Biphobia and bi-erasure should not be as prevalent as they are

    For International Day Against Homophobia, Transphobia and Biphobia 2021, Emma from our Lease and Contracts team explains what biphobia and bi-erasuare are and how they are sadly still too prevalent in today’s society.

    There are many different stereotypes depicted that are then perpetuated by society and contribute to bisexuals having such a negative reputation. Biphobia and bi-erasure have sadly been prevalent in society for decades, if not longer, and as I’ve gotten older I have noticed some similarities and some glaring differences in the portrayal of bi men, women, non-binaries and all other gender identities in the media. For clarification, for the duration of this blog, I will be using the term “bi” to cover all those under the umbrella term (e.g. bisexual, pansexual, omnisexual, multisexual, polysexual, heteroflexible, homoflexible, fluid).

    A common stereotype of bi people generally is that they’re greedy nymphomaniacs unable to settle down with one person, and therefore more likely to cheat which then leads to the belief that they are more likely to contract and pass on STIs. There are no facts to support any of these claims, and yet these are the most common accusations the bi community faces. Bi people usually find that a lot their “friends” believe they are always trying to flirt with them, usually after we have opened up and come out to them which discourages many from being open with others about their sexuality. Partners often accuse bi people of wanting to leave them for someone of a different gender, claiming they can’t be satisfied with one partner because they can be attracted to more than one gender. A common claim is that bi people are just going through a phase or doing it for attention before they eventually decide on heterosexuality or homosexuality; that sexuality is and can only be that black and white with no grey areas. Additionally, when a bi person goes from dating one gender to another and people comment “so you’re straight/gay now”; this insistence that we must be one or the other invalidates our orientation and is one of the most infuriating things to experience.

    As for differences, bi women are often sexualised and fetishized whereas bi men are abhorred and ridiculed. Bi women face comments from straight men about automatically being ok with a threesome, and many face attitudes for so-called “gold star” lesbians who won’t have anything to do with bi women as they may have been with a man in the past. Bi men are not as fetishized; instead, they are often avoided by straight women, who act as though they are dirty or shameful and more likely to pass on STIs due to possible relations with other men, and gay men, for being “too straight”. There is one common element I have noticed about the different things said about bi men and bi women in particular that I would like to draw attention to. A lot of the comments I and other bi women hear is that we’re only doing it for attention from men, to make us seem more sexually appealing, and that eventually we will settle down with a man so we can have a family. Bi men, on the other hand, are frequently told that they’re just too scared to be gay and that they will eventually admit that they are gay and settle down with a man. In both circumstances, a male partner is viewed as the inevitable ending for us all; it implies that women are not a viable option for a long-term partner, and this in itself is a very sexist attitude to hold and perpetuate.

    Those who identify as non-binary, genderfluid, genderqueer, etc. usually face the same comments as bi men and women but it is dependent on how others perceive them which in itself is alienating and can be very dysphoric to the individual.  It erases more of their identity than bi men or women as their gender is invalidated as well as their sexual orientation, and this can be very damaging.

    One of the most concerning things I have found from speaking with others within the bi community is that some of the worst biphobia and bi-erasure they have experienced has come from within the LGBTQIA+ community itself. Here, too, exist the beliefs that bi people will cheat with a different gender because they can never be satisfied with one partner. This is not only unfair and untrue, but it also invalidates any who choose a polyamorous lifestyle. There are also many who claim bi people don’t belong if they are in a relationship with someone of a different gender to themselves as they have “straight passing privilege”, meaning they don’t face the same discrimination as an openly and obviously gay couple would as they can pass as a straight couple. This further alienates bi people from a community that is supposed to accept us, and has left a lot of bi people questioning if they want to date outside of the bi or straight community as they feel they will get less judgement.

