HAST - '14 Days of Christmas' - 12/12/2022

HAST are the Homeless Assessment and Support Team. They shared a recent case study to highlight the work they do in Sheffield to support people experiencing homelessness.

 

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Client J – Well known to mental health services in Sheffield, with a long history of Schizo-Affective Disorder, substance use, homelessness, convictions and prison sentences. Has been in high and medium secure units in the past.  

When SORT was disbanded, J was transferred to Eastglade Community Mental Health Team (CMHT).  Unfortunately, due to his chaotic presentation, he was classed as a non-engager and therefore discharged with no follow-up from mental health services.  Spent a long period being off his medication with deteriorating mental health.  Lost his flat due to non-payment of rent, and environmental health concerns due to hoarding problems.  Mental health continued to deteriorate further along with increase in his substance use.  Known relapse trigger is stress caused by financial hardship.  J is a previous victim of financial exploitation.  

Vulnerable man, continuing to deteriorate in his mental health, rough sleeping and with a long risk history of violent, aggressive behaviour towards others.

Led to his arrest after he was found in the possession of a knife in a public area.  Went to prison for 9 months for this offence.  Released from prison with no address and no benefits in place.   No medication and no team assigned to monitor his mental health risk.

Seen out rough sleeping by Framework team.  Placed into Victoria court and referred into HAST.

Built up a good relationship with J using an assertive outreach model, giving plenty of opportunity to access the service, flexibility in where to meet, access to consultant appointments in a short waiting time.  Also flexible in how his appointments were offered, as in places to meet.  

Given prescription of antipsychotic oral medication.  Appeared compliant with these and often contacted workers just before he ran out.  

J had some problems with the temporary accommodation provided. He formed a negative relationship with a peer who was dealing with Spice.  J went to stay with that peer when they got rehoused, but this did not last and J ended up rough sleeping again.  This was in the winter 2021/2022.  This was a very difficult period for him as nowhere was willing to offer him accommodation due to his risk history and poor mental health, and all of the usual hostels had been closed.  

The team worked proactively with J without judgement of his past, putting strategies in place to reduce the risk of relapse.  There was evidence that he was being financially exploited by people in the area, his main trigger was financial hardship and he could never make his money last any more than 2 days, no matter what the amount was.  He agreed that he would like to try an appointee.  This was a huge piece of work but eventually stabilised his mental health and he found it really beneficial.  His substance use appeared to reduce and he was much less stressed by the people he had following him around on paydays.  However, he was still homeless.  

Agencies had to work closely with each other to ensure his wellbeing was being monitored and the people who could make the right decisions for him were given the information about his vulnerability.  The problem was there were/are very few accommodation options available for people with significant mental health problems and severe complex needs, so there was very little accommodation that could be offered to J. even on a temporary basis.  

He ended up living in a Pod that had been donated to the council by the Salvation Army.  Through this collaborative working and many Complex Case meetings, it was eventually decided that he could be placed under the Housing First Project.  This meant that he would be eligible for a secure tenancy from the council, with wrap-around support to help him maintain the tenancy.  Housing First also has access to HAST through the Community Mental Health Nurse who has a dual role in both teams.

J is attending groups at Sidney Street for the first time and engages with a number of workers from the outreach network that covers the city centre for the homeless population, despite not being homeless anymore.  

HAST and Housing First have played an integral part in this client’s positive outcome.  We offered him a multidisciplinary and multiagency approach to develop a care package that would give him the best opportunity to thrive in the community.

Homelessness does not end once a person is housed.  The problem of being rootless and having had the stigma of being homeless can severely impact a person’s self-esteem and confidence.  The trauma experienced from living on the streets can stay with people forever.