New Mental Health Support Services in Brighton and Hove

A wide-ranging range of support service for residents in Brighton and Hove who are experiencing mental health problems start today.

The services are part of the shift towards a ‘recovery’ model of mental health care which supports people’s efforts to improve their health and wellbeing in every aspect of their life.

Rethink Mental Illness, the largest voluntary provider of mental health services, has won the contract to provide two local services: suicide prevention and support, and help for people with mental health problems who are involved with the criminal justice system.

Mental health charity MIND in Brighton and Hove will provide comprehensive mental health advice and information from its New England   Street office, online, and at outreach sessions across the city.

Southdown Housing Association will provide Brighton and Hove Employment Service in association with Sussex Partnership NHS Foundation Trust. The service will offer one-to-one support to help people with mental health problems to get and keep a job.

BHT will help people build up their emotional resilience through one-to-one sessions, wellbeing groups, life skills workshops and similar services run from our North Street offices. Our mental health and wellbeing service will encompass two women-only therapeutic support sessions a week.

Third sector organisation MindOut will provide mentoring for lesbian, gay, bisexual and transgender people who have mental health issues, and will also extend its out-of-hours mental health support service to the LGBT communities in Brighton and Hove.

Allsorts Youth Project has been given a contract to support 13 to 25 year olds who are for lesbian, gay, bisexual, transgender, or unsure of their sexual orientation and/or gender identity. Its work will include individual support and group work on issues such as mental health, sexual health and substance misuse.

The Carers Centre for Brighton & Hove will contribute to better mental health by offering individual emotional support, information and advocacy to adult carers; groups and activities for adult carers; and assessment, support and activities for young carers.

Assert (a local charity supporting adults with Asperger Syndrome or high functioning autism, and their parents, partners and carers) will facilitate two Life Skills courses. One will cover communication skills, building and managing positive relationships, and managing anxiety. The second will cover managing stress, organisational skills, household management, managing finances, staying safe, using public transport and health and well being.

Southdown Housing will support people’s recovery through two centres at PrestonPark and Buckingham Road – each offering support, activities, information, internet access, links with other community services, a café and other facilities – and by running activities in community venues across the city.

Sussex Oakleaf will work with voluntary sector partners and Sussex Partnership NHS Foundation Trust to support people with personality disorders. Its Lighthouse Recovery Support service will provide intensive treatment, community activities, a café, drop-in and online support services.

(The above information was taken from a press release put out by the Brighton and Hove Clinical Commissioning Group, the new GP-led organisation which now buys many health services for local people, and which has agreed contracts for mental health support with a range of voluntary and NHS organisations.)

Good news as BHT-led partnership is given the go-ahead to bid for £9.2 million Big Lottery funding

We have had some very good news this week which is attracting some media interest.  A consortium, being led by BHT, is in the running for funding from the Big Lottery of up to £10 million over 8 years.  The initiative is designed to improve services for men and women with complex needs (a combination of mental ill health, homelessness, offending behaviour and substance misuse problems) in Brighton, Eastbourne and Hastings. Between now and September, a full bid and business plan needs to be prepared.  A decision will then be made by the Big Lottery and the new services will begin from April 2014.

The purpose of this funding is to bring about lasting change in how services work with people with multiple and complex needs; this funding is a vehicle to help bring about that change. The legacy of the 8 year programme will be that systems and services in all 3 geographical areas will better meet the needs of this group.

At this stage we have been awarded funding to develop the bid on behalf of our partnership which includes partners in local government and in the third / charity sectors.  Should the partnership be successful, it won’t just be BHT staff (contrary to what the Argus reported this morning) who will provide services.

My colleagues, Nikki Homewood and Jo Berry, are leading on this initiative for BHT. Nikki said: “As the lead partner for the Brighton and Hove, Eastbourne and Hastings area, BHT is thrilled to receive funding to develop our partnership bid to ensure better service provision for people with the most complex needs.

“Using the wealth of knowledge and expertise within our local Core Group, comprising seven voluntary sector organisations and five statutory partners including commissioners, along with the 60+ organisations in our Partnership Group, we will develop a programme that will truly bring about change for the clients the programme work with, and local communities.

