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Archive for the ‘Health’ Category

The Children’s Society yesterday reported on the numbers of pre-teen runaways increasing (link below) and the risks that these young people face once they have fled their home or care. The report noted that a child runs away from home every five minutes in the UK and one in three of these will go unreported.

As a society we seem easily able to understand the impact that this type of thing has on children and how unacceptable it is that they are left in such a vulnerable position. The report also said:

“Agencies are unaware of the scale and nature of the problem and often fail to see runaways as children in need. Yet the report reveals that a quarter of them are forced to leave, often fleeing violence, abuse and chaos at home.”

For us we know these young people who miss out on a good start in life and then slip through the net of services all too often end up as adults with some fairly challenging support needs. The tough bit for us to swallow is when these people aren’t children anymore ‘as a society’ we seem to think differently. But they are the same people with the same traumatic pasts, they simply can’t be seen as ‘helpless’ anymore even though they are officially vulnerable adults.

A few hundred years ago these people were known as ‘sturdy beggars’, and were punished for begging when they were physically able to work. Today society is still obsessed with people’s physical ability to work and blames ‘choices’ to become drug or alcohol dependent adults or their irrational and problematic behaviour as the reason for their situation. As the above shows we have to get away from the physical and have more capacity to work with the emotional and psychological state if people in this situation are to find a way to reach their own potential.

http://www.childrenssociety.org.uk/news-views/press-release/report-worrying-new-trends-increasing-pre-teen-and-male-runaways

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This letter was published in the Times and Independent on Tuesday 7th Jun 2011, said:

We are deeply concerned that homeless people will be left without a safety net under the Government’s radical reforms to the health service. Homeless people suffer from high rates of poor health, but ensuring that they receive the right care benefits them, and saves tax-payers money.

 

The NHS proposals fail to ensure that the needs of homeless people will be considered. People who don’t have a home are often transient and they can be invisible to the very GPs who are about to become responsible for commissioning health services.

 

At a time when thousands of homeless people already face cutbacks to the lifeline services that help them get a home, regain their health and rebuild their lives, these health reforms threaten to make this situation worse. The reforms offer opportunities to improve the health of the poorest by enabling housing and health services to work in a new way, but these must not be missed.

 

We are calling on the Government and NHS Future Forum to establish greater accountability for new health bodies including GP commissioners to address the needs of homeless and vulnerable people so they are not forgotten in the health reforms.

 

David Orr, Chief Executive, the National Housing Federation. Charles Fraser, Chief Executive, St Mungo’s. Jenny Edwards, Chief Executive, Homeless Link

 

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Jon, one of our support workers shares the experiences of a day ‘at the office’ in Huddersfield:

As I was walking down to the Mission to meet Tim I bumped in to Julie who I have been doing some short term work with regarding her abusive relationship and domestic violence. She had blood on her coat and clothes and what appeared to be a cut on the side of her head. I spent some time talking to her and tried to get her to either go to the doctors’ or to let me call her an ambulance due to the fact she had a head injury. She refused to go seek any medical help and insisted she was fine. While talking to her she informed me that she had been stabbed in the leg with a screwdriver repeatedly and had been attacked by her husband but she still refused to see a Dr or to have an ambulance called.

As I had an appointment to go to and I could not get anywhere with Julie and she insisted on staying in the park I went to meet Alan. I managed to book him an appointment at the Doctors’ in order to talk to the Dr about his mental health and the options available to him for treatment. While waiting for the appointment we managed to phone and restart a benefits claim for him and he is now just waiting for the statement to be posted ou.

I also called the addiction service for Alan to talk to his worker there about his community order. When I managed to talk to his worker there she told me that he had not been engaging, as we knew, and that all efforts on their part from home visits and outreach that they had been unable to re establish contact. His worker was keen to help me to help Alan re engage with herself, his
CPN and probation and gave me the names and contact details of his probation officer and his CPN. On contacting these I managed to establish that Alan has been discharged from the mental health team due to non engagement, however they are willing to re asses him if the need arises. I was also told by probation that if Alan re engages with either the addiction service or probation or both them he would not be in breach of his community order and they could work to sort things out for him. I made an appointment for Alan at Lifeline tomorrow at 10am, his worker agreed to contact me to let me know if he did or did not attend so that we can discuss ways to help him to engage.

