Transcript Helen Mathie, Homeless Link- Coalition on Older

POLICY UPDATE
SNAP 2010 (SURVEY OF NEEDS AND PROVISION)
HEALTH NEEDS OF HOMELESS PEOPLE
OLDER HOMELESSNESS
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1. SNAP 2010
• What is it?
• What can it be used for?
• Key headlines from 2010
– Dramatic improvement in service availability
– 43,655 bedspaces nationally
– The sector's diversity is increasing but clients’ support
needs seem to be remaining stable
– Funding a key concern for agencies
– Mental health and move on also key issues
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SNAP 2010: Substance misuse
HEADLINES
– Overall availability of substance misuse services increased
Type of service
Overall service
availability SNAP
2008
Overall service
availability SNAP
2009
Overall service
availability SNAP
2010
% increase
2008-2010
Drug services
87%
91%
95%
8%
Alcohol services
88%
94%
96%
8%
Mental health services
78%
93%
96%
18%
Physical health services
71%
90%
97%
26%
Meaningful activity
61%
90%
94%
33%
Education, training and
employment (ETE)
66%
89%
98%
32%
Advice
92%
97%
99%
7%
Resettlement
59%
86%
92%
33%
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HEADLINES, continued
•Provision of substance misuse services via external agency most common
•Roughly 1 in 10 agencies provide substances misuse services in house or in
partnership
•However, problems with access remain. Inadequacy of external service and
client motivation most commonly reported problems.
Type of service
Of projects
where service
available…
Problems with
access[2]
%
Of projects where there are problems with access…
Some
clients
ineligible
%
Some clients
unsuitable
%
Sometimes
due to client
motivation
%
External
service
inadequate
%
Internal
service
lacks
financial/
staff
resources
%
Internal
service lacks
suitable
premises
/equipment
%
Drug services
47%
5%
3%
66%
32%
11%
3%
Alcohol services
53%
4%
2%
62%
41%
12%
2%
Mental health services
57%
8%
6%
33%
62%
10%
2%
Physical health services
23%
2%
1%
55%
26%
16%
5%
Education, training and
employment (ETE)
45%
11%
6%
67%
18%
16%
5%
Meaningful activity
46%
1%
2%
60%
18%
34%
6%
Advice
20%
0%
3%
55%
32%
18%
2%
Resettlement
29%
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16%
12%
15%
56%
19%
3%
OTHER FINDINGS
•
Proportion of clients experiencing drug or alcohol problems remained fairly
consistent over 3 years
•
10% respondents cited alcohol and drug services as biggest gap in
provision (3rd most commonly identified gap)
‘Alcohol services for adults. It seems to be very distant for waiting times and
referrals. It is because of the different agencies that provide it.’
‘Having somewhere for chronically excluded people, the rough sleepers
who are in and out of hostels, somewhere for the chronic drinkers/drug
users, to try and keep them off the streets and support them.’
•
6% agencies cite alcohol and drug use as the top issue facing them. This
refers to issues around behaviour as well as accessing appropriate
services.
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2. HOMELESSNESS and HEALTH
HEALTH NEEDS AUDIT
• Project to evidence health needs and feed into commissioning
• Looks at picture of local health needs. Client, not staff, perspective
POLICY CONTEXT
LOCAL DRIVERS: needs assessment
and delivery at a local level (LAA,
JSNA)
HEALTH INEQUALITIES: delivering
to most excluded - .eg Marmot Review,
Inclusion Health, No One left Out
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What can it tell us about substance
misuse?
•
•
•
•
Levels and type of consumption
Health needs relating to substance misuse
A&E and hospital admissions relating to drugs and alcohol
How clients are currently engaged, if atall, with drug and alcohol
services and how effective clients think they are
• Unmet need/demand for different D&A services (eg reduction, harm
minimisation)
• Access to relevant screening
• Dual Diagnosis
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How will the data be used?
•Improve dialogue with clients about health
•Feed clients’ experiences directly to commissioners and
JSNA (joint work with JSNA and alcohol teams)
•Encourage agencies to take action at local level – from
across LA, NHS and voluntary sector
•Inform agenda around health of socially excluded.
‘Inclusion Health’, DH commissioning guidance
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3. Older homelessness?
SNAP suggests more agencies are working with clients who are over 50.
Recent research is showing an increase in hidden heavy drinking among
general older population.
37 % of newly homeless older people reported drinking heavily before
becoming homeless. Some said this had contributed to the breakdown of a
relationship which had then led to homelessness.
Estimated 50% older homeless population have alcohol needs. This is
often in combination with mental health problems, chronic physical ill health
and lack of engagement in support planning
Particular challenge of move-on for this group. Sheltered housing
reluctant to take alcohol dependent older people and difficult to get funding for
a care package for people who continue to drink.
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Services and solutions
Specialist accommodation projects and floating support
Feed issues into JSNA locally – “PCT to take a leading role in JSNA
and commission alcohol interventions for the needs of the local
population”. E.g make case of high costs of small section of
homeless heavy drinking population.
New guidance for commissioners and providers on how to assess and
meet specific needs of older people and importance of this agenda:
http://www.homeless.org.uk/guidance-older-homelessness
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SNAP: http://www.homeless.org.uk/snap
Health needs project:
http://www.homeless.org.uk/health-needs-audit
More info: [email protected]
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