1. Homeless People Mental Health Unit (E.S.M). Berlin, October 2005 María Isabel Vázquez Francisco Recalde

2. ) Homeless People Mental Health Unit (E.S.M) The Equipo de Atención Psiquiátrica a Enfermos Mentales Sin Hogar-Homeless People Mental Health Unit (E.S.M): The Equipo de Atención Psiquiátrica a Enfermos Mentales Sin Hogar-Homeless People Mental Health Unit (E.S.M): –Was created in May 2003 –Provided by: Madrid Mental Health Services (SERMAS). Madrid Mental Health Services (SERMAS). The general division of Social Services of Madrid Community Social Services Advisory Commission The general division of Social Services of Madrid Community Social Services Advisory Commission

3. Homeless People Mental Health Unit (E.S.M). The team consists of: The team consists of: –A psychiatrist –Two nurses –Four youth and community worker –A psychologist (part time/2 days per week) –A social worker

4. Homeless People Mental Health Unit (E.S.M).Objectives. –To improve mental health services for homeless people –To facilitate integration of mentally ill patients into mainstream services. –ACT+REHABm Coordination Dg,treat Follow-up TrainingOutreachRehabilitation.....

5. Target Population Mentally ill homeless (+dual) Mentally ill homeless (+dual) –Severe, enduring –Old –Phisical Risk –Street People 18 years old 18 years old Living in Madrid city Living in Madrid city Not being attended in mainstream mental health services Not being attended in mainstream mental health services

6. Enduring Severe Mental illness Enduring Severe Mental illness –Negative Syndrome –Handicap/Disabbilities Homeless Homeless –Lifestyle –Social Drugs Drugs Stigma Stigma Barriers Barriers –Personal –Professional Coordination Rehabilitation/support Political/educational Trainnig

7. Coordination Pannel Individualised treatment programs Mentally ill Homeless People Street Teams C.Acogida/ Asociaciones Mainstream Mental Health Services Mentally ill Homeless People EMERGENCY ROOMS Psychiatric Ward Units E.S.M DNI, Housing...Diag, treatment... S.ServicesESM COORDINATION PANNEL Mainstream Social Services Socio sanitary resources

8. COORDINATED WORK DETECTION OF MENTALLY ILL HOMELESS PEOPLE BY U.M.E.S. Social Report for the E.S.M FIRST COORDINATED INTERVIEW Inicial visit of social worker and psychiatrist to the client. OBJECTIVES Engagement and Preliminary Diagnosis. ESM: Engagement Follow up work Diagnosis Medical treatment administration COMMON GROUND: INDIVIDUALISED TREATMENT PROGRAM: Individualised work Follow up work and evaluation Family contact.... UMES: To facilitate and take clients to different resources To obtain documents, social benefits SOCIAL- HEALTH INTEGRATION. Integration of mentally ill Homeless people into mainstream mental health and social services CP C.P: Coordination Pannel

9. Social- Sanitary Integration Rehabilitation/Support Rehabilitation/Support –Structured long term individualized plan –Critical Time/Crisis Out streets Out streets Mainstream Mental Health/Social Mainstream Mental Health/Social Subteams Subteams Coordination Pannel Coordination Pannel –Social Services –MENTAL HEALTH Services

10. Coordination Street work Individualised/”Taylored”plans Social Services Street Teams Shelters NGO´s Rehabilitation Model/ACT

11. Mental Health C.P Monthly meeting Monthly meeting –July 2005 Mental Health Services Mental Health Services Continued Care plans Continued Care plans –Who –When –How –Need –Follow up

12. Rehabilitation Subteam Low Demand – –Centro Abieto – –Puerta Abierta Transition FIR. CASI Sociosanitary Resources Mental Health Services Other Housing

13. TREATMENT Compliance Awareness Relapse DAILY LIFE Skills Training DRUGS Outreach Rehabilitation SUPPORT Counselling

14. Does it work? ????????? ????????? – –Short time experience Barriers Barriers Develop a range of housing, stable, long term, and adapted to different patterns of patients Develop a range of housing, stable, long term, and adapted to different patterns of patients Drugs Drugs