Real Life Stories: How First Base Day Centre helped Joe off the streets

Many of the people we are seeing are new to rough sleeping, like Joe who was helped by First Base Day Centre.  This is his story:

“When Joe first came into our service, he had never before been in the position of rough sleeping.  He was 45 years of age, had worked fairly consistently and always had friends or partners he could rely on if work dried up and he found himself in between jobs.  The recession had meant that he had faced a longer period of not working, his relationship had succumbed to stress and he found himself sleeping on the beach.

“Joe had made a claim for Job Seekers Allowance, but had not received a payment after several weeks.  He had eaten nothing for two days and was embarrassed, he said that he had not washed or changed his clothes for a week.  We made sure that Joe had a hot meal, a change of clothes and was able to use the shower at First Base.

“Joe was assigned a caseworker who met with Joe every day for the following week and it became clear that he was feeling overwhelmed by his difficulties, ashamed and hopeless about his future.   He said that he had visited a railway bridge on several nights in the previous month and had considered throwing himself under a passing train.  Joe disclosed the difficulties that he experienced throughout his life and that these experiences were re-visiting him on a nightly basis and tormenting him.

“Joe’s caseworker referred him to the Mental Health Team, a multi-agency team providing mental healthservices for homeless people, contacted his GP and made Joe an emergency appointment.  The Doctor was sympathetic and offered medication and follow-up visits.

“It was obvious that Joe was in no position to be actively seeking work and he needed a new claim for a sickness related benefit.   Joe was very anxious and physically shaking while he spoke with the Department for Work and Pensions on the phone so his caseworker supported him with the call.  It was a further two weeks and many phone calls later that Joe received any benefit payment.

“Joe met with the Mental Health Team at First Base and they agreed to offer some on-going support, seeing Joe fortnightly, alongside regular contact with his GP and daily support from his caseworker.

“With the support of his caseworker, Joe arranged an appointment with a BHT housing adviser who suggested that he make a homeless application.  His application was rejected due to lack of medical information supporting his case.  As Joe did not have a local connection to Brighton and Hove it was not possible for him to be referred into one of the City’s hostels, so we began to explore the possibility of privately rented housing with support from another BHT project, Firm Foundations.

“Throughout this time, Joe was continuing to sleep on the beach and his mental and emotional state would fluctuate greatly on a daily basis.  Joe made very good use of services at First Base, including volunteering and on good days was able to plan the direction of casework himself.

“Over time, we collected letters from his GP and from mental health specialists involved in his care and re-submitted his homeless application.   With the additional evidence gathered Brighton and Hove City Council accepted Joe’s application for housing.

“Joe is now living in BHT supported accommodation for people experiencing mental health difficulties.  He has key work support from this project alongside specialist mental health support for Complex Post Traumatic Stress Disorder.  He is engaging with alcohol support services and still calls in periodically to let us know how things are for him.”

First Base operates in the centre of Brighton and is the main centre for the provision of support to assist people who are homeless or vulnerably housed in Brighton and Hove to move on from the streets or insecure accommodation and realise their aspirations.  First Base operates client-centred specialist services to support people who are sleeping rough in the city to get off the streets, start realising their aspirations through work, learning and leisure and find a place they can call home. Several services run from First Base including a Healthy Lifestyles Project (comprising the Catering Training Project and Fitness 4 All), PASH (Promotional and Awareness of Sexual Health), First Impressions (CV and Employment Service), Culture (Heritage and Cultural Activities), and Dine, our catering Social Enterprise company.  

My doubts about the value of Housing First

There is a growing consensus that Housing First is the way to go in combatting homelessness. Housing First is defined as “an approach that offers permanent, affordable housing as quickly as possible for individuals and families experiencing homelessness, and then provides the supportive services and connections to the community-based supports people need to keep their housing and avoid returning to homelessness”.

The concept of Housing First has been around since 1988 but in recent years it has been championed by Homeless Link and, as a result, has attracted more interest and support.

The concept, as applied in the U.K., is that street homeless people, usually with addictions and chaotic lifestyles, get housing and open-ended support in order to avoid further periods of homelessness. This is not conditional on any change of behaviour or the need to engage with support services.

There is very informative research carried out by Joanne Bretherton and Nicholas Pleace from the Centre for Housing Policy at the University of York that is very positive about the nine pilots that have been run around England, including one in Brighton run by CGL (Change, Grow, Live, formerly CRI – Crime Reduction Initiatives).

