5 of 10: A human welcome

“I could have done with a plant in my room, just to make it personal, rather than processing me like a number.”

When asked how people felt when moving into supported accommodation many said they felt lonely and it was like living in an ‘empty shell’.

Moving into a new home is stressful, especially if you’re transitioning from being on the streets, so being alone in a new place with a sparsely furnished room can sometimes feel just as isolating. This transition from being homeless to moving into accommodation was a significant issue for the people who talked to us. It was important to feel welcomed and to have information both on the local area and who to contact in case things go wrong.

Mayday’s Response

People must feel welcome. This can be achieved by implementing a welcome protocol, which expects staff to make regular contact with the people they are working with before and after moving in and this can include going out for a coffee or lunch, in order to spend time getting to know the local area. A personalised Welcome Pack could also be created to share useful information regarding the accommodation and local area, and provide basic supplies.

The new protocol and Welcome Pack aims to make the transition into their new home as bearable as possible, reducing feelings of isolation and instead, making sure people feel welcome and in control of the situation.

4 of 10: Somewhere to call home

“I don’t want to be ungrateful but it’s like, when you trash your flat they fix it, make it nicer than before. But if you keep your head down and look after it, then you get nothing.”

We were told that by being given substandard housing people were left feeling worthless and insignificant.

Having a decent standard of accommodation, particularly when you have been through a tough time, is so important. Many people felt devalued and disrespected by the standard of their accommodation. Often those who looked after their accommodation felt ignored in comparison to people who disrespected and damaged their property. People also shared that they felt they couldn’t really question the suitability or standard of accommodation because they should just be grateful for what they were given.

 Mayday’s Response

Mayday recommends introducing a minimum standard for the quality of accommodation – WILT. The general principle we adopt is asking the question ‘Would I Live There?’

In addition, staff could be trained on the principles of PIE (Psychologically Informed Environments) so they understand the importance of the environment and what can make a positive difference for people. People could also be given the opportunity to apply for a personal budget to personalise their room.

3 of 10: Stability over instability

“I have moved 6 times since losing my home. I have had to prove that I can look after myself, and now I’m probably moving again. It makes me feel worthless.”

People felt dehumanised by the current system and often experienced severe anxiety due to having to move multiple times in a short period.

Hierarchical and pathway approaches to accommodation are still used today. This means people regularly have to ‘prove’ that they are ‘tenancy ready’ in order to progress to the next stage of accommodation, regardless of their skills or experience. People reported feeling humiliated and worthless; they expressed a desire to settle down, a place where they didn’t need to move after periods of time, somewhere they could make their own.

Mayday’s Response

The psychological impact of multiple accommodation moves and having to ‘prove’ your worthiness in order to secure accommodation is significantly underestimated. There is growing research on the ‘Housing First’ models for the most entrenched rough sleepers which demonstrate more successful approaches to tackling long term homelessness.

Mayday believes that the current pathways and temporary housing provisions hide the reality of the housing crisis and can have a long term impact on the individuals resulting in high costs to health and other statutory services. A way forward would be to trial an alternative solution to supported housing, which will evidence cost savings as well as more positive outcomes for people experiencing homelessness.

2 of 10: Understanding a situation

“They kept asking me if I had any health issues. I kept saying no. Then it dawned on me, I went into A&E and said I was suicidal. They admitted me and I escaped the rain.”

Some of the people we spoke to felt that they often had no choice but to make their personal situations worse in order to be prioritised for housing or simply escape the cold.

Due to the lack of affordable housing and the low priority given to single homeless applications, more people have viewed supported housing as either a way of getting a bed for the night, or a route to moving higher up the council waiting list. Maintaining people in high cost supported housing is not only expensive, but also presents the same perverse incentives for those who have overcome their issues and are ready for employment and independent living.

The high rent charges for supported accommodation and a lack of options for people once they secure employment mean they are at risk of becoming trapped or becoming anxious and gaining a mental health diagnosis. This situation can escalate to people becoming institutionalised or gaining a status as ‘complex needs’. At this point they become a high-cost priority to the state, but on a personal level they are trapped in a situation of no hope or confidence and are disempowered to make positive changes in their lives.

Mayday’s Response

Mayday recommends offering social housing to people with ‘complex needs’. Support offered through the PTS Response is optional (although subject to a duty of care, which means that in some situations Mayday will allocate a Coach in the best interests of the person). People can decide if, when and what support they need – meaning that they have control of their own situation.

4 of 13 Delivery to the Lowest Common Denominator

“Before I became homeless, I worked as an accountant. Now I have to prove I can write my own budget plan. It’s humiliating. Is this really how low I’ve fallen?”

The norm has been for skill development courses and tenancy support training to be a requirement for people to complete in order to prove their ability to look after themselves and move out of homelessness. The evidence from what people told us, was that in reality, the only real benefit to them was the short term social interaction rather than any long term sustained improvement.

Low course attendance and strategies for engagement have been high on the agenda for many years. People told us that they didn’t engage because they felt awkward, uncomfortable about what they may have to talk about, feared bumping into people they owed money to or saw the groups as patronizing. One guy said he was booked onto a vocational course which was great, but no one had asked about his educational history… he had two degrees and was easily more qualified than the person delivering the session.

We took action

We stopped running internal courses and replaced them with brokered, community-based opportunities and resources tailored to the individual.

The PTS gives individuals the control to identify their own goals or barriers and how they want to tackle them.

1 of 10: The right to move on

“If I get a job my benefits will mess up. I won’t be able to afford my rent, then what? I’m back on the streets.”

