Ursula Ralph
Ursula Ralph

By Ursula Ralph

Putting Housing First to reduce homelessness

Housing First is an innovative approach to housing some of the most complex and vulnerable people in society, placing them directly into their own tenancy and then providing them with wrap round intensive support. It’s an idea the government has said it’s keen to explore and would replace the traditional stepped approach where a person has to prove they are “tenancy ready” before being housed. This approach has a 80-90% success rate in tenancy sustainment, and Shelter’s Inspiring Change Manchester has been trialing this approach in the city, with great results for the participants, including one of our first clients, Laura.

Laura

Laura’s been with Inspiring Change Manchester (ICM) for nearly three years and was one of the first clients to come onto the programme. She is an independently minded person who has been through some very challenging times in her life but is a very caring individual and a proud mum to her children.

ICM has worked alongside Laura from the start to support her to access and maintain her own tenancy and also to address any other issues that she might identify as being important.

A system that didn’t help…

From the age of ten Laura endured significant traumatic experience having been forced by a parent into sex work and shoplifting. Throughout her adult life she’s survived a number of physically and emotionally abusive relationships.  At one point Laura’s children were abducted by a former partner and she did not see them again for many years.

Before joining ICM Laura had a long history of failed accommodation. This was usually because she wasn’t able to comply with the rules in supported housing.  These rules would, most often, be around abstinence from drugs and alcohol although sometimes it would be that Laura hadn’t been supported to budget for service charges. At other times she’d lose her accommodation and was stated as having “disengaged from the support offered”.

Ultimately – the system failed to offer Laura the sustained emotional support that could help her to begin to address the trauma that has led to multiple needs. Because of homelessness she’s spent long periods of her life street homeless; rough sleeping, relying on abusive relationships for a place to sleep and sometimes sofa surfing.

As a result of longstanding alcohol and drug addiction Laura’s been left with several serious chronic conditions which severely limit her mobility and ability to take care of herself.   She suffers from schizophrenia, depression, anxiety and other emotional problems exacerbated by her drug use and stemming from trauma.

Falling through the gaps

During periods of homelessness it’s extremely difficult for people to engage with any service. Emotional and physical health deteriorates and it’s increasingly difficult to access treatment and support. This happened for Laura who began self-medicating her schizophrenia by increasing alcohol and drug use.

Homelessness charities struggled to access accommodation as Laura’s options were limited by losing previous tenancies. Substance use services would discharge Laura because they “struggled to engage” and mental health services would discharge either because of a “lack of engagement” or her “pre-existing substance misuse”. Rough sleeping and substance use also meant frequent involvement with the criminal justice system.

Inspiring Change Manchester and a Housing First Approach

After meeting her we worked alongside Laura to get a roof over her head. Because of her entrenched homelessness and multiple needs, Laura was able to access a Housing First approach. The traditional approach of placing in supported accommodation, addressing addiction issues and then moving on to long-term accommodation when “tenancy ready” had failed repeatedly.

Laura worked with us to enter into a tenancy with a private landlord. This was in a flat and area of her choice.  She registered with a local GP and Laura and the team then started the real engagement work – making positive lifestyle changes! Laura re-engaged with a homeless Community Psychiatric Nurse (CPN). Having an actual address made it easier for the CPN to stay in touch and begin develop a treatment plan for her mental health.

Today…

Before Housing First, Laura’s physical and mental health was deteriorating rapidly and was at a critical point of frequent A&E admissions and serious concerns for her mortality.

Laura’s health has now stabilised, she’s re-engaged with services and she’s no longer involved with criminal justice. Crucially, having her own property means that Laura’s able to plan ahead and to decide when and how to access support.  She has a door that she can lock and the safety that comes along with that.

Laura’s been in that same tenancy for 30 months which is amazing. She’s engaging proactively in a harm reduction support plan.  For Laura and others in her situation, it’s sometimes not about how bright the future looks, but it’s more about doing something so that there is even a future at all.

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