I can see the positive aspects and achievements of Housing First, but I don’t think it is the panacea it is sometimes presented, and I think it has some fundamental flaws in principle.

The research found many positive outcomes had been achieved, for example:

  • 74% remained housed for over a year;
  • Bad or very bad health fell from 43% to 28%; and
  • Bad or very bad mental health fell from 52% to 18%.

But while there have been improvements in other areas, the situation remains depressingly poor:

  • Drug use fell only from 66% to 53%;
  • Those who “drank until they felt drunk” reduced only from 71% to 56%; and
  • Anti-social behaviour, compared to the year before entering Housing First, remained at 53% compared to 78%.

I am not sure whether we can regard a scheme as a success when the majority continue to use drugs, drink until they are drunk, and continue to commit anti-social behaviour.

In other areas of their lives, the improvements, while welcome, are not very encouraging. Begging dropped from 71% to 51%. Why, we should ask, are people who are housed, and getting support to claim benefits, still begging? 36% of those housed had been arrested, compared to 53% before they were housed.

For most of us, when we meet someone for the first time, the first two bits of information we share about ourselves are our names and what we do, be it paid or unpaid, work or hobbies. In the Housing First research, there was absolutely no change in the number of clients entering work, remaining stubbornly low at just 3%. Those in Housing First schemes are at risk of continuing to be defined by what they do: drinking until they are drunk, using drug, begging, perpetrating anti-social behaviour. Housing First hardly helps people to achieve their aspirations and their full potential.

My doubts about Housing First are those very principles that its advocates regard as its strengths:

  • It is based on a harm reduction model;
  • It offers open-ended support;
  • It is not conditional on engagement: and
  • Retention is not based on behaviour modification.

At its heart, Housing First lacks ambition, that change is possible, that people can achieve their aspirations and full potential. It embeds dependency, on welfare benefits and support. As one interviewee put it: he gets “help with everything”. At BHT, part of our ethos has seen a move away from staff always doing things for clients, helping with everything, to promoting change so that people can take advantage of the opportunities available to them so that they can combat their homelessness, poverty, mental ill health and addictions.

Economically, can the modest savings be regarded as adequate? The report found that savings were £15,000 per person per annum. While that is not to be dismissed, by being more ambitious, greater savings can be made. Our Addiction Services, for example, will see 60 individuals each year with a history of homelessness and addiction becoming abstinent and housed. Most go on to training and employment. Relationships strengthen, they don’t beg or steal, and their health improves. As a result, crime rates plummet and there are no demands on the police and criminal justice, there are fewer ambulance call outs, fewer attendances at A&E, welfare dependency reduces, people begin paying taxes.

For how long should landlords tolerate rent arrears and damage to property, disturbance to neighbours and the community excused, high levels of public funds be expended?

Housing First is an open-ended commitment. It would be great if we had open-ended resources, if we had plentiful housing, if we had homes with no neighbours being impacted by anti-social behaviour. But even then, I don’t find it acceptable, morally or economically, to leave people in action addiction, committing anti-social behaviour, begging and offending, when better outcomes are possible. Surely we can do better.

‘Managing Your Anxiety’ wellbeing group for women

BHT’s Mental Health & Wellbeing Service is to run a ‘Managing your Anxiety’ wellbeing group for women.

The 5 week group aims to provide a safe space to support women to:

  • understand anxiety
  • recognise early signs of anxiety
  • find ways to reduce and cope with anxiety
  • manage feelings and uncertainty

The group will be facilitated by Sue Boyer, a Wellbeing Practitioner (Counsellor) with many years experience and will take place on Tuesdays: 15, 22, 29 November and 6 &13 December from 11.00am – 1pm at BHT’s Mental Health & Wellbeing Service, Second Floor, 27 – 29 North Street, Brighton, BN1 1EB.If you are interested in taking part in this group, please contact us on 01273 929471 or email wellbeing@bht.org.uk

Announcing the start of a new BHT post-natal art therapy group

BHT’s Mental Health & Wellbeing Service is running a new post-natal art therapy group, starting on Thursday 3rd November between 9.30 – 11.30am which will run for 6 consecutive weeks.

new-pnd-art-therapy-poster-nov-2016My colleague, Rachel Pearce, said that the group is intended to support mothers who may be struggling with feelings of depression, anxiety or difficult birth experiences as well as those who would like the opportunity to use art making to explore issues of changed identity and create some space for self, amidst the demands of new motherhood.

