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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
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Page 1: Circles of support: A floating support service for moving ...nda.ie/.../HAIL-HSE-WRC-Presentation.pdf · • Difficulties with communication and engagement and repeated ... attends

Circles of support:A floating support service for moving people with

mental health problems to independent living

Richard Wynne, Work Research CentrePaula McNulty, HAIL Housing

Aoife Farrelly, HSE

NDA conference 2017

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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

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Hostels /CommunityResidential

Floating Support(mental health oriented)

‘Recovery’ dimension

Tenancy-related support

PreparatoryPhase

Transition/Settling in

PhaseMaintenance &

Recovery Enhancement

Homeless InappropriateLiving Situation

LA Tenants

Other SocialHousing Tenants

HAIl Tenants

PsychiatricHospital

OtherHospital

Private RentalTenants

Prison

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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

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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.

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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 outreach and homecare.

• Reconfigure services - reduce places in hostels, close high support hostels and reassign staff to community teams.

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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)

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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.

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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

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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.

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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).

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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 status69 people supported by the project; 56 had moved in; only 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 accommodationHostel – 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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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 on 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 own personal

space

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Value case

• Delivery on policy – the projects help realise policy on:

• 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


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