Accommodating the homeless with complex needs

We are now approaching having completed the second of the seventeen week program for the 2015/16 Church Winter Night Shelters (CWNS) in Southend and much to everyone’s relief it has gone remarkably well, with no serious altercation, helped by virtue of the fact that the numbers we have catered for have been less than expected and who have responded well. One reason for this is there is now more accommodation available through homeless charities, like HARP, that cater for rough sleepers prepared to “engage”.

Among other reasons for a reduction in numbers (shelters this time round are at best half full) compared with this time last year is the careful vetting process that takes place. There have been few, if any, guests that might be described as problematic with complex needs, even though we have seen several harrowing situations that is often linked to people being on the streets in the first place. It is likely there are several such persons in the problematic / complex needs / hard to reach category, typically due to mental health, substance misuse and behavioural issues, sleeping rough in the town. There are some with no more problems than the rest of us but for reasons as dislike of the way HARP, and other agencies. deal with them, they do not engage or won’t get referred because of behaviour issues.

One of the shocking (although sadly not uncommon) pieces of news this past week is one of those who might be put in the “problematic” category was found sleeping under a bush when some youth decided to set on fire to it. Fortunately, he was safe although damage was done. The rough sleeper in question is well known to many of us who work among the town’s rough sleepers and he has been in that situation for a matter of years, and it is only a matter of time, unless there is a change, that he will die from a mixture of health issues brought on by rough sleeping and alcohol abuse. He is a courteous man, who recently blessed me by passing on some words of encouragement and advice I needed, yet who I would think twice before allowing into the shelter I happen to manage, based on concerns for the health and safety of guests and volunteers.

I mention this because my rough sleeper friend is one of many who do not come to the night shelters, either by choice or they are not allowed to stay. Yet it is these more difficult “cases” that are the bane of statutory agencies intent on reducing the rough sleeper count, especially when they end up in places like tents on the cliffs, the main bus station or disused garages, thus creating a major head ache, and where the socio-economic costs are considerable. While it is encouraging to see some impact made regarding helping rough sleepers with complex needs by initiatives like employing outreach workers who engage and a concerted multi-agency approach for dealing with the more difficult cases, the fact still remains that only ten of the fifty plus rough sleepers in the town go in our church night shelters and are unaccommodated. Moreover, help outreach services around mental health and substance misuse are often noticeably absent. Too often the revolving door situation is seen such as when people in the problematic category go on expensive alcohol detox programs and soon after go back on the bottle or are found accommodation that appears suitable, maybe with support, yet cannot sustain it and find themselves back on the streets. It should be noted that with a dire shortage of affordable housing such that the result is it becomes difficult to accommodate those without complex needs, with such needs it becomes even more so.

A lot of the above I have discussed in previous blogs and yet sadly too little progress has been made and some of those with responsibility in these areas either don’t get it or don’t care. When I discussed this with a friend a little earlier, he shared a report by the charity Shelter (2008) with the title “Good practice: briefing – Housing first – Bringing permanent solutions to homeless people with complex needs”. Having just read it, my feelings are mixed. Few would dispute the point the report makes strongly that the type of person we are talking about needs to find basic accommodation with a level of support and a basic set of rules before some of the “complex needs” can be dealt with. It advocates the “housing first” model that takes into account two key convictions: housing is a basic human right, not a reward for clinical success and once the chaos of homelessness is eliminated from a person’s life, clinical and social stabilisation occur faster and are more enduring. My skepticism is I can hear some of my friends who are involved with these sorts of interventions saying this has been tried but such is the nature of those with the complex issues this is easier said than done and I am inclined to reluctantly agree, even though my own damming indictment is that statutory authorities too often play lip service to the issues and are not serious enough when it comes to its intent in resolving the issues and involve a lot more those who can help.

I don’t claim to have all or even many of the answers to the multi-faceted issue of homelessness, especially concerning those with complex needs, and I don’t have the energy I would like and need to be the next William Booth and take these more problematic folk, a number of who I have regard and affection for, to some out of town setting to get sorted and saved and be there for them when back in town, supporting them on their journey up Maslow’s tree of hierarchical needs.  My endeavours reaching out to these folk are well documented and it is all credit to the many who try to help that we achieve something, and while we must not decry the significance of what we do, there are times I feel we merely scratch the surface. The need is on our doorsteps and it is staring us straight in our face. We dare not walk away, and neither should government, or anyone else who wishes or purports to be part of a caring community.

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