She said: “The group will be an opportunity for women to explore their feelings through the use of art materials and discussion, boost their creativity and self-esteem and connect with a small group of other mothers who may be sharing similar experiences.

“A formal diagnosis of Post-Natal Depression is not required and any woman who feels she may benefit from this small, creative group is welcome to self-refer.

“A number of free childcare places will be available alongside this group, for women who need to use it. Places in this group are limited so I would encourage women who are interested to make contact as soon as possible.”

Please contact Rachel on 01273 929471 if you would like more information about this or any other aspect of the services offered by the Mental Health & Wellbeing Service or the women’s counselling service, Threshold.

Real Life Story: The Fulfilling Lives project is changing lives

fulfilling-lives-logo_W220Fulfilling Lives, working in East Sussex, is one of 12 projects across England where Big Lottery Fund investment is supporting people with complex needs.  This will be a combination of mental ill health, addictions, offending behaviour, and homelessness.  BHT is the lead partner in the south east project, one of twelve funded by the Big Lottery and operating nationwide.

As well as supporting people, the funding will evidence more effective and efficient ways for designing, commissioning and delivering support services for this group in the future.

The purpose of this initiative 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.

biglotterylogo_W300-220x125The legacy of the eight year programme will be that systems and services in all three geographical areas will better meet the needs of this group.

Here is an account of one client who has benefited from the Fulfilling Lives programme.

Before joining Fulfilling Lives Jane (not her real name) had received support from a number of services and workers but only for short periods of time. This was due to a mixture of the set number of sessions available and staff turnover. She explained that the longest time she had been with a single worker was eight weeks. Having to repeat her story to new people caused stress and anxiety and she felt it was a contributing factor to her continual relapses.

One of the ways that Jane’s specialist worker at Fulfilling Lives has been able to support her is by negotiating new ways of accessing services that would benefit her recovery. Previously Jane had become homeless after entering a detox programme because her room in supported housing was not retained while was in the programme. In effect, the system saw this decision as making herself intentionally homeless. In addition, Jane had previously not completed detox programmes as she was excluded due to her behaviour.

Through the advocacy of her specialist worker, Jane’s housing was retained whilst she entered a detox programme. Her worker regularly visited her during detox and was able to advocate for Jane with service staff by recalling information and discussions undertaken. This advocacy helped address Jane’s behavioural challenges while providing her with the support she needed through the detox process from someone who knew and understood her well.

Fulfilling Lives provided Jane with access to therapeutic support via Horse Therapy. Before therapy Jane was unable to get on buses, go shopping, visit busy places, wait in queues of more than four people or use stairs. The therapy has enabled her to deal with her anxiety, rationalise her fears and conduct mindfulness.

Jane has now successfully been part of Fulfilling Lives initiative for over a year. She has completed her detox, retained her supported housing and is successfully addressing her mental health issues.

For her, the Fulfilling Lives approach has provided her with freedom: She is now looking at volunteering for a gardening programme, finishing her A-level English and conducting further volunteering with animals. Her focus is to undertake activities that are not completely wrapped around recovery so that she can feel normal.

Real Life Story: A journey from mental ill-health to recovery in BHT’s Archway Project

In a clients own words, his experience of BHT’s Archway Project:

I just want to take a couple of minutes to describe my time at the Archway and my journey through it.

My journey has been a physical one in that I have moved from high to low support. It has also been a personal journey of recovery from poor mental health, drug use and hospital admissions to a place where I am taking responsibility and control, making better choices and planning for and looking forward to the future.

Before I arrived at the project my life was a mess. My mental health was poor and the voices in my head made me drink and do drugs. To fund my habit I stole from people and from shops. I did not care about my health and abused my body with drink and drugs.

When I moved into the Archway care home I felt reassured by the term “care home” and with the idea that I would be cared for, helped, advised and supported throughout the day. Because of the intensive advice and support I received I gradually came to realise that I was making the wrong choices – choices that did not make things better.