People told us that once they had transitioned out of their need for support and had secured employment they then couldn’t afford to live in supported accommodation, leaving them facing an uncertain future.

The current supported housing system combines charges for accommodation and support. This has been viewed as an efficient and successful way to fund housing associations and supported housing providers to deliver a holistic approach to working with ‘vulnerable adults’. However, for many of the people we spoke to, it also creates a perverse incentive.

For those who do get a job their options are limited to either trying to find alternative accommodation, giving up their job, or to ‘go undercover’ and not declare their employment – risking fines and possible eviction. Even when the finances and arrangements are in place, for some being labelled as ‘vulnerable’, moving accommodation and settling into a new job is not an ideal combination. People even reported being encouraged by staff not to work until they had paid off their rent arrears. Not only is this costly to the system but it also stops people from moving on with their lives.

Mayday’s Response

Mayday recommends an alternative model of accommodation and support, where accommodation charges Local Housing Allowance rates or affordable rents. This would mean people do not have to move when they are successful in gaining employment. Support is Person-led, Transitional and Strength-based and totally separate to accommodation. Importantly, people can continue to access the support when they move.

3 of 13 Over Medicalisation of Mental Health Issues

“That’s just what I need. More pills and someone to talk to about why I feel crazy. You would too if you slept in a tiny room next to someone screaming all night.”

Significant numbers of people talked of being prescribed drugs for depression, anxiety or bipolar disorders, when in reality, their emotional distress was related to their homelessness, isolation and abuse from people around them.

Many people were referred to mental health services and community psychiatric teams due to behaviour that was later identified as post-traumatic stress. Suicidal thoughts or attempts were often a result of events in the past or their circumstances – for example, living in unsuitable housing where they were intimidated or didn’t feel safe.

Many people became defined by their ‘mental health’ diagnosis. This acted as a barrier to moving from their homeless situation and led them to be institutionalised into the system.

We took action

In many situations, we changed the focus of our conversations to ask ‘what happened to you?’ not ‘what’s wrong with you?’. We aim to identify whether mental health issues and emotional distress are the reasons why people are homeless or if they are a symptom of their situation. This allows support to be tailored to the individual and informs whether solutions are medical or whether alternative options are more appropriate.

The PTS provides a range of options, choices and information to promote healthy, mental and emotional wellbeing

Introduction to Wisdom from Behind Closed Doors

Based on our experience of working with people from all backgrounds and providing accommodation in challenging circumstances, we wanted to know about their experiences and how they feel about the services and accommodation they have received. Wisdom from Behind Closed Doors is based on 80+ conversations with people who are housed in temporary or supported accommodation, as well as people who are sleeping rough and sofa-surfing.

People told us that they wanted a home where they could feel safe and secure, where they would receive a warm welcome; where they could just get on with their lives.

People moving into accommodation didn’t want to feel labelled, stigmatised or that they had to prove themselves in order to remain. What they want is to start rebuilding a sense of purpose and value to their lives. People want to stay somewhere with a decent standard of accommodation which supports them to access education or work. People told us that they wanted a place where they can make friends and maintain contact with their family. People want the assurance of knowing what to expect from their landlord, including how long they can stay, and what their responsibilities are within the accommodation. Like any tenant, people want access to a feedback and complaints process when the accommodation is not up to standard or things aren’t going well.

“I did two years in prison and now I’m doing two years here. They say I got sentenced for two years, but in reality it’s four.”

2 of 13 Right Intervention at the Right Time

“Right now isn’t a good time for me to start my healthy eating plan. Right now I’m trying to get my kids back, so this pizza will do just fine.”

People told us that often, the help available to them wasn’t what they needed at that point in time. Instead of being able to access what they knew would really help, they ended up attending key working sessions that focused on box ticking rather than what was really going on in their lives and what they felt they needed. The interventions were not ‘ real world’.

Having to engage in activities that didn’t reflect their interests, spending months on waiting lists and undertaking tasks and courses to prove that they were ready to move out of the homelessness sector was often further proof of how far they had failed in life.

We took action

We threw out needs and risk assessments and the use of paperwork in front of people and replaced it all with real world, advantaged conversations.

Our focus was on listening and hearing people, then providing what they needed to make whatever difference they wanted to make in their life. Often, this didn’t involve providing a service but was instead providing an opportunity. We gave everyone access to small personal budgets and bonds so they could shape their own markets and drive supply based on what they knew they needed at the times they needed it.

Providing the right opportunity at the right time also meant that the PTS doesn’t just operate 9am to 5pm.

The PTS embeds personalisation through the approach, personal budgets, talent bonds and transition grants that finance the services, activities and opportunities that individuals need, when they need them.

1 of 13 More than Fixing

“What I need isn’t just to come off drugs, quit alcohol and to get a job. I need to feel I’m worth something, then I might want to do those things.”

People told us about the focus of the services they received. They felt that the aim was to find out what the problems were and then set about trying to fix them without understanding that they weren’t ready to give up the things that were helping them cope. Many used drugs, alcohol or self-harming as ways to cope with traumatic experience. Some did so to keep in with their friends, forget about their situation or just get through the night. Without finding more positive things to replace them, they needed something to help them get through.

Often, it is difficult for people to move on positively from a place of shame, feelings of failure or where their experiences aren’t validated by someone significant in their lives.

We took action

We researched further and found that this is common. There was a body of evidence that identified that, by maintaining people in their area of weakness (their needs), minimal impact would be achieved. By harnessing people’s strengths, evidencing their previous successes, exploring what they can do and validating their experiences, people build on their own abilities and move toward more positive, sustainable life changes. Training staff on how people use coping strategies is a key part of this.