Brent Dual Diagnosis Project

2 Service History 1998 Brent Mind establish service 5 placements 2000 Additional 6 BME placements 2004 Supporting people housing related funding 2005 Remodel, introduction of structured groups 2006 New provider St Mungos add specialist input

Stakeholders Brent PCT ( 70% funding / referrals ) ) Supporting People ( 30% funding ) Paddington Churches ( Houses the service ) St Mungos ( Manages the contract ) 3

Aims of the service Assist people who need support in the community around mental health and substance use issues. Reduce compulsory hospital admissions. Reduce severity and frequency of risk behaviour by promoting harm reduction around substance use. The service values people for who they are and share their vision of achieving independence. 4

5 Aims of the Service Promotes Social & life skills, Tenancy sustainment, Personal development and the belief that recovery is obtainable. P romote recovery and maximise wellbeing, supporting tenants to meet their long term aspirations.

Dual diagnosis / homelessness Historically ( prior to being referred to the service ) clients spend long periods in a transitory state revolving through various short term accommodations. 6

Transitory accommodation Family Home (Breakdown) Independent Tenancies (Failed) Hospital (Revolving door lack of move on provision bed blocking ) B & Breakfast ( short term to address lack of move on provision) Supported Accommodation (Short to medium ) Prison ( to a far lesser degree ) 7

Impact of remaining on the homeless threshold Lack of integrated service provision Viewed as hard to engage / problematic Vulnerable to exploitation Entrenched substance use 8

9 Service Profile 18 Months Tenancy / 6 months Floating Support 2 week trial period ( attending day programme ) Groups AMDaily Tenant meeting, current affairs, self development, Tenancy sustainment & Drug group Groups PMDaily Art class, Relaxation, Shiatsu, Tai Chi, Life skills cooking 1 – 1 Sessions Weekly Keyworker, Substance use & Psychotherapist

10 Substance use Role Bridges the historical gap in service provisions Sign posts and introduces tenants to external drug agencies Substance use interventions tailored to the individual (harm reduction) ( Peek into abstinence ) Weekly engagement in group and 1 – 1 sessions Inspire tenants to practice abstinence through informed choice

11 Psychotherapy role Provide a safe environment where Clients are encouraged to talk about and explore their feelings, behaviour and inner conflict. Find new ways in which to alleviate stress Clinical supervision / reflective practice which provides a forum for frontline staff to present, discuss and share ideas and thoughts on how to holistically address the complex issues faced by clients.

Outcomes of the service Move on 20% Moved into Independent accommodation ( private rented) 75% Moved into lower supported accommodation ( self contained ) 5% Moved into medium/high support 12

Outcomes Hospital admissions greatly reduced Greater awareness of substance use in relation to mental health. Increased talk & alternative therapies Engagement of service user across a wider range of issues No evictions planned moves 13

14 Innovations & User Involvement There is a scarcity of Dual Diagnosis services ( Locally or Nationally ) that are effective. The Project provides a structured supportive environment that considers clients needs beyond medication and Housing. Engages clients holistically using a range of interventions, models and informative groups

Innovations & User Involvement Tenants that have moved on have access to daily programmes as well as specialists. Local user involvement – includes Service User Magazine – Quarterly “Your vibes today” Workshops & Forums – Q&A’s Action Plans & Outcomes Stars 15

16 Why Replication ? The Service profile in terms of high levels of engagement ensure that vulnerable adults can address issues within a supportive rather than punitive environment. Floating support ensures that the transition from high to low / independent living is consistent. The theory that clients ( any clients ) are hard to engage will not and does not hold

Why Replication ? Local and National services will be able to network and benchmark, ensuring a consistent approach in working in the community with clients with complex needs. The question of who treats what and when will be addressed through integrated working. The belief that recovery is possible will ensure services work with clients where they are and not where they are expected to be. 17