“Our vision is to bring about long-term systemic change by putting service users at the heart of services, fully understanding what they need in order to move forward with their lives: thorough monitoring and evaluation will result in well-evidenced findings, which will then be used to influence future commissioning.”

BHT’s partners in this initiative, and who are represented on the local Core Group, include: Brighton and Hove City Council, Brighton Women’s Centre, CRI, East Sussex County Council, Eastbourne Borough Council, Hastings Borough Council, Homeless Link, Sanctuary Supported Living, Southdown Housing Association, Sussex Oakleaf, Sussex Probation Service

The work of BHT’s Advice Centre: preventing homelessness, reducing inequality, community cohesion

This morning I reviewed the impact made by BHT’s Advice Centre in Brighton. Here are some basic statistics. I would ask you to reflect on the difference we make to the City and the consequences should this service close:

• 35% clients belong to a BME group
• 42% clients have either a disability, addiction or suffers from mental or physical ill health
• 55% of housing clients are in “priority need” and so the possible responsibility of the City Council.

Positive Outcomes (expressed as a percent) of Cases Closed during 2011/12

• Housing Advice 88% (This includes homeless prevention, conditions improved, accommodation found, better able to manage affairs)
• Housing court duty 85% (This includes homelessness prevented through stopping a possession order or execution of bailiff’s warrant)
• Accommodation Advice and Assistance 60% (This includes Homelessness prevention, PRS Accommodation found or sustained. These statistics are based on tracking 317 clients over 12 months).
• Welfare Benefits 95% (This includes clients who received increased or backdated benefit, and who are now better abled to manage their affairs)
• Debt 87% (This includes debts negotiated to an affordable plan, client better able to manage debt, debt reduced/written off etc.)
• Immigration 78% (This includes being granted Leave to Remain, refugee status, citizenship, family reunion etc. and includes 63% of appeals won)

Our legal services directly contributes to City strategies on:

• Prevention of homelessness and rough sleeping by reducing the numbers in temporary accommodation.  In 2011/12 homelessness was prevented or accommodation found in 1,531 of cases above. A 70% homelessness prevention rate.
• Reducing Inequality through helping to lift clients out of poverty (often suffering multiple problems, for example mental health, addictions, offenders, street homelessness, anti-social behaviour, poverty)
• Community cohesion through immigration advice helping families achieve stability and live together

Real Life Stories from BHT’s Crisis Response and Support Services

This is the fifth in a series of contributions from BHT clients.  This post has two contributions from clients of our Response Services that comprise three separate and distinct services – Crisis Response Service, BHT Rough Sleepers’ Initiative and Support Response Service. All are funded through Housing Related Support (SP).

The first is a thank you letter received from a client:

“I really would like to say ‘Thank You’, for all of the help that you have provided me with. It’s been quite a stressful period, being evicted and becoming homeless and I know that without your help … I would not have dealt with the problem very well at all; I do fully appreciate everything that you have done for me and continue to do with your team at BHT, and, also, appreciate that without your help I would certainly have become street homeless. There’s no way that I can repay any of you for all the help that you have given, but I really do want you to know that you have been an essential part of overcoming my housing problems and needs and that I am so very grateful. So, thank you, so much, again”.

The second is an account of an 83 year old.  It shouldn’t but I am still taken aback when I hear of someone of this age in dire need:

C came back to the UK from the Canary Islands aged 83 and partially sighted to be near her family, after having sold her house to pay for medical bills when her son became ill and had no insurance. Any money she had left was then stolen by her grandson, who was addicted to heroin, and had gained access to her bank account. This left her with no money and she was not allowed to claim benefits initially because she had none of the necessary proofs, particularly where the money from the sale of her house had gone. She ended up sofa-surfing and sometimes sleeping on a camp bed at her sister’s. The Council found her a privately rented flat but hadn’t realised there were issues regarding her access to benefits.  We worked with her to prove that she had not spent or hidden the money herself and made the case to Housing Benefit and the Pensions Service so that she could eventually get her rent paid and have money to live on. We also kept the landlord informed about what was happening and arranged for the rent to be paid directly to the landlord when she got it. She is still waiting to hear about a grant for some furniture, but has been given essential items by members of her family.”

