FEATURE HEALTH EQUITY
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Homelessness is a complex and persistent public health challenge that can have a devastating effect on individuals , families , and communities .
This enables the individual to contribute financially to their housing needs , as well as regain a sense of purpose and meaning to their every-day living . For clients that require additional support with applying for benefits and budgeting their finances , we can signpost to the appropriate services , such as outreach case co-ordinators .
The impact is that clients are being housed in a timely and appropriate manner , especially where needs have been raised as urgent . Environmental assessments and adaptations have led to clients being placed in permanent accommodation much sooner than was originally anticipated , as we have been able to adapt available properties to meet their physical needs .
By making recommendations for care packages , clients have been able to regain function in their own home and meet needs that had otherwise been neglected .
Accessing specialist mental health support One of the main challenges we are faced with is supporting clients to access specialist services for their co-morbid mental health and substance misuse difficulties .
There is a significant increase in the number of clients presenting to the homeless service in Cardiff with mental health issues that are impacting on their ability to function and manage their housing needs .
We have been able to recognise the inequalities and occupational barriers that prevent engagement with secondary care ; to name a few , these include poor cognitive and physical health , financial hardship , clients ’ lack of awareness and understanding of the impact of mental health on their wellbeing , as well as environmental restrictions such as a lack of suitable transport and location .
This client group is often misunderstood , due to limited societal insight into the unique dynamics of this population . We have therefore felt a need to develop strong links and connections with specialist services , such as the community mental health teams , substance misuse services and prison in-reach , by sharing the results of our complex assessments to highlight the need for targeted input .
We complete occupational formulations to share our thoughts and understanding of a person ’ s situation , to better navigate the direction of treatment and signposting where necessary .
The impact is that clients are now being recognised as needing support , they are receiving early intervention and urgent assessment , leading to being prioritised for treatment , such as outpatient psychiatry appointments .
This has shown to have a positive impact on their mental health , their overall wellbeing , and there has been a noticeable improvement in individuals ’ abilities to look after their personal and housing needs .
Integration of homeless people within communities We see first-hand the impact that ‘ belonging ’ has on a person ’ s overall wellbeing . Social and community integration supports somebody to be a part of society , leading to overall improvement in health , selfesteem and quality of living .
Homeless people are faced with challenges to their inclusion in society , for example : some might find themselves in situations where they have no recourse to public funds ; the impact of welfare reform may lead to more financial difficulties ; environments not being accessible to those with physical , mental health and cognitive issues ; and societal stigma and misconceptions around homelessness .
As occupational therapists we support a person ’ s integration back into community living at a pace that is appropriate for their presenting issues , in line with their values and occupational identity . We utilise occupational analysis and graded exposure to break down physical , cognitive , mental health barriers in the context of a new environment .
We draw upon activity scheduling and pacing strategies to prevent feelings of being overwhelmed and to focus on the individuals ’ unique life responsibilities and roles to achieve optimal occupational balance .
To support this , we link in with the public and third sector organisations and projects , and we refer individuals to the diversionary activities resource within the multidisciplinary team , providing occupationally focused recommendations and treatment plans .
We identify when an individual requires an outreach case co-ordinator , who can offer assistance to support with benefits and charitable or government funding opportunities .
20 OTnews December 2021