Transcript David Campbell, Service Manager, St Mungos Dual

Brent Dual
Diagnosis
Project
Service History
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•
1998 Brent Mind establish service 5 placements
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2000 Additional 6 BME placements
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2004 Supporting people housing related funding
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2005 Remodel, introduction of structured groups
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2006
New provider St Mungos add specialist input
Stakeholders
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Brent PCT
Supporting People
Paddington Churches
St Mungos
( 70% funding / referrals )
( 30% funding )
( Houses the service )
( Manages the contract )
)
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.
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Aims of the Service
• Promotes Social & life skills, Tenancy
sustainment, Personal development and the
belief that recovery is obtainable.
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Promote recovery and maximise wellbeing,
supporting tenants to meet their long term
aspirations.
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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.
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Transitory accommodation
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Family Home (Breakdown)
Independent Tenancies (Failed)
Hospital (Revolving door lack of move on provision bed blocking )
B & Breakfast
to address lack of move on provision)
Supported Accommodation (Short to medium )
Prison ( to a far lesser degree )
( short term
Impact of remaining on the
homeless threshold
• Lack of integrated service provision
• Viewed as hard to engage /
problematic
• Vulnerable to exploitation
• Entrenched substance use
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Service Profile
• 18 Months Tenancy / 6 months Floating Support
• 2 week trial period ( attending day programme )
• Groups
AM
Daily
Tenant meeting, current affairs, self development , Tenancy sustainment & Drug group
• Groups
PM
Daily
Art class, Relaxation , Shiatsu, Tai Chi, Life skills cooking
• 1 – 1 Sessions
Keyworker, Substance use & Psychotherapist
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Weekly
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
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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.
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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
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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
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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
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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
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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
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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.
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