    The attitude towards bisexuality from both straight and LGBTQIA+ people is that it is a stepping point to “picking a side”; they ignore the huge expanse of no man’s land between straight and gay where all the bi’s live. Also, both straight and LGBTQIA+ people try to dictate what bi means, assigning descriptions without discussing it with those it concerns. For example, bi people are often told that identifying as bisexual is transphobic and/or doesn’t include non-binary people and, that if you are attracted to trans/non binary people, you are automatically pansexual. The basis is that “bi” means “two” and is interpreted as two genders; this is not the true definition of bisexuality which is romantic or sexual attraction to more than one gender.

    Biphobia and bi-erasure should not be as prevalent as they are. In the last fifty years, we as a society have made great strides in acceptance for those within the LGBTQIA+ community, and we are in a much better position than our forebears. That’s not to say that there isn’t more still to do, but now imagine that that community who fought so hard to get here are also still ostracising one of their own; bi people are still fighting stereotypes, misconceptions and ignorance from all corners when we should be banding together. We need to unite to show that, regardless of our spectrum, all flags are valid, seen, respected, valued, and loved.

    Find out more about Diversity and Inclusion at St Mungo’s 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.

    Looking back at the last year, “What a privilege to be a part of it all”

    John from our Outreach team in Bristol reflects on what has been achieved in the past year.

    Looking back at the last year, the first words I think of are tiring and exhausting. But also, what a privilege to be part of it all. What we managed to achieve within that year is absolutely amazing.

    When we first went into lockdown we had to get everyone in, and we had to find the best way to get everybody in. It was that simple. My role is to go onto the streets and reach out to people. To build a relationship. To build trust.

    Sometimes, I was literally able to chat to someone who was sleeping rough, talk to Bristol City Council, and depending on what was available I could get them into emergency accommodation within 20 minutes.

    I have to mention other services. I can only talk about my experience but I can’t emphasize enough how much it was a collective thing. The team, St Mungo’s, other homelessness organisations, the emergency services, Bristol City Council – us as a city, we all pulled together.

    Let’s not forget that most important is the person who is on the street. What we manage to achieve alongside each other. When I think about people who are homeless and how difficult it must have been – one minute they were on a busy street, the next thing they knew the whole city had locked down. How hard that was for people with no homes, for people that needed support or who had alcohol and drug problems. We had to make sure we tailored our support so it was right for their needs.

    You need to remember how fast everything happened at the beginning. Hotels being opened for people on the streets, supported accommodation project making changes so they could keep going – it all happened very quickly! It’s also important to emphasise how Bristol City Council stepped in to help, and how the government gave funding.

    It was stressful and exhausting. I remember some nights I’d get home after a day’s work and fall asleep with my tea on my lap. Go straight to bed and then wake up the next morning to do it all again.

    When we offered people on the streets a hotel room, they couldn’t believe it. Honestly, within a night you could see a difference. An instant stabilisation – being somewhere warm, safe and with a hot meal. Doing the job I do I know how important that is. Imagine how difficult it is on the streets; how hard it is to rest, to find food, to find warm bedding, to find somewhere safe to sleep. And how traumatic that must be for anybody.

    Of course, Covid has been horrific for everyone. But I do have gratitude for some of the positive things that I’ve seen come out of a bad experience. There were people that we had been engaging with for some time – who might have experienced trauma, difficulties with their mental health, or have had challenging experiences – and we were able to get them in for the first time. And because we could get them into emergency accommodation, we have had so many amazing stories of people moving into their own places. Sometimes I see people that I supported into accommodation and they are walking down the street like a completely different person.

    Recently, over winter, we’ve activated our severe weather response three times in Bristol. So we’ve got Covid, we’ve got lockdowns starting and stopping, shops opening and closing and then all of a sudden the weather is freezing and it’s all hands on deck again. We’re out from 6 in the morning until midnight, going out to get everyone in from the cold.

    Even though we achieved what we did in lockdown, sadly there are still people on the street. We can’t lose sight of that. Every single person deserves a home.