Real Life Stories: Sue’s Story

This is the second in a series of Real Life Stories, the experiences of BHT clients in their own words:

“I am at last writing to you to inform you of how Homeworks has helped me over the past 18 months.

“In September, 2010 I experienced a period of severe clinical depression which necessitated me leaving my job, and therefore the accommodation that was tied to that job. I had minimal input from the Mental Health Teams despite two suicide attempts in a week, but I was given a Homeworks leaflet.

“On contacting Homeworks, I met Mandy, who instantly facilitated looking into my options. She linked me in with Housing Benefit and Employment Support Allowance, which was something I had absolutely no prior experience or knowledge of.

“I quickly moved in with relatives, after my landlady staged a break-in at the cottage I was soon to vacate, in order to encourage me to move out quicker than the four week notice period. I eventually moved in with my Mother, with my 2 children, to a rented house in Eastbourne and thanks to Mandy’s advice added my name to the tenancy which then permitted me to claim Housing Benefit, facilitating a level of independence. She also suggested applying for Disability Living Allowance, which was granted. I used the first payment, which was back-dated to September, to pay for a week’s respite at Forresters in Southampton, again Mandy’s idea, which was a really useful break.

“Mandy helped me to navigate the Mental Health Teams, which was something I just could not manage, and liaised between the acute and community services, which at that time did not appear to communicate, in order to find out where I was on the list for Cognitive Behavioural Therapy, and which list I was on; a list I had been added to at least a year earlier before I became acutely unwell.

“I saw Mandy weekly and provided a huge amount of emotional and practical support. She sorted out all my Benefit applications, which was further complicated by divorce proceedings and imminent sale of my part of the marital home. We used the Eastbourne Advice Centre on a number of occasions to clarify matters relating to Benefits. I would not have been capable of any of this without Mandy’s help and support.

“At this time Mandy also supported me through making a complaint to the NHS regarding the lack of mental health care I was experiencing. Having written to the NHS Trust and getting no reply, I eventually wrote to my MP, Norman Baker, detailing my experiences, who contacted the Trust on my behalf. Mandy and myself subsequently attended two meetings, one with an Acute Services Manager and one with the ‘Adult Mental Health Recovery Team’ Manager, and ultimately received a written unreserved apology from the Trust.

“Since contacting my M.P. the care I have received has been good, with regular support from a Clinical Psychologist for several months, followed by a course of Cognitive Behavioural Therapy, and regular follow up with a Consultant Psychiatrist.

“Again, Mandy’s support was instrumental in pushing to get the mental health support I needed, and which was not forth-coming until I complained. She helped me to stay calm enough to get my point across when I was finding everything very difficult.

“In March 2011, my Mother needed to move on and I became homeless. Mandy supported me through submitting a Homeless Application, which was accepted by Lewes District Council. I moved to a series of Bed and Breakfast accommodation, to Seaford for a weekend, to Jevington Gardens, Eastbourne for a couple of months, then to Hanson Road, Newhaven, for three months. Mandy supported me through all these moves, which were stressful, unsettling, expensive and a bureaucratic ordeal, as each move required a new Housing Benefit application, requiring new evidence etc. At Hanson Road, I managed to persuade the Council to allow my 2 cats to be returned to me, by supplying a “cat reference” and supporting letter from my GP, which again were Mandy’s ideas.

“At each step Mandy’s gentle insistence that all the options be looked at, gave me the feeling that I could make the decisions regarding my future, which was very difficult due to my mental health problems at the time. She facilitated my independence when I felt very low and unable to mentally juggle all the issues that were immersing me.

“In October 2011, I moved to a three-bed house in Newhaven, and am currently on a starter tenancy, with the full likelihood of going on to a secure tenancy. I have a house that suits my family’s needs, is affordable, and close to my children’s school in Seaford. Mandy’s support at every step of the way has enabled me to get to a point where I am again living independently and in receipt of Benefits that are enabling me to recover from my mental health problems.

“I cannot thank Mandy and Homeworks enough for the help and support that I received during a very difficult time. Without that help, I have no idea where I would be.”

A BHT service that is reducing crime, homelessness and many thousands of Pounds for the tax payer

Each week Patrick Allen, the Chair of the BHT Board of Management and I visit a different project around the organisation. It gives us a chance to deepen our understanding of the work of the organisation which is diverse and complex.

