Half term report: RCPsych scholarship and Brighton and Hove CCG
Nearly midway through the RCpsych Sustainability Scholarship, I’ve been thinking about the last 6 months and where I am at the moment. Having been paired with Brighton and Hove CCG, the first few months were getting to meet the relevant people and gain some understanding about the sustainable aspects of the CCG by reading through their sustainability plan and the progress they had made so far. It was clear from early on that they were keen for me to be involved and highlighted a new service being commissioned and piloted called ‘Mental Health Hostels Link’. The aim of the pilot was to gain a greater understanding of the mental health needs of the homeless within hostel settings and to identify barriers to mental health treatment and support.
Whilst significant progress has been made to improve health outcomes of the population as a whole, inequalities remain for many socially excluded group, one of which is the homeless population, with evidence of lower life expectancy and poorer health outcomes. In March 2014, services estimated that 132 people were rough sleeping in one night in Brighton. In addition, there are approximately 400 people in emergency accommodation and the city has 288 hostel places, with a current waiting list of 125 people.
The first few months of the scholarship involved me carving a role for myself in this project, with the 4 principles of sustainability being key in this. Various possibilities were discussed including patient related outcome measures (PROM) and focussing on the restoration of social capital, leaner, more effective pathways and training and empowering hostel staff with training.
In the last few months, after some very informative and useful meetings with individuals at the CCG, we identified an area of focus for the project which would have a sustainable basis and also be helpful in developing the service. To research the evidence around mental health intervention from the 1st stage (every contact counts) and how ‘treatment’ could be incorporated into the engagement process which can be time consuming in this complex population. How does this link into sustainability I hear you say? Improving value – by ‘treating’ from the very first contact, we are delivering interventions that provide the maximum benefit for the least cost (in theory reducing the time spent in the service by ‘treating’ and engaging side by side rather than one after the other). Prioritising prevention – aiming to prevent this population from becoming homeless again by equipping them with skills to build resilience (there is well known ‘revolving door’ phenomenon in the homeless). Empowering individuals and communities – promoting self-management and independent living.
And there you have it, the first 6 months of my scholarship. Let the final 6 months proceed…..
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