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California dreaming

We need action on mental health and homelessness – not another report, argues Antonia Forte.

One of the perks of retirement is the ability to take extended and numerous holidays: I took one to California last month. Not a fan of the current political administration, but one can’t help but be inspired by the west coasters efforts to make access to public services easy for people with a physical disability – riding on public transport for wheelchair users compares so favourably with the experience in Wales. Something to do with the rise of rights movements for veterans after the Vietnam war maybe.

And Yosemite is awe-inspiring!

But, the extent of street homelessness is shocking. I know we have considerable evidence of the failure of housing policies in the UK, but the human misery that we witnessed was of a different dimension. One weekend, the Santa Monica authority held a ‘festival’ of local activities to publicise the services the City Hall provides, and I talked to a few people about what I’d witnessed. They told me about the collaboration between ‘statutory’, business and non-profit making organisations in the delivery of services and emphasised a ‘can do’ attitude to working in partnership. But we soon started talking about the link between mental health and the cause and effect of mental illness on those living permanently on the streets – and the difficult of dealing effectively with this once people have lost their homes.

Which made me think about our own approach, and in turn to wonder what had happened to the piece of work of a cross disciplinary group I chaired for the Welsh Government’s Effective Services Board in 2013/14, which produced in November 2014 a report entitled Prevention Through Early Intervention – Helping people with mental health problems to find and keep a home. That report acknowledged the several previous reports about these topics had almost disappeared without trace and made a real plea that the same did not happen to its own recommendations. I’d be interested in knowing if this plea was successful.

The recommendations weren’t rocket science, as I know my colleagues on the group will have readily admitted: but they did suggest some things that could make a real difference.

The faces and behaviour of some of the victims of street homelessness in Los Angeles and San Francisco will be with me for some considerable time, they were so distressing (and even more so for the individuals, I appreciate). Such things remind us of what a civilised and prosperous country should look like.

Maybe it’s time to revisit what needs to be – and can be – done but this time without another report.

Antonia Forte has just finished her stint as chair of the WHQ advisory board. Many thanks to her from all of us for all her hard work for the magazine and our best wishes for the future

THE KEY RECOMMENDATIONS MADE IN 2014

  • Recommendation 1:  Local authorities should be able to demonstrate that the needs of people with mental health problems are part of the local housing market assessments (LHMA) to inform future housing provision planning.
  • Recommendation 2: Professionals need to work together to ensure people with mental health conditions have full access to and are given appropriate consideration under housing allocations systems.
  • Recommendation 3: Regional Collaborative Committees for the Supporting People programme, and local authorities should review their supporting people provision, including the balance between supported accommodation and floating support.
  • Recommendation 4(a): There should be ‘top-up’ funding by Local Health Boards where it can reduce demands on health services, particularly high cost inpatient services.
  • Recommendation 4(b) There should be   a pilot project to inform the “top-up” of Supporting People services by Local Health Boards.
  • Recommendation 5: There should be greater interaction between housing and health workers to increase knowledge, awareness and understanding of the mutual benefits of closer working relationships
  • Recommendation 6: Senior health leaders should encourage training across public services support agencies to raise awareness of the dual diagnosis pathways and services to improve recognition of the condition, improve risk assessment, and enable signposting to appropriate specialist services.
  • Recommendation 7: There needs to be an improvement in data collection by use of consistent definitions for ‘patients’ and ‘tenants’.
  • Recommendation 8:  The ESVG Delivery Board should disseminate findings, to ensure key messages are clear and understood at all levels including leaders, professional practitioners and all frontline staff.

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