HEALTH EQUITY FEATURE
We also complete wheelchair assessments and referrals to support clients with physical disabilities to access the community , making recommendations for the package of care to include assisted community access where necessary .
There is an increase in clients reporting that they are feeling more included , engaging in healthy routines of varied occupations , and seeking further opportunities via employment or voluntary services .
They describe having more hope for a future outside of homelessness and they are better able to continue their engagement with services which supports their move-on from homelessness . This has had a positive impact on their confidence and has supported them to regain their sense of self .
A whole system approach Occupational therapy is a key aspect of the wholesystem approach to wrap-around support for homeless individuals and is increasingly recognised for its importance in the promotion of health , the avoidance of disability and the addressing of health inequalities .
Our experiences in this setting have shown us that engagement in meaningful occupation can truly support a homeless person to reclaim and rebuild their life in accordance with their unique values and volition , at a time when they are so at risk of alienation , deprivation and injustice .
A holistic response to homelessness depends on a multidisciplinary team of professionals who are united in their common goal of eradicating health injustices , for the purpose of setting individuals and households up to succeed .
References
Cardiff Council ( 2018 ) Cardiff Homelessness Strategy 2018- 2022 . Available at : www . cardiff . gov . uk / ENG / resident / Housing / Cardiff-Housing-Strategy / homeless-strategy / Documents / Cardiff % 20Homelessness % 20Strategy % 20 2018 _ 2022 . pdf [ accessed 1 October 2021 ]
Public Health Wales ( 2010 ) Our healthy future . Available at : www . wales . nhs . uk / docopen / 176451 / [ Accessed 01 / 10 / 2021
Welsh Government . ( 2019 ). Strategy for Preventing and Ending Homelessness . Available at : https :// gov . wales / sites / default / files / publications / 2019-10 / homelessnessstrategy . pdf [ Accessed : 01 / 10 / 2021 ]
Hayley Baker , team lead occupational therapist , and Gabrielle Jones , rotational occupational therapist , Cardiff Homeless Multidisciplinary Team , Cardiff and Vale UHB
Case snapshot : Move-on to a leased tenancy from hostel living was one client ’ s primary goal . Occupational therapists worked with the client to develop insight into his strengths and needs , and he came to a place of readiness to accept a package of support .
This meant that therapists could then refer the client to the temporary housing team , with the understanding that his support needs would be met and he would be able manage such a tenancy .
Detailed environmental recommendations were made for the move-on , which was facilitated promptly . This new environment supports and stimulates the client ’ s valued occupations , and he is now able to achieve his occupational goals with greater ease .
The client now lives close to his valued social groups , and he can make use of his village of support – this has had an incredibly positive impact on the client ’ s quality of life , his mental health and wellbeing and overall sense of belonging .
Case snapshot : One client was supported to access specialist mental health services . Over an extended period of occupational therapy assessment and intervention , rapport and trust was developed with the client and community mental health outreach assessments were requested as it became clear that the client ’ s severe and enduring mental health issues were a barrier to him accessing outpatient appointments .
Joint assessments were completed with the consultant psychiatrist , the community mental health nurse and adult social services , and the client is now being supported with treatment in the community .
At this early stage , the client has already demonstrated improved engagement with groups , and increased ability to meet his occupational responsibilities with support and better resilience for change .
It is anticipated that by having supported the client to access the appropriate specialist mental health services , he will continue to experience functional improvements as treatment progresses .
Case snapshot : One client achieved positive change across multiple domains of function . Most notably , the client and his carers ( family ) have experienced a huge reduction of distress following intervention .
Extensive occupational therapy interventions related to environmental adaptations , mobility aid referrals , referral to other specialists ( community resources teams and counselling ), recommendations to council housing teams , and graded exposure to community access and anxiety education work , have led to the client now reporting feelings of hope and excitement for his future , where he was previously extremely depressed and demotivated .
The practical implications of this are that the client has recently started engaging in community access for the first time in over six months , and he has regained contact with several members of his family , due to his improved mood and function , which are incredibly positive outcomes for this individual .
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