistency because we are with people for the whole process allowing the worker/client relationships to develop slowly.

    We have greater freedom to individually tailor our approach to achieve the end goal for our clients, backed up by funds. This kind of approach is harder to take in more traditionally commissioned services, where costs and time spent with each client is directly influenced by commissioning frameworks and contractual expectations.

    Our success

    As we come to the end of the programme, I am proud to say we have achieved some great results. We have engaged with 100 people which is 100% of the original target. We have supported 78% to either enter or sustain their accommodation, providing the vital support they need to get their life back on track, 28% people have successfully signed a long term tenancy agreement and 15% have sustained their tenancy for over one year. There are currently no rough sleepers in Brighton that sit within the SIB Cohort. It’s wonderful to see people feeling in control of their lives again.

    Find out more about our Social Impact Bonds model and successes and outcomes to date here.

    Paulina no longer works for St Mungo’s but she has given her permission to use this article.
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