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A new government report pledges to stop the slide into homelessness,
particularly for those with drug and alcohol issues. But are these empty
words in the wider context of welfare cuts?
DDN
reports
News focus |
Analysis
A MISSED OPPORTUNITY?
6 |
drinkanddrugsnews
| September 2012
www.drinkanddrugsnews.com
The Department for Communities and Local
Government’s
Making every contact count – a joint
approach to preventing homelessness
has a ‘simple
aim’, it says – to ensure that every contact between
local agencies and vulnerable people and their
families ‘really counts’ (see news story, page 5). To
this end it intends to bring together government
commitments to improve both joint working between
the health and housing sectors and outcomes for
homeless people with a dual diagnosis.
It also pledges to tackle ‘troubled childhoods
and adolescence’, provide better advice about
employment, skills and finances and improve
access to housing for prisoners. Early engagement
with drug and alcohol treatment agencies and
interaction with the criminal justice system are
critical points for identifying and helping those at
risk of homelessness, the report states, and it
praises the London Drug and Alcohol Network for
supporting frontline organisations ‘to work together
strategically, share good practice and improve the
quality of service delivery’ for homeless people with
drug and alcohol issues.
The government intends to work with local drug
and alcohol treatment teams to ‘develop sector-led
guidance to improve understanding of how the two
sectors can work together’, with initial material
promised later in the summer. Meanwhile, Homeless
Link – the membership body for organisations
working with homeless people in England – is being
funded by the Department of Health to work with
five local authority areas to support local services
and commissioners to understand and identify
clients with dual needs, and ‘develop and
disseminate effective service models’.
While homeless people with both mental health
and substance issues might have a formal dual
diagnosis, others will be undiagnosed or fall below
treatment thresholds. Whatever the definition,
however, they are often unable to access the services
they need, project lead and Homeless Link policy
manager Helen Mathie tells
DDN
. ‘While effective
approaches do exist, what impact will the changing
NHS commissioning landscape and reduced funding
have?’ she says. ‘At this time of change, we need to
think creatively to make sure the most vulnerable do
not fall through the gaps in services.’
Homeless Link will provide free support to the
five areas over an 18-month period, helping to
understand the extent of local problems and the
needs of those with co-existing mental health and
substance issues. It will also review the
effectiveness of local practice, identify gaps and
‘develop targeted solutions that take into account
the new commissioning landscape’.
The aim is to bring ‘measurable improvements’
to the wellbeing of homeless people with co-
existing issues, says Mathie. The project will also
feed directly into future policy work, such as the
ministerial working group on homelessness and the
Department of Health’s inequalities team, with
solutions helping to shape an evidence base and
share learning across the country.
The organisation is calling for extra commit-
ments from the government, however, including the
means to hold organisations to account if they don’t
provide good services, and to make sure that
health, social care and other bodies understand the
numbers of homeless people they deal with. Does
this mean that there still low levels of awareness
among these services about homelessness?
‘We would say there is a low level of
understanding in many areas,’ she says. ‘For
example, housing status or need is not routinely
asked about or recorded by many health services, so
opportunities may not be taken to put preventative
measures in place, such as referring someone for
housing advice. There are indications that some
homeless people also experience prejudice.’
In fact, a recent Homeless Link report found that
more than 70 per cent of homeless people were
being discharged from hospital back on to the
streets (
DDN
, June, page 4), while others were
turned away or experienced poor standards of care
because they were homeless or deemed ‘too
difficult’. ‘We also know that significant numbers of
homeless people are refused access to a GP or
dentist – often because these services demand
specific forms of ID or proof of address, when in
fact this is not required,’ she says.
Ideally there should be routine training for health
professionals on how to work with vulnerable or
homeless patients, she states. ‘There are some
great examples of joint training sessions or
networking between the sectors and this is
something we would like to see far more of. The
other thing that would help would be better
recording of housing status and awareness of how
to respond to a patient if they are homeless.’
While homelessness organisations have
welcomed the report’s aims, however, many have
been highly critical about its publication in the context
of ongoing welfare reforms, which, they say, risk both
increasing the number of homeless people and the
existence of the services designed to help them.
The government has done much to ‘encourage
innovation in helping individuals off the streets’, Mathie
says, but some welfare reform policies ‘threaten to
make the homelessness problem worse, while many
decisions about funding are made at the local level.
‘The vision behind the government’s prevention
report – that homelessness is everyone’s business – is
welcomed, as is the ambition that we should all expect
the best possible help if we find ourselves threatened
with homelessness. However, if we are to realise the
plan, we’ll need strong commitment from government,
councils and every professional group which comes
into contact with homeless people.’
DDN
‘Early engagement
with drug and alcohol
treatment agencies
and interaction with
the criminal justice
system are critical
points for identifying
and helping those at
risk of homelessness.’