    When I reflect back on the last year – exhaustion, tiredness, not sleeping very well – have I recovered from it? Absolutely not! As a team it’s been hard work.

    But also, what a lovely thing to be able to do. What a privilege to be part of it.

    And you know what? I’d do it all again tomorrow.

    World Social Work Day: “I am because we are”

    Today (16 March 2021) is World Social Work Day, which recognises the hard work and dedication of social workers, as well as celebrating best practices in social work. This year, the theme of World Social Work Day is “Ubuntu”. Here, Toni-Lea John-Baptiste, a student social worker on placement with St Mungo’s, discusses the concept of Ubuntu and how it applies to the work we do with our clients.

    I have recently been working as a student social worker with the St. Mungo’s Wellbeing Team in Westminster. While working with the team, I have gained invaluable transferable skills that I will use in my future practice, and I have gained a deeper understanding of the importance of creativity in social work, as well as how social workers can use these skills to think outside of the box when working with service users.

    Due to the current climate of COVID-19, I have had to adapt to remote working. This situation enabled me to draw upon my creativity to engage service users and promote digital literacy in a time where we heavily rely on technology.  Upon reflection, I have realised how important creativity is as a social worker, to be able to adapt and work in any environment.

    The idea of Ubuntu is all about humanism. It is the belief that your sense of self is shaped by the relationships you have with other people ‘I am, only because we are’, and this was a key theme throughout my placement at St Mungo’s. As an example, we used this philosophy as the basis to create a postcard project which involved members of the Westminster community sending ‘messages of hope’ and discussing things that have helped them during this time, to residents within the different projects of the Westminster Wellbeing Pathway.

    At the heart of this project was a sense of community and helping one another, through encouragement, regardless of who the person is or if they even knew them. This was ubuntu in its purest form, as the project was all about helping one another as humans and extending love and hope to echo the philosophy that as a human ‘I am’ ONLY ‘because we are’. It was a truly beautiful project that I am grateful to have been a part of.

    My placement has encouraged my creativity as a student social worker, which has played a big part in me developing projects to engage clients. I found that when working remotely, using a person-centred approach to develop tailor-made projects for clients was the best way to engage and support them.  An example of this would be my work with a client, in which I used a strengths-based approach to create a project based on their artwork. This then led to working on an intensive 1-1 basis, to create a virtual art exhibit with this client, to not only showcase their artwork, but also potentially create a social enterprise opportunity.

    Throughout all of this, particularly because of COVID-19, I’ve realised that you can’t limit social work to a building or a particular place. It’s about treating people as humans, with respect and dignity.

    Housing First – achieving the aim of ending rough sleeping for good

    Housing first was once thought of as a radical rethinking of how homelessness could be tackled – but over the years it has become an increasingly important element to achieving the aim of ending rough sleeping for good.

    One person who has witnessed the scheme’s successes – and a few challenges – over the years is Stephen Brett, Housing First Service Manager in Brighton. Here he shares his thoughts on the scheme.

    A Pilot Scheme and Beyond

    I have worked in homelessness services in Brighton for 20 years. In 2014 I was part of a conversation on how we could adopt different approaches to ending rough sleeping.

    Through this discussion we uncovered aspects of the Housing First model and were afforded the opportunity to run a pilot Housing First scheme.

    It represented an exciting moment in service delivery, a chance to try something genuinely different for people who had exhausted many of the pre-existing resources the city had to offer.

    Housing First is a different model because it provides housing ‘first’, on the basis of right, rather than at the end of a process as a reward.

    And years later the bedrock of the model remains as exciting today as it was in those early stages as we have learned, adapted and grown along the way.

    Challenges and Successes

    I think it’s important to accept that Housing First is not a panacea, but rather as for many people experiencing multiple complex needs offered the prospect of attaining a way out from the risks, rigours and traps of enduring rough sleeping.

