Health & Homelessness Workshops March 2009 Working with you to make Highland the healthy place to be

Background NHS Board: Health & Homelessness Action Plan. Part of overall inequalities agenda for NHS and partners. Multi-agency Steering Group in NHS Highland with CHP (Community Health Partnership) reps , council reps, voluntary sector reps CHPs inform and deliver much of the H&H activity. Issue for mainstream frontline service delivery. Each Highland CHP has nominated H&H lead(s) – usually Public Health Practitioner(s) Current H&H Action Plan being revised & finalised for Board 4/09. CHPs asked to identify local actions for inclusion – ‘bottom up’ Workshops included in Action Plan Feedback and involvement of service users

Feedback from focus group (1) Focus Group, Inverness. Facilitated by SDF Service User Involvement Development Officer. Participants: experienced rough sleeping, car, B&B, temporary / supported accommodation. Several from outwith Inverness originally. Health issues included alcohol, drugs, mental health. Discussion broad – not just health/NHS services Positive experiences: day centre health team “first place where people were not judgemental”; support workers (from eg vol orgs, Housing Support); OOH by A&E Raigmore (formerly Nessdocs)

Feedback from focus group (2) Negative experiences: refused GP registration (rural and town) as no address; lack of time “don’t assess you properly or know what you’ve been through” Lack of information about services & what’s available – importance of information. “One stop shop” . Role of support workers/CPNs here No support until crisis “you’re left on your own till you get a drink problem”; “get to rock bottom before you get help” Waiting time for services “need help now, not months down the line”. Continuity of care important to prevent relapse Poor health can prevent working – barrier to employment Changes of address/accommodation – letters can be a problem “why not use mobiles/texts?”

Feedback from focus group (3) Difficulty getting job when living in B&B Difficulty providing ID when homeless More staff from agencies need to be involved in tackling homelessness “the more help you can get from all sources the better”, including support groups, help with day to day activities, keeping yourself occupied Support to maintain tenancy “if housing see you having problems keeping a tenancy together, they should get help for you” Attitudes: “wash their hands of you as soon as you mention drugs”; loss of services “if you slip up or they don’t like your behaviour”. Feeling judged, labelled or not listened to: “they think you’re fabricating”. Red tape – gets worse if you challenge it. Lack of knowledge or understanding by services, especially decision-makers “people who make the decisions don’t have the understanding; the higher up you go the less they know”

Finally…. Range of issues for homeless households: £; social care needs; health issues; relationship breakdown; violence; children; ….. Joint work (health, housing, social work, voluntary sector, clients) to address whole needs of households – to reduce health inequalities and promote wellbeing. Early intervention, prevention Knowing who’s who, referral criteria, sharing information? Service user involvement and feedback Improve understanding of what homelessness is Mainstream/ general services rather than specialist services in rural areas