Tag: Mental Health

    The new NHS plan for mental health services has a clear offer for people sleeping rough

    For organisations who have campaigned for many years on homeless health, the NHS Mental Health Implementation Plan is a cause for celebration. Beatrice Orchard, St Mungo’s Head of Policy, Campaigns and Research, explains why the plan must deliver on its ambition to make sure everyone sleeping rough can access the mental health support they need.

    When the Government’s Rough Sleeping Strategy was published exactly one year ago by MHCLG, there were some positive signs that other government departments would also be doing their bit to reverse the dramatic rise in the number of people sleeping rough in England.

    One of the most solid commitments was in relation to improving mental health support for people who are sleeping on the streets. Last month, the details of this commitment became clearer when the NHS Mental Health Implementation Plan was published.

    The plan is clear that by 2023-24, 20 areas with high levels of rough sleeping will have established new specialist mental health provision for people sleeping rough, which will be made possible with £30m of central NHS funding invested for this specific purpose.

    This is a fantastic result for St Mungo’s Stop the Scandal campaign and our continued efforts to press the Government for investment in specialist mental health services to ensure people sleeping rough can access the support they need.

    Sleeping rough and mental health – the links

    It is fairly easy to understand that sleeping rough has a negative impact on a person’s mental health and wellbeing, as well as their physical health.

    Evidence shows people sleeping rough are 17 times more likely to be victims of violence compared to the general population. News reports describe horrifying attacks and abuse on people sleeping rough and our clients tell us about their experiences of feeling lonely, frightened and even suicidal.

    Furthermore, we mustn’t overlook the fact that some people sleeping rough have already been through many traumatic experiences in their lives, including violence and abuse from a young age.

    All of these experiences can cause mental health problems to develop or worsen, but also impact on the type of mental health support people need and how easy they find services to access.

    New avenues into support

    The new, NHS-funded, specialist services will make sure that people sleeping rough can access to clinical mental health support by integrating with existing homeless outreach, accommodation and physical healthcare services.

    They will be required to adopt a trauma-informed approach, known to help improve the psychological and emotional wellbeing of people with complex needs. We also expect the new services to help people who have drug and alcohol problems and are currently excluded from some mainstream mental health services as a result.

    This specialist support breaks down all of the barriers people sleeping rough often face when trying to get help to improve their mental health. Really effective specialist teams can also influence mainstream health services in their local area, encouraging them to become more knowledgeable and understanding of the needs of people who are sleeping rough.

    So far, so good. But what about people sleeping rough in other areas not in receipt of this new funding?

    A welcome step forward

    Research shows 4 in 10 people sleeping rough in England have an identified mental health problem. The latest data from the CHAIN reports on rough sleeping in London shows 50% of people sleeping rough in the capital in 2018-19 had a mental health support need.

    It is welcome, therefore, that the new plan for mental health requires all areas of the country to complete a mental health needs assessment for people sleeping rough and take action to increase access to mental health services for this group.

    This new approach to mental health for people sleeping rough is a real step forward.

    Specialist mental health services have been tried in the past. We know they can make a dramatic difference to individuals’ lives, and help to reduce rough sleeping by supporting people to move on from homelessness for good.

    Better still, it doesn’t stop with specialist services this time. Instead all NHS services will need to think about how people sleeping rough can access the healthcare they need in order to rebuild their lives.

    St Mungo’s will be watching closely and encouraging all areas to ensure the plan delivers.

    Twenty vibrant years at St Mungo’s

    Jen, St Mungo's Creative Arts Volunteer

    “The enjoyment of it has kept me going for 20 years. It’s a great pleasure. It’s all the people that I meet and talk to, and the work that I see.”

    As we celebrate Volunteers’ Week, Jen Burnham, St Mungo’s Creative Arts Volunteer, tells us about what she’s learned through volunteering.

    I’ve been a volunteer at St Mungo’s for 20 years. I was one of the first volunteers on a programme called ‘Make It Work’ which I think was the beginning of a formal volunteering programme at St Mungo’s. Now I understand it has something like 900 volunteers a year!

    I’m almost 75 years old now. I’ve always had an interest in art but I never did much with it. In 1998, I was at a dead end in my life and I decided to do some art-related volunteering, including an art group at St Mungo’s in Argyle Street, King’s Cross. I was made very welcome there.

    A few years later a member of St Mungo’s literacy team produced a booklet of poems by Argyle Street residents and asked if we had some artwork that could be included. The resulting booklet was much admired and one resident Joe asked, ‘why don’t we do this on a regular basis?’ That was the beginning of Homeless Diamonds magazine. It started as a photocopied A5 booklet for art and writing from the King’s Cross area; it’s now a glossy A4 magazine for all of St Mungo’s and a bit beyond (thanks to support from Regional Director David Devoy, who from the start has supported the project).

    We produce three editions of Homeless Diamonds per year, each containing the work submitted since the previous issue – no more and no less. Everyone who submits will have something printed. On the suggestion of contributors we have recently set themes for particular editions, but always maintain this submission policy.

    Producing Homeless Diamonds is a big, varied job; the hardest (and most rewarding) bit is gaining contacts with residents throughout St Mungo’s and encouraging them to contribute. We are very lucky to have our volunteer designer, Gasan, who has designed most of our editions. When all is gathered, typed, corrected, photographed and laid out for the printers we can look forward to celebrating with a little launch party; then the task is to get our 350 copies distributed, to all the contributors and to as many residents of St Mungo’s as we can,

    It’s clear that contributors value the magazine, and that it gives them a great boost to see their work printed in a quality publication. It’s a wonderful way to communicate across boundaries, at a more personal level.

