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Cluster 3

By Ray Alexander,2014-07-11 17:12
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Cluster 3 ...

    Ealing Supporting People Strategy Refresh

    Needs analysis - Cluster 3

Appendix 4 - Cluster 3: People with mental health problems,

    people with drug and alcohol problems, offenders and

    offenders with mental health problems.

Current Supply

    People with People People Mentally Offenders Client group

    mental with drug with disordered and people

    health problems alcohol offenders with

    problems problem offending

    behaviour Annual 2,185,356 221,000 103,883 ?48,176 577,866 Expenditure

    Accommodation 261 18 18 39 based units

    Floating support 128 12 106 units

    Total 389 18 18 12 145 Inner London 372 24 59 4 33 Average

    Outer London 179 12 12 0 53 Average

For all these client groups Ealing has a comparatively good supply of services

    when compared with the London averages. The borough has above average

    supply when compared with other outer London boroughs and, with the

    exception of substance misuse services, above the inner London average as

    well. There are many overlaps between these groups of people as many

    people with a substance misuse problem commit offences to support their

    habit and there are significant proportions of offenders with a mental health

    problem.

Our move-on survey shows that there are some difficulties in moving on from

    services, for example one 6 unit service reported 50% of service users were

    ready to move-on at the time of the survey, another reported 30%. However

    the probation service and the DIP team report a good though put where

    people have access to the rent deposit. There is more of a problem for those

    who are not statutorily homeless as their banding for Choice Based Lettings is

    lower and access to social housing more difficult. Most people in this cluster

    will not be accepted as statutorily homeless. We are planning to increase

    move-on opportunities in the private sector and improving access to rent

    deposits and expect that this will generate better move on.

Information on needs varies for this cluster; there is good information on

    people who access statutory services such as the DIP, probation services or

    who are in contact with statutory mental health services. The CAT team

    provides good information on the street population including street drinkers

    and drug users. There is less information available on people who have

    support needs but who are not in touch with any of these agencies, such as

    people with alcohol problems who are not street drinkers. The Gateway

    service will help us improve our data gathering for these groups of people.

    Ealing Supporting People Strategy Refresh

    Needs analysis - Cluster 3

The summary of support needs for this cluster identified a number of

    themes:

Multiple needs

    ? Lack of specialist services for people with mental health problems who

    have a dual diagnosis with substance misuse/learning disabilities, drug or

    alcohol problems

    ? Lack of schemes for mentally disordered offenders with 'dual' diagnosis,

    sex offenders and those with a history of violence ? Lack of schemes for people with drug and alcohol problems that have

    specific health issues and multiple or special needs groups Women needs

    ? Lack of refuges/ safe hostels for women with drug and alcohol problems

    who have multiple needs such as mental health problems, substance

    misuse, suffering domestic violence

    ? Lack of women only services for women with mental health problems

    especially for multiple needs e.g. drug or alcohol problems, learning

    disabilities

    ? Lack of information on the housing-related support needs of women

    offenders and substance mis-users

    BME needs

    ? Lack of information on the needs of people with mental health problems

    from BME communities

    ? Lack of information on the housing support needs of refugees with mental

    health problems

    ? Lack of information on the resettlement needs of offenders from minority

    ethnic backgrounds and what housing support would be appropriate ? Lack of information on whether there is a need for culturally sensitive

    services for people with drug and alcohol problems

    Other needs identified

    ? Lack of a range of support models and services ranging from high to low

    levels of floating support

    ? Insufficient accommodation for single men who are a low priority on 'local

    authority housing lists'

    ? Lack of specific accommodation & support for people with early onset

    dementia/Korsakoffs

    ? Lack of schemes for high level care and support provision following

    inpatient detox

Progress

? We have completed a strategic review of mental health services which

    concluded there was a need to focus funding on a smaller number of

    accommodation units capable of working with people with more complex,

    and multiple, needs;