As well as support from the Archway staff, I also had support from the Assertive Outreach Team and began to take an active part in developing my support plan by taking part in key work sessions and CPA meetings with my care coordinator and psychiatrist. Through this work I developed the ability to accept that I had an illness, that I needed to get the right treatment and accept help from support workers.

At the care home I was able to improve my mental health and my self-esteem. I felt stable, stronger in myself and ready to move on. I felt that others could trust me and I wanted to be more independent. When a place came up at an Archway supported house I was offered the chance to move to lower support and decided to accept it. I felt confident enough to do this because I would keep the same workers. I felt clear about what I needed to do to maintain my tenancy so I felt safe in moving.

I moved from the care home to my own bedsit. I felt more comfortable being in my own place, creating my own routines and taking responsibility. I enjoyed the freedom. I could get support when I needed it from people I was used to working with. When I felt troubled, I could phone staff, get support and reassurance and feel better but I had my own space and was living on my own.

Since moving to low support I’ve continued my voluntary work. I’ve started permitted paid work and I’m bidding for council or housing association flats. I’m no longer on a community treatment order and I am looking forward to leaving supported housing to live independently.

In the last year I feel that I have made a lot of progress. I am making better choices about who I see and I’m building a network of friends who don’t drink or use drugs. I’m filling my time with things that make me feel good about myself and I’m risking doing new things. I don’t know exactly where I’ll be in a year but I’m hoping for the best and looking forward to the future.

Thank you for listening.

 

 

Real Life Story: Mike and the Phase One Project

Mike was referred to the project in September 2014 having been sofa surfing with friends following the breakdown of his tenancy in the private rented sector. He had been evicted illegally from his property which, as a consequence, impacted negatively on his mental health and his feelings of anxiety and depression became more problematic for him as he was not linked in to local community mental health services or getting support from his G.P.

Mike has a history of substance misuse issues (alcohol and cannabis use) and while serving a short prison sentence had started to use “Spice” (synthetic cannabinoid) which he had become dependent on.

At his interview for BHT’s Phase One Project, he was incredibly insightful as to what he felt he needed from the service with regards to support, and he was keen to focus on working through his dependency issues, establish links to community projects (as he is a keen artist and gardener) and work towards meeting the criteria for getting rehoused as he recently has had experience of managing a tenancy.

At the beginning of his stay at the Phase One Project we were notified by Housing Benefit that he had an overpayment for which he was liable from his previous tenancy. Once Mike had explained to us how his rent had been collected, it became clear that he had been taken advantage of by his former landlord due to his levels of vulnerability.

Mike’s support worker began the process of getting legal advice so that the overpayment decision could be appealed which, if successful, would mean that he would have a much better chance of being able to financially manage a tenancy when he was ready to be referred to more independent accommodation.

While this process was being undertaken Mike, with the support of his support worker, started to look at local services that could support him in get treatment for his synthetic cannabinoid dependency issue, support him with his feelings of anxiety and depression and provide him with the opportunity to use his skills as an artist and gardener. By being more meaningfully occupied he was working towards meeting the criteria for housing.

He made steady progress during the first six months of his stay and started courses at the Brighton Unemployed Centre to improve his feelings of self-worth and to broaden his network of support outside of the project.

He was also referred to the substance misuse service to get specialist support with his addiction. Mike and his support worker worked closely with his GP around his long term mental health issues to ensure that appropriate support was in place for him so that he would be better able to manage his feelings of anxiety and depression, and be medicated appropriately.

Over the following six months Mike’s confidence grew and he continued to broaden his social network by becoming involved with a local church and volunteering there on a regular basis. He also managed to secure a small plot on a local allotment which enabled him to use his skills as a gardener to prepare the plot for growing fruit and vegetables, further raising his sense of well-being.

In November he enrolled on an art course which started in January, and he also joined a local orchestra – he had been learning to play the clarinet and was keen to join a group so that he could further develop this new skill.

During this period Mike was notified that his appeal regarding his housing benefit overpayment was successful which meant that he was now in a position to be able to afford to manage an independent tenancy again. With these additional activities in place and his housing benefit overpayment resolved he was nominated for a long term tenancy within BHT.

Mike moved into his new home at the end of January.

Mike’s story is not untypical of the work undertaken regularly at the Phase One Project, dealing with a number of issues that had previously impacted negatively on each other. By a methodical approach, Mike’s issues were addressed and he has gained greater independence and makes few demands on on services he previously depended on.