2. 9th SEMINAR SMES-EUROPA DIGNITY & HEALTH A PERSON ONLY EXISTS WHEN THEIR VOICE IS HEARD HEALTH & SOCIAL CARE IN COMMUNITY: ACCESS FOR ALL TO RIGHTS & SERVICES “Low threshold centre for the homeless a door for community mental resources” David Blanco Rosado, José Antonio Hernández Mondragón (E)

3. LOW THRESHOLD KEY CONCEPT “ Flexibility ” MAIN OBJECTIVE “Hoocking” METHODOLOGY Minim rules TO BREAK “REJECTION” KEEPING CHRONICS INSIDE

4. Puerta Abierta Started on June 2001 Mission Give Lodging and social support to Homeless with dificulties to stay in other resources People with severe mental diseases Chronic alcohol and other substance abusers Important physical pathologies (HIV, BHV,...)

5. Staff Co-ordinator – Social Worker Social Worker Social educator Occupational Therapist Nurse Auxiliar Staff (12)

6. Social aspects Street and environment Street and environment Help regection Resources Administrative tasks Administrative tasks Social isolation Languaje Citicen attitude Interagency co-ordination Interagency co-ordination

7. Análisis demográfico Data: 2005 Sample: 99 people Stability of users gives significance to data...

8. Alcohol abusers 72 alcohol abusers in 99 people sample 71.28%

9. Illegal Substance abusers 19.80%

10. People with Mental disease 44.55%

11. Concept changing LOW THRESHOL D LOW THRESHOL D Center adaptation Center adaptation Healthy Habbit Improving Healthy Habbit Improving Social Skills Unconditional acceptance Unconditional acceptance Occupational Therapy Occupational Therapy Administrative Regulation Administrative Regulation Social and Health resource access Social and Health resource access

12. Co-ordinated Work

13. Incomes 26 Retired Economical Social 100% of users are registered at a District in Madrid

14. Mental sick people under treatment

15. Psychiatrist: assessment, treatment, follow up... Psychologist: assessment, follow up, co-ordination of cases derived by Puerta Abierta Staff. Educators (3) Support, motivation, social skills. MHST – PRISEMI Puerta Abierta (2)

16. Derivation process AcceptsREjects Antecedents SOCIAL REPORT Psychiatric assessment MHST MHC OUTCOME

17. Intervention Nurse. Psychiatrist Indications Evolution Follow up Psychologist + Social Workers + Technicals Intervention Design Educator (2) Intervention following up Educator Hookin at street MHST – PRISEMI Puerta Abierta (3)

18. EC-PSH – PRISEMI Puerta Abierta (4) Outcome Nurse. Psychiatrist Psychologist + Social Worker + Technicals Educadoras (2) Educador Normalized net derivation Medical outcomeCenter entrance

19. Health Center & Puerta Abierta Agreement signed to give assistance to Puerta Abierta users Attending their special necesities

20. Puerta de Hierro Hospital & Puerta Abierta Co-ordination with social work Depmt. to: Arrange return home. Access to other resources. Extend staying at hospital. Sending Medical reports. Help to more close link.

21. Thank you for your attention