    Ealing Supporting People Strategy Refresh

    Needs analysis - Cluster 3

    ? We have commissioned rent deposit scheme for this client group ? We have commissioned HAWK workers to work with people coming out of

    prison;

    ? We have commissioned a floating support service for clients of the Drug

    Intervention Programme;

    ? We have re-tendered a number of poorly performing services for people

    with substance misuse problems and people with mental health problems

Ealing LAA targets

    There are a number of Ealing’s draft priority LAA indicators that relate to this cluster:

    NI 142: Number of vulnerable people who are supported to maintain independent living

    NI 38: Drug-related (class A) offending rate

    NI 15: Serious violent crime rate

    NI 16: Serious acquisitive crime rate

    NI 17: Perceptions of ASB

Other relevant National Indicators (out with the LAA) are:

N1 115: Substance misuse by young people

    NI 18: Adult re-offending rates for those under probation supervision NI 30: Re-offending rate for prolific and priority offenders

    NI 31: Re-offending rate of registered sex offenders

    NI 39: Alcohol-harm related hospital admission rates

    NI 40: Drug users in effective treatment

    Access to housing with appropriate support is an important factor in reducing re-offending, improving stability and reducing drug use in people who have a substance misuse problem and maximising independent living for people with mental health problems. Reducing drug use also helps cut drug related offending. We also fund an outreach team to work with rough sleepers and the wider street population. Reducing rough sleeping, street drinking and drug usage helps reduce perceptions of anti-social behaviour.

Current Needs

People with mental health problems

    The Mental Health accommodation strategy identified the following gaps in services which could be SP funded:

    ? Accommodation and services for people with a dual diagnosis (particularly

    where the mental health issue is combined with substance misuse and/or

    learning disability);

    ? Female hostel accommodation;

    Ealing Supporting People Strategy Refresh

    Needs analysis - Cluster 3

    ? Accommodation and support services which are ethnicity specific

    (particularly for the Somali and Afghan communities who have made up

    80% of asylum seekers in recent years, many of whom have been given

    leave to stay and who do not have a robust support network)

    We have recently carried out a strategic review of our services for people with mental health problems. The review included an appraisal of all SP funded schemes, an analysis of referrals and a survey of the views of service users. The review identified that it is difficult to place people with high support/complex needs and there are too many shared housing schemes as many, but not all, service users would prefer more independent living. The review proposes funding a small number of high support units through a remodelling of services that will require a reduction in low support units and a rationalisation of the current array of floating support services.

People with drug and alcohol problems

    Many people with a substance misuse problem will not be found in either drug or alcohol specialist services. In 2006/7 the Client Record form data shows that 21% of the 122 people whose primary need was identified as mental health had alcohol problems listed as a secondary need; 24% had drug problems. Where homelessness is primary need drug problems is a

    secondary need for 11% and alcohol for 6%.

    National Treatment Agency (NTA) data show the number of people in structured drug treatment for 05/06 in Ealing as 1,547 compared with an estimated number of problem drug users as 2,725 (Integrated Commissioning Strategy). The relevant population in Ealing is relatively young with the majority in their 20s and 30s.

    The Drug Intervention Programme (DIP) works with drug misusing offenders to offer a route out of crime and into treatment. The support on offer includes access to housing, and where appropriate, clients are helped into supported housing or provided with floating support in independent housing. The DIP currently (March 2008) has 60 clients of whom 12 are in supported housing and 15 in shared housing with floating support; 14 are currently in prison. The remaining 19 are in a range of housing situations, some of whom also receive floating support.

    The DIP team reports that clients housing needs are generally met but some clients in shared flats or independent housing would benefit from more support than is currently available, as the floating support services only operates 9-5 and on weekdays.

    The Contact and Assessment Team (CAT) provides an assertive outreach service targeting and engaging street drinkers and drug users in key town centre areas of Acton, Southall, West Ealing and Hanwell. The CAT targets and engages street drinkers and drug users using assertive outreach to assess their needs and link them into relevant services. These include

    Ealing Supporting People Strategy Refresh