    From a burgeoning concept, the approach has now become a valid and established approach to ending rough sleeping. And our experience of delivering Housing First in the intervening years has demonstrated this based upon the achievements of the people that we support through this model. It would however be misleading to say that our growth has been without challenges.

    Housing First workers will work assertively to engage our service users, build lasting supportive relationships, work in a person centred and recovery focused way and manage and respond to any risks. The delivery of the support is therefore both rewarding and challenging. The Housing First model very deliberately attempts to re-frame the typical criteria applied to people sleeping rough accessing self-contained accommodation.

    And part of the journey has, therefore, involved highlighting and indeed contributing to the growing evidence base around efficacy and challenging scepticism.

    We are trying to turn well established processes on their head, we accept that there is an inherent risk within this and related wariness. As people engage in support and maintain their tenancy we aim to break the cycle of rough sleeping so that there is opportunity to address the factors that have contributed to people  ending up on the streets.

    Our longer-term aim is for people to achieve long lasting recovery.

    In Brighton, where I have worked for St Mungo’s since 2016, we have received extra funding from NSAP (Next Steps Accommodation Fund) to offer an additional 20 places – growing from 40 to 60 offers of Housing First.

    The accommodation is dispersed across the city, consciously so and the bedrock of Housing First remains ‘housing as a human right’. We believe that for some people living within a congregated setting hinders their chances of moving away from homelessness.

    We also acknowledge that there are challenges inherent within this offer, and work hard with people to reduce the risk of isolation, maintain regular and consistent contact, coordinate support and provide motivation and encouragement to engage in their recovery goals thereafter, and indeed their new community.

    We make the offer of stable accommodation alongside intensive long-term support, but don’t act as landlords. If people choose not to engage with the support or indeed get to a place whereby the support we offer is no longer required they can still occupy their home.

    That said, the model works best when people engage with intensive support and the adoption of assertive engagement is crucial to this relationship.

    There has been many compelling stories of success:

    • We have had high rates of tenancy retention and continue to contribute to ending rough sleeping in the city
    • We have seen positive engagements with health care support such as completion of treatments for hepatitis and cancer and more generally a reduction in missed appointments
    • We have seen people move away from a cycle of offending
    • We have seen a reduction is substance misuse
    • We have seen abstinence based recovery
    • We have seen people parenting their children
    • We have worked with people on longer term aspirations such as accessing training and employment
    • We have seen people reconnecting with family after many years of disconnect
    • We have seen people connecting with the community they live in

    Hopes for the future of Housing First

    Key to what we are attempting is to offer something of quality to someone experiencing multiple disadvantage that they in turn actually want to accept – I hope that this facet of the Housing First model becomes more prevalent in our approaches to ending rough sleeping as we move forward.

    Given the challenges presented to us all during the pandemic, one of the clear silver linings has been the opportunities created to reduce street homelessness and the incredible work undertaken to implement such opportunity.

    My desire is to see a continuum of this trajectory by affording people lasting, well considered, move on options alongside person-centred, robust support.

    St Mungo’s Housing First

    St Mungo’s is one of the largest providers of Housing First services in England, supporting more than 282 clients and currently delivers Housing First to 14% of places available.

    We have Housing First services in Bournemouth, Brent, Brighton, Camden, Ealing, Hackney and City of London, Hammersmith and Fulham, Haringey, Reading, Sutton, Tower Hamlets and Westminster. Camden and Brighton are our largest schemes, supporting 72 and 60 clients respectively, while our Reading and Sutton services each support five clients.

    As an experienced Housing First provider we have been at the forefront of designing, implementing and running Housing First services in the UK for several years.

    For more information about St Mungo’s Housing First schemes click here.

    Why the cold weather feels a little bit different this year

    Petra Salva, St Mungo’s Director of Rough Sleeping, Westminster and Migrant Services, explains why our services ramp up as temperatures drop. And why Covid-19 is making things a little different this year.