This week’s visit was rather different as we visited our HMP Lewes to Brighton project based at Lewes Prison. The Project works with prisoners with complex needs, including those with mental health and substance misuse problems, who would be homeless on release from the prison, by identifying support and accommodation needs and keying them into appropriate services.

Most of these clients are serving sentences of under 12 months, have a local connection to Brighton and Hove, and are repeat offenders.

During 2011 our worker, Sean, supported 60 individuals, ensuring that 93% were housed at the point of their release. Because most have accommodation, and Sean is able to support them, a very small minority (less than 15%) commit further offences and are returned to prison.

It costs approximately £40,000 to keep someone in prison each year, with a disproportionate share of the costs being incurred at the point of reception and induction. Given the number of repeat offenders entering a prison such as HMP Lewes, a scheme such as HMP Lewes to Brighton reduces re-offending. Because it is a significant factor in reducing repeat offending, it saves the Prison Service, and thereby the tax payer, tens and more likely hundreds of thousands of Pounds each year.

The Project works closely with a housing officer, also based in the prison, employed by Brighton and Hove City Council. Together, in their separate but mutually supportive projects, mean that prisoners from Brighton and Hove are well served. The impact of their work is a reduction in homelessness, less anti-social behaviour, and less crime. The modest investment in these services pays dividends, and it is a model that other localities in Sussex would be well advised to replicate.

The HMP Lewes to Brighton project is funded jointly by the Prison Service, Brighton & Hove City Council and the Henry Smith Charitable Trust.

Jeremy Swain – a prophetic voice in a media-frenzy world

The prophets of the Old Testament were not the Russell Grant of their time, making predictions for the future of your love life, romance, body and soul. No, they told the truth, no matter how uncomfortable, and no matter whose wrath they might incur. In today’s media-frenzy world, we have many people willing to express their opinions on a whole range of subjects whether or not anyone ins interested! I include myself amongst their number.  But those speaking with originality and in an unfearing manner are few and far between.

Every now and again I am lucky enough to come across someone who is truly prohetic, in the true sense of the word. Jeremy Swain, Chief Executive of the homelessness charity Thames Reach, is one. He has one of the most original minds of anyone I know. His views are rarely conventional, always challenging, sometimes shocking. But he retains a clear focus on what is right for clients.

His column in last week’s Inside Housing is a good example. He challenges the mantra that “anyone can become homeless” by pointing out that “a typical rough sleeper will often have experienced dysfunctional family relationships, experienced a disrupted education, had early experience of the criminal justice system, misused alcohol or drugs and suffer from low self-esteem and poor mental health”.  He reflects that the businessman who earnestly states that “any of us could become homeless and that we are all just two pay cheques away from homelessness” may have admirable intentions but “let’s be honest, those cufflinks alone would have cost four weeks’ of jobseeker’s allowance”.

Jeremy is right.  Someone from my class background, with my economic circumstances, with my support network, with the absence of alcohol and drug problems and of mental health problems, is unlikely in the extreme to find himself homeless.  The bottom line is I do not experience poverty, financial, emotional or social.

Do read Jeremy’s column and his blog.

Initial reaction to the Comprehensive Spending Review

Like many others, I have awaited George Osborne’s statement on the Comprehensive Spending Review with a great deal of trepidation.  This is my reaction to it, just two hours after the Chancellor sat down and before we have had chance to assess some of the detail.

The announcement that adult social care and the Personalisation agenda are to be protected is particularly welcomed, although I am disappointed that there are to be further cuts of, on average, £100 million each year for the next four years in the Supporting People budget .  This equates to an annual cut of 6.25%.  This is disappointing given that it comes on top of cuts of £200 million over the 6 years since 2004/05 and there is no fat left on the bone.  Supporting People services are aimed directly at the elderly, the frail and the poorest in the country.  However, I had feared that the cuts to the Supporting People programme were going to be greater, and it was good that the Chancellor specifically recognised this programme in his speech.  On the ground the reduction in funding may be greater given that Supporting People will no longer be ring-fenced, and councils are having their overall funding cut by 7.1%.

