Psychologically Informed Approach to Homelessness

Following recent reports looking at the UK homelessness system, an empathy led approach is being called for by professionals.

In 2018, a point in history so close in proximity but seemingly unrelated to the world we live in now, the Government set a bold goal to halve rough sleeping by 2022 and end it by 2027. There is no set pathway to achieving this, due mainly to the unique and complex needs each person facing street homelessness may need support for, but one practice that is gaining traction in the UK is the Psychologically Informed Approach.

A few weeks ago our CEO, Jonathan Prew read an article in the Municipal Journal, De-traumatising the sector and was struck by the approach “that homelessness is a social problem with a housing dimension, and not a housing problem with a social dimension.”  That article gave exposure to a new report, ‘A Traumatised System’ from Riverside Housing. The report underlines the impact of a ‘bitty’, underfunded and politically ‘incentivised’ approach to homelessness across the last decade on housing and homelessness services, leaving in its wake a largely de-humanising system for tackling complex human problems.

The report calls for an empathy-led approach to de-traumatise the system, naming the three most significant innovations which can be adopted to tackle homelessness in the UK:

1. Wrap-around services for Multiple Complex Needs
2. Housing First
3. Positive Psychological Approaches

What is a Psychologically Informed Approach?

There is no single way to implement a Psychologically Informed Approach into homelessness services, or any other social focused sectors. With homelessness it involves building services primarily based on the understanding that an organisation is dealing with individuals with complex, sensitive needs. A growing body of research suggests that those who are rough sleeping experience a higher level of mental health problems. The University of Southampton estimate that 60% of those living in hostels will have a diagnosable personality disorder, with other mental health problems significantly over-represented in this segment of society in comparison to 10% within the general population.

Building services around psychological considerations of these challenges has historically been difficult, as individuals will often be presenting themselves at services at a point of crisis. In these situations, the help provided is necessary, urgent and immediate, such as sourcing shelter, but less focused on future recovery. A Psychologically Informed Approach will not see urgent services disappear but will mean that many of those who approach in times of crisis would then have access to follow-on care.

Five Elements of a Psychologically Informed Environment (Homeless.org)

1. Relationships
2. Staff support and training
3. The physical environment and social spaces
4. A psychological framework
5. Evidence generating practice

When a homelessness service or environment is designed with a Psychologically Informed Approach, it is thought about in terms of the emotional and psychological needs of the individuals accessing the care, as opposed to first and foremost, the practical elements of cost, convenience and material provision.

Of course, these logistical pressures still exist and consistent case management that tracks interactions between housing providers, charities, institutions and those rough sleeping is key for building up a true picture of the ‘full circle’ needs of an individual. Having a detailed record of a person’s behaviours and movements can be the beginning of tailoring an approach that works for them.

“Training all staff within an agreed framework, or combination of frameworks, will help them work more effectively with clients experiencing complex trauma. This approach will help clients who often behave chaotically to gain an understanding of their behaviour, take responsibility for themselves and develop negotiated, positive relationships. This in turn will help them move away from a street lifestyle and rough sleeping.”

Psychologically Informed Services for Homeless People – Good practice guide Dept of Communities and Local Gov 2012

Two weeks ago we spoke with Dr Kelly Henderson about domestic abuse as a pathway to homelessness. Taking this particular complex need as an example, in a Psychologically Informed Environment the staff supporting these individuals would have training and an understanding of trauma and its ramifications. Alongside careful and consistent case management, this would allow for support to be picked up as users make their way along the rough sleeper pathway, perhaps dropping in and out of services along the way. To achieve any level of continuity, an ‘elastic tolerance’ needs to be encouraged. What this means in practice is instead of a rigid set of provisos accompanying any help given, individuals would be viewed for what we all are: fallible and prone to inconsistency.

“To be effective, there needs to be corporate commitment to the introduction of a psychological informed approach, which ideally should then become part of an organisation’s service commissioning or business plan.”

University of Southampton

In order to truly tackle rough sleeping and homelessness, each person approaching services needs to be given a tailored and consistent approach. Understanding and recording the experiences of those involved can help connect multiple agencies and address rough sleeping as a social issue spanning health, addiction, opportunity and education – as well as simply the roof over someone’s head.

MRI Software build a number of solutions for the social housing sector including Housing Jigsaw, RISE, Streetwise and Housing Analytics. If you would like to know more about what we do, please drop an email to socialhousing@mrisoftware.com