At the doctor’s appointment Alan was told that he needed to start re engaging with the addiction service as his short to medium term problems were best addressed by them and that once engaging with them more medium and long term solutions could be considered for his mental health. Alan gave the doctors’ permission to share his information with me and to contact him through me. From this I learned that when Alan was discharged from hospital his assessment was that there were no mental or psychological needs and that he was not in need of any medication. I am not sure if this diagnosis/assessment is still accurate as Alan talks about hearing voices and has told me he is a paranoid schizophrenic. He does exhibit signs of increasing paranoia and has been very agitated since the passing of a friend of his.

Later on when I went back to the mission I was told that an ambulance had been called for Julie as she was looking to be very sleepy and people were worried about her injuries. I talked with the paramedics and because she refused to be taken to hospital there was little they could do except to inform us of the signs to be aware of with head trauma. After this Julie wanted to go to a housing appointment we had booked previously and so we went up and presented at housing.

Initially they processed the application as a domestic violence application but after going through the interview and checking details the only places they could offer were in Keighley or Rotheram, neither of which Julie wanted to go to for differing reasons. As she had been sleeping rough for 2 nights we managed to go down the rough sleeper process rather than domestic violence. Once this was done they found her some temporary accommodation in until such a time as they can give her a temporary flat.   Julie was over the moon with this and was very thankful that I had managed to get her somewhere to stay and said that although she still felt scared she did feel safer. I called into the mission with her on the way back in order to make a referral for clothes as the only ones she had were the ones she was wearing and they were all covered in blood. Julie appeared to be ok when I left but I’m still worried and will catch up with her again as soon as I can.

 Jon, Support Worker

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Another film from Simon on the Streets

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If you would like to help Simon on the Streets support homeless people in Leeds, Bradford, Huddersfield please check this link to make a donation or here if you would be interested in volunteering

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I have noticed that one of my clients, Paul, has been looking more and more unwell over the past few weeks.  He said he had been assaulted a few weeks ago by a large group of people and has been feeling ill ever since.  He is also rough sleeping after being evicted from a hostel for having rent arrears of £18, and he has numerous other health problems including DVT’s.  Medically he needs to go to A & E (on his doctor’s advice) but feels he needs to get some accommodation first.

I spoke to the housing dept who agreed that Paul had priority and that if he presented with proof of benefits they would provide emergency accommodation.  He was extremely relieved as he said that he knew rough sleeping was making him even more poorly.  He agreed to go to HAP with me which was a really big step for him as he has had negative experiences of other services in the past.  We queued up for just under an hour, during which time Paul was still really positive despite being in obvious pain and feeling very unwell.  When we were called to the front desk we were informed that Paul’s case had been closed and there was no record of my phone conversation with them.  When I questioned this they said that they would have to get Paul’s file and see what had happened and that they were too busy to do it straight away.  They agreed that they shouldn’t have closed his file but, despite the fact that the error was on their part, Paul would have to come back later and wait, again, if he wanted to be considered for emergency accommodation.  They also stated that Paul needed a letter from his GP stating his health issues.  I reminded them that it is not Paul’s responsibility to seek evidence but theirs.  During this time Paul remained very quiet and polite, despite being extremely disappointed and upset.  Paul decided that he would try and find somewhere to stay himself.  The way which Paul’s case was handled just reaffirmed Paul’s mistrust of services. 

Paul is still rough sleeping and his health is deteriorating.  He is also reluctant to go back to the housing dept as he feels that they don’t want to help him.  I will encourage Paul to go and accompany him if he does.  I will also continue to contact housing and chase up what is happening with his case.  By advocating for Paul I hope that his case will be reopened and he will be given the priority status that he clearly requires and will be placed into suitable accommodation. 

Fiona, Support Worker

 

This case demonstrates how the people we work with find it almost impossible to engage with services.  Had Fiona not been with Paul on his visit to the housing dept, being told his case was closed would probably have ended his attempts to secure housing.  Our service users often feel powerless, in fact often the only power they perceive themselves to have in this kind of setting is aggression and fear – and it is this behaviour that leaves many banned from services.

Our government is committed to ending rough sleeping yet we are making the services for rough-sleepers severely inaccessible.  The worrying thing for us is that the longer an individual sleeps rough the harder they find it to move out of rough sleeping.  In Paul’s case this does not bode well – he is very ill, and getting worse. 

Our service users often get blamed for their own situation.  They certainly take some decisions that lead them to where they are.  But blaming them won’t support them to move on!  We firmly believe that people who aren’t getting the support they need should get it, whatever the reason for their situation. 