There could well be opportunities for organisations such as BHT as new ways of working are expected.  Local decisions on local policies and local delivery will allow charities and local councils to work together to meet the needs of communities.  Charities like BHT can bring innovation and good practice and we can help to change and improve the communities within which we work.

We welcome the recognition that house building is needed – 150,000 new homes over the next 4 years.  The government is looking seriously at how this can be funded through increased rents on new lettings.  However, we are concerned that social housing rents for new tenants will be 80% of the average market rent.  This will mean that these homes will not be affordable for the unemployed and low paid households with three or more children when a £26,000 cap on benefits payable to individual households is applied. 

The question has to be asked whether such households will be able to afford rents in high cost areas such as Brighton and Hove.  With the changes to housing benefit and benefit entitlement, I can foresee households with three or more children having to move out of Brighton, where they may have been born and brought up, to areas where they may have no connection, no family and no support, and where additional pressure will be put on local services such as schools and health services.  We support the calls that areas like Brighton and Hove should be exempt from these changes.

We are concerned about what cuts will be made to Legal Aid.  Details of these are to follow.  There will be consultation on how to reduce the budget by £350 million.  We hope that any cuts will not undermine our ability to provide advice and legal representation from our advice centres in Brighton, Eastbourne and Hastings.

Other details will emerge over the next few days.  For example, we have just heard that the restriction in housing benefit  for those under 25 to the cost of an average room in a shared house is to be extended to those under 35.

Please comment on your reaction to the CSR and how you think it will impact on our clients, on BHT itself, and on the communities within which we work.

Mental health patients DO fare better in the community

There is a letter in today’s Argus supporting Lisa Rodrigues, the Chief Executive of the Sussex Partnership NHS Trust, for her moves to increase proactive community support services. The letter writer, Kevin Lindsay, writes: “Admission to a psychiatric hospital should be the very last resort for people experiencing mental health problems and only after every alternative form of care has failed to maintain the individual in their home environment. Care in the community, if delivered effectively, is not only a cheaper alternative to hospital are but it is by far the most humane and effective”.

I do agree with him.  Brighton Housing Trust was in the forefront of the care in the community evolution when, in 1989, we opened our Portland Road Project, the first of its kind locally.  We saw people who would have been left in the old long-stay psychiatric units get a fresh opportunity to live in the community.  We were told that because we weren’t medically qualified, the patients/residents would not survive.  One ‘expert’ told me that every resident would be back in hospital within 3 months.

3 months came and went, a year went by.  Not a single hospital admission.  The original nine residents enjoyed a quality of life that they could not have hoped for had they remained tied to the hospital model of care.  Many take advantage of education and training opportunities, and some secure employment.

Today we  have 86 residents in a range of accommodation where they can receive care and support according to their needs.  Of course there are the occasional hospital admissions, but they are few and far between.  While some of our accommodation provides high levels of care and is not cheap, it is still a lot cheaper than hospital care. 

Care in the community, when provided properly, makes sense for the NHS, for the community and (most importantly) those men and women who can live more active and independent lives.

How are we getting on about employing former clients of BHT services

We have recently undertaken a survey about the personal experience of homelessness amongst BHT’s staff.  We have a target that, by the end of 2012/13, 15% of our staff should be former users of our services.

So how have we done?  9% of our staff have used BHT services in the past, and 33% have received a homelessness service (although not necessarily from BHT).  We are not there yet, but it is a start.

Being a former client doesn’t necessarily make one a good worker, or a better one than those who are not.  We don’t employ someone because they were once a client.  No, we employ people because they are the best person for the job.  We employ them because they are professionals, that they understand the ethical framework within which we work – competence, confidentiality, non-judgemental attitudes, and integrity.

One reason we have this target is to ensure that we continue to facilitate learning and work experience opportunities for current and former clients.  We recognise that there can be prejudice against men and women who have a history of homelessness, unemployment, mental ill health, substance misuse problems, and so on.  Part of the role of BHT is to challenge prejudices.

Another reason for the target is to demonstrate that our Mission (tackling homelessness, creating opportunities, promoting change) is more than six words.  It shows that change is possible.

There is no tokenism at work here.  I want the best possible workers within BHT, and I want all our projects to be of the highest quality.  Who knows, the person who knocks on our door today needing help and support may one day be the person answering the door when you and I are in need.