    I’ve dedicated my whole working life to supporting people out of rough sleeping and homelessness. Over the last 20 years or so, I thought I had seen everything in terms of the impact rough sleeping can have on a person and their families.  I’ve seen the harm, the hurt and the pain that people experience, and then came the Covid-19 pandemic.

    All of a sudden, the physical and mental vulnerabilities people already experience whilst sleeping rough came into even sharper focus and became a greater emergency.

    Just imagine what it must feel like, sleeping on a pavement, in the dark, alone, fearing for your safety, maybe taking drugs or drinking, just to numb the pain of your situation, feeling physically unwell because of the toll of this lifestyle or because you have another physical problem that has gone untreated or not even yet diagnosed .

    Then you are faced with the fear of a pandemic, a virus that if caught by you, is likely to make you even more vulnerable and possibly kill you.

    I, and colleagues and volunteers across our organisation,  have had the privilege of helping to house and support hundreds of people since the start of the pandemic to try to address all these risks, but despite our best efforts and that of many charities and local authorities, we have not been able to house everyone, so tonight, too many people are still faced with the grim reality of sleeping rough.

    And now comes the winter and the cold.

    Sleeping rough is dangerous at any time of the year but when the cold strikes, it is even more deadly. Cold weather can, and does, kill.

    On top of that, we know many people who rough sleep already have underlying health conditions, so the risk of Covid-19 makes it even more vital that our clients have access to safe accommodation which will protect them from not just the weather, but from contracting the virus as well.

    There is no doubt, this year will probably be the most challenging that I and our outreach teams have ever experienced but, that won’t stop us from working around the clock to try to save lives by bringing people in from the cold and supporting them when they need us the most.

    The Severe Weather Response, also known as ‘Severe Weather Emergency Protocol’ (SWEP) is triggered when the Met Office forecasts freezing temperatures.

    This can vary from region to region. In London, it is called if it’s going to be zero degrees or below for one night. In our regional areas, it will be activated if zero degrees is forecast three nights in a row, except for in Brighton where our commissioners use a “feels like” temperature.

    In previous years, when local authorities have informed us that our severe weather response is needed, we have provided emergency shelter in the form of communal spaces.

    This year however, we will not be able to provide this type of accommodation. Our clients must be able to sleep somewhere which also allows them to self-isolate, away from others so that they are not at increased risk of contracting Covid-19, but this doesn’t mean we won’t be helping people this year. Instead, we have found new ways to keep our clients safe this winter.

    Our teams have been as agile, adaptable and creative as they always are – seeking out every possible option which can be used to provide much needed accommodation – cleaning rooms previously used for storage, converting meeting rooms to bedrooms – resourcefully adapting as many spaces as we can. As well as working with local councils to find other suitable places.

    Protecting people from the elements is just the beginning for us. Because I know that providing somewhere warm and safe to stay is just the first step.

    Often, when it’s really cold, we have a valuable opportunity to engage with people who, under normal circumstances, might be reluctant to come indoors. So our teams are committed to trying their very best to ensure every person brought inside never has to go back to sleeping outside again.

    They go above and beyond to help people with their future plans, including reconnecting them with family and loved ones, providing permanent housing and linking them to health services, as well as assisting with benefit and employment support.

    Like I said at the very beginning, I have seen first-hand the harm and pain that rough sleeping causes people, but I have also seen how, with the right help and support people can and do recover from homelessness.

    The reason I am still here fighting is because I have hope and belief that mass rough sleeping really can be a thing of the past.

    Anyone concerned about someone sleeping rough should contact StreetLink via their website or app. Alerts will be passed on to the local outreach service or council who will attempt to find them and offer support within 48 hours of being contacted. StreetLink is not an emergency service. If anyone is in need of urgent medical attention, please call 999.