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One of the individuals, Karen, who is on my case load had been impossible for me to engage with as I had never had the chance to meet her.  I had heard a lot about her from various agencies, all expressing a great deal of concern for her well being as she leads an extremely chaotic life and isn’t receiving any support from any other services due to her problematic behaviour.  She is a rough sleeper, an alcoholic and a chronic street drinker, she also has mental health problems and was hospitalised nearly 100 times in 2008 for various issues including self harm and deliberate overdose. She has some serious, possibly life threatening, physical health problems.  She has been arrested hundreds of times too and is known to be extremely abusive and aggressive. 

 

 I found out Karen was in court so decided to turn up and introduce myself.  When I arrived I saw someone being escorted from the court who was very abusive and distressed, from what I knew I realised this was Karen.  I introduced myself and although she was still extremely agitated I tried to engage with her.  When we were outside the court she was surrounded by a group of people who seemed to be taking advantage of her financially and who were also being quite verbally intimidating towards her.  I stood and had a cigarette with her and she was very hesitant about talking to me and was extremely guarded, she didn’t understand why I would want to talk to her if I didn’t have an agenda.  Karen was quite distressed and kept saying that the people she was with were taking her money and she couldn’t cope like this, I tried, gently, to get a little bit more information from her but all she would say was that they were taking her money and her alcohol and she couldn’t stop them.  She also kept saying that she had been really ill, she wouldn’t really go into detail but just kept repeating that she had been ill.  During this time she was getting very distracted by the group of people milling around outside the court so I suggested that we maybe go for a coffee and a chat, she looked very suspicious but said ok. 

 

We walked into town and as soon as we were on our own she really seemed to open up, she told me about her kids which were taken into care, about her cat, that she had had since she was young, that died because her ex-partner neglected it when she was sectioned.  Although she was very distressed and emotional when recalling this, Karen was actually quite articulate and said that she understands how people perceive her but that she’s not a bad person, despite what people think.  She mentioned that she wants to see her kids but that she’s ashamed of her appearance and the ways she acts when she drinks so she tried to stay away because it’s not fair on them.  On the walk into town she made sure that she stopped and gave every Big Issue vendor £1 and she even had a bit of banter with some Community Support Officers.  She said that I had got her on a good day, she hadn’t been drinking that much but that some days she could “feel her head going” and that she was really struggling to cope at the moment, I asked her if she would like me to accompany her to the doctors and it turned out that, because she struggles to engage with services including her GP, she had been without any medication for nearly 8 weeks.  The medication she was without was for her mental health conditions and it was essential that she took it regularly.  I called her GP’s surgery and explained the situation to them, after some persuasion they agreed to fax a prescription to a chemist in the town centre. I went with Karen to the chemist and waited with her while she got her medication.  During this time we were having a bit of a laugh together but she still didn’t understand that I didn’t have an agenda, she couldn’t get her head round the fact that I just wanted to see if there was anything I could help her with. 

 

By the time I left her, Karen had asked me to make sure I was there next time she was in court and also to accompany her to an appointment she had with ADS (Addiction Dependency Solutions).  I received a phone call the following day from ADS saying that Karen had gone in to the office and told them that she now had a support worker that would be coming to her appointments with her.  I have had a look for her on outreach a couple of times since then but there has been no sign of her, I’ve received a couple of calls from other agencies over the past few days stating their growing concern for her.  I’ll go to her next court date and see if she turns up, hopefully I can start to offer her some support because she is clearly extremely vulnerable, not just due to her health and mental health problems but she is also at risk of financial and emotional exploitation.  Karen’s self esteem is obviously very low, she really thinks very little of herself which is reflected in her destructive behaviour and frequent bouts of self harm.  Despite her challenging behaviour, Karen is someone who has a lot of potential and I’m really looking forward to working with her.

Fiona, Support Worker

 

The purpose of our work is to find the best way forward for each individual.  Fiona had recognised that Karen’s case was far more complicated than any one issue that she faces.  As someone who is so used to being restricted from services and told what to do Fiona saw the value in offering Karen some humanity.  This will build the foundation for further work.  The fact that Karen’s medication issue was resolved in this first meeting is a real bonus.

 

The key to our work is to not get too hung up on individual issues or our assessment of the ones that should be dealt with first.  We have to allow the people we work with to have some say in their care.  In this case Karen’s health and mental health issues are a real concern, as well as her rough-sleeping.  But Karen’s main worry is that she is being intimidated and having her money and her alcohol taken from her.  If Fiona did not listen to these concerns and remain supportive about them then it is very likely that Karen would refuse to engage with her.

 

 

 

 

 

 

 

 

 

 

 

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