    The enjoyment of it has kept me going for 20 years. It’s nice to see contributors as they progress in various ways (including working at St Mungo’s) – many have told us how much their engagement with the magazine has helped them. There is a huge pool of experience, and talent, at St Mungo’s, a resource of great value to society.

    Volunteering has helped me a lot. I had lost confidence in myself when I started, and it gave me an experience of being valued that I really needed. And I stumbled upon such interesting people, such remarkable characters! So the feeling was mutual!

    I hope Homeless Diamonds will continue, perhaps as part of St Mungo’s Recovery College, when I get too dotty to carry on.

    If you have some spare time and would like to make a difference to someone who is experiencing homelessness or a decline in mental health please visit St Mungo’s current volunteering opportunities. You can also email: VolunteerServices@mungos.org or call 020 3856 6160 for more information.

     

    On a typical day…

    “For me, if I can go home knowing I have helped at least one person away from the streets, or just one person away from the distress of mental health illness, I feel blessed.” St Mungo’s Mental Health Practitioner, Fatima, shares her experience of working in Outreach, helping people sleeping rough in the Tower Hamlets area.

    I’ve been a mental health nurse for 18 years. In 2011, I became and an approved mental health professional, which incorporates social work. I will work typical outreach shift in terms of going out early in the mornings and staying out late in the evening, as late as two or three in the morning, speaking to clients who are sleeping rough to try to form therapeutic relationships with them to help them move away from a life on the streets.

    ‘Blinded to homelessness’

    I was one of those people who was blinded to homelessness. I could walk past a homeless person or rough sleeper and not really see them to understand what they’re going through. It’s been an eye opener for me and I’ve fortunately been able to influence others to see homelessness through what I do at St Mungo’s.

    It can take a week or months to be build a relationship with a person. Sometimes they are in denial – they have no insight about what is happening to them so I try and to slowly educate them. I take decisions out of people’s hands when they’re experiencing mental distress.

    I enjoy my work. I can get people registered with a GP surgery, then get them to start medication, stabilise their mental health illness and then help into accommodation whilst we support them. Many people may have been de-registered and have been turned away from Accident and Emergency (A&E) wards. They can go through those revolving doors three or four times a month, back and forth from A&E.

    I also work with the clients to ensure they engage with the process of recovering from homelessness. You cannot take someone off the streets and expect them to turn up for every appointment. I have to build that relationship, that rapport and that routine of them coming to see me to talk about their mental health, the medication and the side effects.

    ‘Long days full of drama’

    My days can be very long and full of drama. Sometimes I get abused, which can be quite stressful. But my job is also fun and flexible. For me, if I can go home knowing I have helped at least one person away from the streets, or just one person away from the distress of mental health illness, I feel blessed.

    It’s brilliant to see someone who has been sleeping on the streets for five or six years leave that life behind. The kerb becomes their family so getting them into accommodation is not easy. When you put them in a room in a hostel it can be very lonely. The silence can be deafening for them because people out on the streets give them money and say hello – some people get to know them as they walk past them on their commutes. So they run back onto the street and people wonder why because they have accommodation.

    ‘Everybody is unique, everybody has a journey.’

    A lot of clients can lose their accommodation in hostels because of poor mental health – some people cannot understand their journey. Everybody is unique, everybody has a journey. How you hold their hands to support that journey is what makes a difference. People might think, ‘go to housing and get a property, get off the road and get your benefits’, it’s a much longer journey, however.

    Different clients talk about their living conditions. Finances are a problem. People have not been used to managing money and paying bills. Universal Credit has also caused a lot of problems for our clients.

    I have one client, for example, who believes he has all his money invested in stocks and shares. He says when his investments mature, he’ll pay his rent. He has a diagnosis of schizophrenia with delusional disorder. I ask for my colleagues to work with him in terms of hand-holding to ensure he does not get evicted from his hostel.

    I’m working with this lady that I’ve known since I was a student nurse. Up to now she will not allow anyone else to work with her. She was sleeping in a bin shed. She became mentally unwell, and started using drugs to self-medicate the voices she was hearing. Her children were taken into foster care when they were young. I worked with her and got her a place in a hostel. He son got in touch after 15 years and they’re building a relationship again.

    ‘You cannot be judgemental’

    Because of the nature of the people we work with, many with chaotic life styles, who are extremely marginalised, it’s very difficult to get through to the NHS. Even though I am that link between the NHS and homelessness services. Sometimes the nurses have no understanding or knowledge of homelessness. They’ll say, ‘he needs to go, he might bring drugs in here’. It’s a big challenge to get my clients treatment because of the way they look, or dress and their circumstances.

    Working in outreach, you cannot be lazy. I have gotten used walking everywhere. You must be able to multitask as you’re dealing with more than one client, sometimes up to seven a day, who are in crisis. I’ve jumped over six feet walls and walked along canals to help people – it’s part of what we do. You must have people skills, respect humanity, and you cannot be judgemental at all. It takes a lot of character to try and support people who are not ready to receive help.

    It’s a nice feeling to know you’ve helped someone from being a hermit to re-engage back into society and to be part of a community. I think that’s what has been missing in [conversations about] homelessness. Our country has forgotten how to be a community. To me, it feels like in London everyone is in a rush, so in that mad rush, we are blinded to homelessness.

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