(pictured: New Directions Team members in Merton, south London)
Natalie Valios visits a scheme that aims to connect excluded adults to services and society and finds that it could be saving the emergency services money
● Project: New Directions Team.
● Delivered by: South West London & St George’s Mental Health Trust in the London Borough of Merton.
● Annual funding and sources: £180,000 per year funded by government, until June 2011. After this the trust is committed to part funding the team and is seeking funding from other sources.
● Number of service users: 30.
● Number of staff and job roles: Six staff (three outreach workers; one employment specialist; one recovery worker; one administrative worker); six volunteers.
● Aims and objectives: To provide an early intervention for adults in Merton who are not engaging with frontline services and are experiencing multiple disadvantage, exclusion and chaotic lifestyles.
● Outcomes: 88% of clients have been helped with their housing needs; 24% supported into education or employment; there has been a 35% decrease in offending behaviour.
It is difficult to win over individuals in need who are not engaging with frontline services, either because they don’t want to or because they have been turned down for a service in the past. But the New Directions Team (NDT) in Merton has found a way. Set up as one of 12 pilots under the last government’s Adults facing Chronic Exclusion (ACE) programme, the NDT began work in March 2008.
It is delivered by South West London & St George’s Mental Health NHS Trust and reports to a local multi-agency partnership that includes Merton Council housing and social services, Sutton and Merton Primary Care Trust, the Metropolitan Police and drug and alcohol services. Representatives from each service form a steering group that meets bimonthly to oversee the NDT.
Referrals generally come from Merton’s Safer Neighbourhoods community policing teams, non-statutory drug services, housing associations, mental health services, GPs and the third sector. According to NDT leader Matthew Willoughby, clients are predominantly facing eviction or living on the street, and often have an alcohol or drug misuse problem. Mental health problems are another common factor, while there are others on the autistic spectrum who have slipped through the net of frontline services because they do not meet criteria for either learning disability or mental health services.
Finding the clients
Once referred, an individual’s situation means they are not always easy to find so Willoughby goes out to look for them. This is where the NDT differs from most services. “Our office is the community,” he says. “A lot of the time we are just walking around a car park getting extremely wet until we find them, even if it takes two weeks.”
And this is why partnership working is so crucial: “We can’t function without it; for example the Safer Neighbourhoods teams can tell us where they have moved someone on to that we are looking for.”
As lack of housing figures largely in these people’s lives, partnership working with the council’s housing department is critical. Elliot Brunton, housing options manager, does outreach with Willoughby to find those that the NDT is worried about “because people can be reluctant to come to council offices”, he says. “Street drinkers can be challenging cases and we get involved with that so it is part of a joined-up response.” He is positive about the impact of the NDT. “If you have someone that the YMCA is reluctant to take, it really helps when they know that the NDT is involved. The NDT plugs the holes and picks up cases that no one else will.”
As Willoughby can receive an abusive welcome the first time he introduces himself, a plain-clothed police officer accompanies him to ensure the situation remains safe. He uses a ‘chaos index’ with 10 questions that scores individuals on issues such as risk to themselves and others, whether they’re abusing substances and their housing situation. This works out whether they are eligible for the NDT’s help.
Willoughby adopts a relaxed approach while attempting to persuade someone that the NDT will make a difference.
“I’ll say we can just go to a caff to talk about what they want to do first and I’ll buy them breakfast. I find out whether they’re on benefits, whether they’re eating, what their physical and mental health is like.
“I’ll ask them what they expect from us and other services. We’ll discuss goals, such as having a home and a job and it all helps knock down a few barriers.”
The outreach worker assigned to each client develops a support plan with them: “We are not in the business of ‘doing things to’ people,” says Willoughby. “A lot of our work is done over the phone greasing the wheel for other services. It’s very much done in partnership with the individual, we don’t do anything that they aren’t aware of.”
The NDT also has immediate access to a budget to give clients a customised package of support, for example by buying groceries or travel cards, or meeting rent arrears on a short-term basis.
“Our job is to get them seen by social services if necessary and get them into services – we broker the relationship between the individual and the service,” says Willoughby.
The NDT’s funding from government ends next June but the trust is committed to part-funding it beyond this and is in talks with local partners and the Department of Health about meeting the rest of the costs.
Ignoring excluded adults is not an option, says Willoughby. “The regular services they are in contact with are the police and a 999 ambulance call: not dealing with them is a false economy.”
Case study: ‘I’m on my way back’
Three years ago, Anthony Livett had a girlfriend and a job as a dustman. Within a few months he had lost both and found himself sleeping on the stairs at the back of a shop where addicts scored from drug dealers.
By October 2009 he was still sleeping rough, depressed and had started drinking. “A friend advised me to go to the Salvation Army in Wimbledon. A helper there also volunteered for the NDT and she put me in touch with Matthew Willoughby.
“He came to see me at the Salvation Army and to say I was relieved would be an understatement; it was a godsend.
“He put me in touch with Elliot Brunton in housing at the council and he came to see me too. He was brilliant. He filled out a form and in less than a week I got a call from the YMCA. I went there and there were more forms to fill out, including housing benefit, and I thought months would go by before anything happened. But Elliot took the forms back to the council department himself and it was all sorted in one day. It was 23 December, so I had a bed for Christmas.”
The support gave him the strength to stop his daily drinking habit. He also turned down the offer of a referral to mental health services because he felt things were on the up.
“Matthew or the recovery worker, David, phoned me a few times a week and we met up at least once a week when they’d buy me breakfast. If I didn’t have any money when I was going for interviews the NDT would put money on my oyster card.”
Livett was also helped by the NDT’s employment specialist and has been on courses to help him find a job.
“Being put in touch with the NDT changed my life. I’m definitely on my way back.”
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