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,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Click to edit Master title style,*,Secondary Mental Health Input and the NSNO Pilot,Learning to tackle inequalities,address mental health and help prevent rough sleeping.,Background,Need for statutory mental health input had been anticipated.,Camden and Islington NHS Foundation Trust approached in December 2021.,Islingtons then Homeless Mental Health Service,ARC,was obvious host.,Proposed Model,Training and information re emergency pathways.,Telephone availability at specific times Monday-Friday.,Agreement that assessment should be possible within 3 days not necessarily with a psychiatrist.,Foundation Trust Concerns,That need would be higher than that funded(equivalent to 0.5 wte post).,Acute admissions of people without local connections.,Community Services were in state of flux already.,Level of Activity over 6 months,61 face-to-face assessments.,Most have involved a psychiatrist.,Written up normally in the form of a report focussed on appropriate outcome for that individual e.g.around ongoing needs or vulnerability in terms of Housing Act 2006.,Activity continued,20%cases,individuals have been seen more than once.,3 people have been admitted to hospital informally.,5 people have been detained under the Mental Health Act 1983.,Who have we been asked to see?,Wide range of needs,including acutely unwell,dual diagnoses,people with recent trauma.,Have,not,seen those who could be;Reconnected without fresh assessment and/or managed by team without concern.,-A less resourced and active NSNO would have led to many more referrals.,Quantifying the activity.,The professional time been equivalent to:,-0.1 Band 6 Mental Health Worker,-0.3 Senior Social Worker/AMHP,-0.2 Psychiatrist,But,Challenge 1.Host?,ARC has been decommissioned Now input is“hosted by the local CMHT.,CMHT itself is going to lose role “intake function taken on by a borough wide service.,Will that larger service have capacity to respond in time scale needed and will it have expertise?,Challenge 2.Admissions,Number of admissions lower than feared by FT.,Higher than predicted by GLA thru comparison with Rolling Shelter.,Local bed managers,very,loathe to take NSNO referrals.,Questions?,Is there a place for homeless mental health specialism?,How would mental health services manage in your area with NSNO challenges?,ie-Prioritisation based on social situation not necessarily clinical need.,-Lack of local connection.,Group discussions.,Using case studies as a prompt,discuss how you think MH services in your area would,or could,support a NSNO model.,Feedback and discuss with large group.,Case Study 1-John,59 year-old UK citizen.,Was engineer retired 8 years ago.,No history of MH problems.,With wife he moved abroad.,Bought,developed and sold properties.,High quality of life.,Final house in Bulgaria.,Received cash sale on a Friday.,Kept over weekend went missing.,Police did not acknowledge crime.,Became targeted,dogs poisoned and further thefts.Sold fixtures to buy food.,Wife returned to UK.,He was subject to further intimidation.,Arrived back in the UK 2 days ago.,Penniless,unkempt,fearful.,Found in shop doorway.,Wife doesnt want to see him.,No meaningful relationships in UK.,He expresses concern for his mental health.,Also appears insightful.,Not a risk to himself or others.,Grateful for help.,OK in the hub,anxious outside,.,Case Study 2 Brian.,33 year-old from different town.,Well known to mental health services.,Diagnosis of schizophrenia.,History of serious suicide attempts.,Brought to project in the early a.m.,Uncommunicative with staff but talks to his CPN by phone.,CPN advises that has distressing delusions,that wants to die and has active suicide plan.,Wont speak to staff or make eye contact.,He is sat in a corner sometimes talking to himself.,Case Study 3-Anji,24 years old.Birth family are from nearby.,Disturbed early years,some time spent in care.,For past 5 years has lived with partner in a different part of country.,Suffered a miscarriage last year was prescribed anti-depressants soon after by GP.,Didnt take them and has had no contact with mental health services.,Indicated that ex-partner was abusive,but denies that was physically violent.,Left partner with intention of staying with father.,He lives in drinkers project-not allowed overnight guests.,With support from NSNO staff approached housing department in her fathers area.,Advised not in priority need.,Case Study 4-Hameed,42 year-old from the West Midlands-Known to homeless services.,Recent years spent in church shelters and on the streets.,One psychiatric admission several years ago.,Had been experiencing persecutory delusions which reduced with treatment.,Not sustained contact with mental health services since,but did attend an assessment 6 months ago.,Felt to be unwell but not detainable und
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