    Our severe weather response will save lives

    Severe Weather Emergency Protocol (SWEP) is triggered when the Met Office forecasts freezing temperatures. This trigger can vary from region to region, for example in London it’s zero degrees or below forecast for one night, in Brighton, our commissioners use a “feels like” temperature. Most boroughs will activate SWEP when it’s a three night zero forecast. Due to the pandemic SWEP will be different this year. Here Wendy Dodds, Outreach Coordinator in Reading shines a light on what this means and what’s been happening on her streets.

    Photo of Wendy Dodds, Reading Outreach

    I have worked in outreach for sixteen and a half years. In that time I have seen many system changes but the heart breaking circumstances for people remain devastating.

    St Mungo’s were first commissioned to run the outreach service in Reading on 1 January 2008 and we have managed it ever since. We took it over from an organisation called Crime Reduction Initiative, where I had been working since April 2004 and when St Mungo’s took over I moved to be on the team.

    The past context and why SWEP is important

    The homeless picture was very different then, we didn’t have a homeless pathway and it very much depended on our relationship with housing providers to enable a client to access accommodation. This saw an imbalance in service provision and often people with the most complex needs suffered the most. People were more willing to accept a person with low support needs into their accommodation. We saw people who were more entrenched in rough sleeping because there was no pathway for them, yet some people new to rough sleeping were picked up quickly while others remained on the streets for years. It’s shocking to reflect back and I’m glad that has changed.

    We didn’t have a Severe Weather Emergency Protocol (SWEP) back then either. SWEP was introduced as a life-saving initiative by central government. I have a love hate relationship with SWEP, I love that we get more people in and treated as a priority but it adds a lot more pressure to an already pressurised team.

    Some people still refuse help and it happens a lot, mainly because people do not want to share accommodation – especially if a person had experienced trauma there can be a lot of triggers sleeping in a noisy environment where people are wrestling with all kinds of issues, people often say they don’t feel safe and would prefer to sleep alone on the street. The worry never leaves you, I get frustrated and I make sure people know they are at risk of death, you have to be blunt sometimes – there’s no point dressing it up SWEP is lifesaving and there is no doubt cold kills. In Reading we have people refuse to come inside, people who will accept our help and people who are sofa-surfing booking a space in the hope they will be escalated through the pathway into housing. It’s a tough call, as all are vulnerable but SWEP is emergency provision to save lives. If I give you an example on one night during SWEP last year we had 14 people stay and 9 were sofa surfing.

    During the pandemic

    So with the Covid-19 pandemic and our policy to offer everyone a room of their own in a local B&B will bring a new SWEP. I will be really interested to see what the landscape is like this year. It’s going to be very interesting. The barrier to shared accommodations has been removed so I’m hoping we will be able to help people who tend to refuse support.

    This year has been a difficult year with constant changes to our service provision to adapt to Covid-19 restrictions.

    The highlights of my job and what drive me

    Housing First! In Reading we received funding for a Housing First Outreach worker through a philanthropist. I am a huge believer in housing first and I would love to see it expand across the UK. Seeing the progress people make has been inspirational. It makes me proud to have played a small part in it. Watching a client on their road to recovery and bumping into them on the high street and seeing the difference… it makes me so proud even when they are not my client.

    It’s a massive privilege to do a job I really love. These are people that have fallen through every single safety net in society. We should be the ones that feel privileged that they even engage with us. We need to look at the barriers to why people don’t want to engage. Housing is a right, it shouldn’t be deserved, and it is disgusting. People shouldn’t have to be on the streets but unfortunately they are. If I came in to work tomorrow and was told I had no job because we had solved homelessness – I would skip all the way home.

    Cold weather can kill. Our clients are at greater risk due to underlying health conditions and the year round dangers of sleeping rough. But in extreme cold, these challenges are brought into sharp focus for our clients, for our staff and for our partners and supporters.

    It is vital that everyone who is on the streets, or who is at risk of rough sleeping, can access self-contained accommodation as soon as cold weather hits, alongside the support they need to recover and rebuild their lives. Find out more how you can help here.

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