A floating support service for moving people with mental health - - PowerPoint PPT Presentation

Circles of support: A floating support service for moving people with mental health problems to independent living

Richard Wynne, Work Research Centre Paula McNulty, HAIL Housing Aoife Farrelly, HSE NDA conference 2017

A floating support service

• 2 Genio funded projects – Doras and Slan Abhaile
• Collaboration: HAIL Housing and HSE Mental Health

Rehab team

– Housing – Tenancy and personal support – Clinical support

• 56 clients over 4 years

Hostels / Community Residential

Floating Support (mental health oriented)

‘Recovery’ dimension Tenancy-related support Preparatory Phase Transition/ Settling in Phase Maintenance & Recovery Enhancement Homeless Inappropriate Living Situation LA Tenants Other Social Housing Tenants HAIl Tenants Psychiatric Hospital Other Hospital Private Rental Tenants Prison 3

Dublin North City Mental Health Services | CHO 9

CURRENT SERVICES

• DNC provides community and local and regional in-

patient services to 337,000 people in north inner city Dublin.

• 13 CMHT’s
• Programme for the Homeless team
• 3 Community Rehabilitation Teams

Dublin North City Mental Health Services | CHO 9

REHABILITATION AND RECOVERY MENTAL HEALTH SERVICES

• A Specialised Tertiary Service for people with complex

needs that can’t be met by general adult MH services

• Individuals with severe and enduring mental health issues and complex

needs aged 18-65.

• People with prominent symptoms and partial response to medication.
• Difficulties with communication and engagement and repeated

hospitalisations / involuntary detentions. Some with difficult to manage behaviours and forensic issues.

• Some loss of self confidence, life purpose, institutionalisation,

unemployment, social isolation and housing difficulties.

HSE VISION FOR THE PROJECT

• Collaboration between HSE, Rehabilitation CMHT and

HAIL i.e. Mental health professionals working with housing specialists.

• Implement Vision For Change - social housing

responsibility of local authority.

• Provide secure independent housing in safe

environments .

• Promote active community participation and

meaningful social roles.

• A model of CMH rehabilitation based on community
• utreach and homecare.
• Reconfigure services - reduce places in hostels, close

high support hostels and reassign staff to community teams.

Process

• Develop personalised support plan and set goals (ICP)
• Housing Support Worker essential member of team,

attends team meetings and ICP meetings.

• Meaningful engagement with families and service

users.

• When client is housed – plan for reduced support,

follow up by team, in some cases referral back to local CMHT.

• Joint training HSE and HAIL in SSDL (SRV)

About HAIL

• Founded in 1985 – St Brendan’s, Grangegorman following the

publication of the report “Let’s Look at Housing

• Approved Voluntary Housing Association
• HAIL provides exceptional quality social and affordable rented

accommodation for people from local authority housing waiting lists, primarily those with mental health difficulties.

• Currently 340+ tenancies
• Individually tailored services (floating support) to support

people with mental health difficulties to integrate and live independent lives in the community.

Our Support Services

HAIL SUPPORT Individual's needs Partnership working Holistic Non- clinical Towards Independence

PICCLS Cloverhill Remand Prison Referred by NFMHS Homeless Complex Needs TENANT SUPPORT SERVICE Permanent home with HAIL Community Integration Phased but open-ended SLAN ABHAILE From hostels to Independence Low/med /high support Working with Rehab teams VISITING SUPPORT SERVICE Tenancies at risk ( MH related) Range of tenancies Crisis Intervention Time limited PEER SUPPORT One to one Peer Support Social, Emotional, Practical Recovery focused

Move On

• Meet with MHRT, Client & Families to

discuss move on, and area of choice.

• Begin the “discovery process” to explore

interests, dreams, previous experiences of clients in order to enhance or develop new positive roles.

• Advocate with Local Authorities and

Housing Bodies in order to source suitable housing.

Moving In

• Familiar with locality of choice.
• Support them with interview & signing a

tenancy.

• Social Welfare and Benefits.
• Shopping
• Assist with setting up utilities (Electric,

Gas, & Water) in clients names.

• Encourage clients to pay utility bills and

rent through direct debit.

• Rent payment system (An Post).

Did the project work and the value case for continuing?

• Stakeholders perspectives
• Resources used on the project
• Value for money

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Doras and Slan Abhaile projects

Marker Doras Slan Abhaile Number of clients 18 51 Client status 69 people supported by the project; 56 had moved in;

• nly one failed tenancy

Nature of MH issue 39 Schizophrenia, remainder mostly bipolar disorder Length of time in previous accommodation 10.2 years (< 1 year to c. 40 years) Previous accommodation Hostel – 53; hospital ward – 6; Family friends – 6; others – 4.

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The sample

• 16 individual interviews
• 10 clients in focus groups
• 28 Hail key workers assessments
• 14 HSE key workers assessments

Data from 37 clients in all

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18

Quiet, good for studying, good accommodation, subsidy is good enough Invaluable for recovery Having my own place, feeling secure, being in control of my life 87% say it is better than previous accommodation

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I can manage better because my new home allows me time and space to deal with issues Because I am living

• n my own now

My accommodation and living conditions are better now HSE KW: 86% ‘OK’ or ‘very well’

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I have no problems in managing daily activities I am saving now and paying my bills HAIL KW: 95% managing ‘OK’ or ‘Very well’

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I want to be better in my studies I am trying to get a job now and I am doing other things The other patients annoyed me Not having my

• wn personal

space

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Value case

• Delivery on policy – the projects help realise policy
• n:
• Health
• Housing
• Employment

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Value case

• Value for clients with enduring mental health needs
• Mental health & Wellbeing gains
• Housing-related gains
• Recovery-related gains
• Social inclusion gains

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Value Case

• Enabling/enhancing service provision
• HSE service provision – Better throughput of clients,

potentially lower service usage

• Housing sector – enabling clients to reside in housing,

reduced problems associated with client group