Alan Kilmister reports from Homelessness Health Event

Alan Kilmister is a Peer Researcher and Expert by Experience with HSCWRU’s Homeless Hospital Discharge Project. The project, which is led by Senior Research Fellow at HSCWRU, Dr Michelle Cornes, is due to report shortly. The project researchers last month published an open access article in Wellcome Open Research—‘Causes of death among homeless people: a population-based cross-sectional study of linked hospitalisation and mortality data in England’. (792 words)

Recent article from the HSCWRU study examining Hospital Discharge of homeless people

Recent article from the HSCWRU study examining Hospital Discharge of homeless people

Hi, it’s me Alan—yes, I know I am becoming a blogoholic. On Friday 8 March 2019 I attended the Queen’s Nursing Institute event, ‘Better Health for all Women especially those suffering homelessness’. It was held at Birmingham City University South Campus: it was a very good venue and we were well fed and watered, and all the speakers were women who introduced themselves with ‘nice to see you all’ on this International Women’s Day. Us poor menfolk were outnumbered by 20/1.

The four key themes of the meeting were: Improve quality of local health; and housing systems; improve access to healthcare; and, increasing knowledge and awareness. This was followed by six key recommendations: Accommodation, Collaborate, Together, Initiative and Intelligence, Ownership, and no Gaps in care. The main point out of these six to my mind was to foster collaborative working for homeless prevention and reduction and to ensure all health services understand their responsibilities regarding care and treatment of those that are homeless. Continue reading

Oh, to be in Finland now that spring is here

James Fuller reports on the ‘Housing First: Ending homelessness across Finland and the UK’ seminar at the Finnish Ambassador’s residence in London, 6 March 2019. The event was organised in co-operation with the Finnish Institute in London and Crisis UK. (1,070 words)

Kensington Palace Gardens, or Ambassadors Avenue as it might as well be called, is a private, heavily guarded boulevard nestled behind the sedate royal dwelling from which it takes its name that is packed with official residences. Not an obvious venue for a series of presentations, organised by the Finnish Institute, about how to house some of the most marginalised and multiply excluded members of society, even if the Finnish building is typically modest.

After a brief word from the Ambassador and the same from Jon Sparkes, Chief Executive of Crisis, we heard from Anita Birchall, Head of the Threshold Housing Project, a specialist housing first, five-year pilot project working with female homeless ex-offenders. As is generally the case for such pilots, Anita reeled off a succession of impressive outcomes for the fifty or so residents THP is helping, although she was clearly anxious about the renewal of her funding, as the end of term is fast approaching. She also revealed that whilst it had been possible to house people within about four weeks during the early stages of the pilot, at present it takes some 71 days on average. This is frustrating for her team, she said and is causing some distress to users of the service, who imagine an application will lead almost directly to accommodation. The idea that this is a ‘from the prison gate’ operation is way short of the mark. Continue reading

Complexity, Homelessness and Addiction

Alan Kilmister (Peer Researcher and Expert by Experience with the Policy Institute’s Homeless Hospital Discharge Project) describes proceedings at recent conference organised by the London Drug and Alcohol Forum. (534 words)

Michelle Cornes with Alan Kilmister

I had the pleasure of attending the ‘Addressing Complexity: Homelessness and Addiction’ conference on Friday 18 January 2019 at the Guildhall in London. I arrived at this beautiful venue a little tired after my early start. My first train was at 06:24. However, a few cups of coffee soon warmed me up. It was an excellent event with a wide range of subjects and very good speakers. I was most impressed by the talk by Kevin Dooley (Recovery Programme Consultant) who at one time had been an armed robber, alcoholic and heroin addict with extensive experience of the ‘criminal justice system’! He spoke very truthfully and emotionally about his time on the streets and how when he was in prison his son had died, he received little in the way of compassion and understanding from the system. Some of the other people at the conference with lived experience commented how they were able to fully connect with what Kevin was saying especially with regard to the shame and stigma that goes hand in hand with homelessness and addiction. Kevin made the point that coming to events like these and talking about ‘our’ experiences takes that shame away. I am a firm believer in involving people with lived experience (“nothing about us without us”) and Kevin made the point that we were are still too few in numbers at events like these. The keynote address by Professor Alex Stevens also made this point, highlighting how, a structurally advantaged social group can dominate the cultural, intellectual landscape, while the people most affected by drug deaths have little say (or in the jargon “corporate agency”). I asked the expert panel in the morning session about this topic and there was consensus about the importance of involvement and engagement, and us all doing more to enable this.

I found the talk by Dr Steve Sharman who presented case studies of people’s experiences of homelessness and gambling very interesting. It reminded me of my time in a Hostel in Wolverhampton. A few of the clients living there were addicted to gambling and just around the corner from the Hostel was a big Casino. This made me wonder if they were addicted to gambling before becoming homeless or took to gambling after becoming homeless.

I found the street drinking in East London talk by Dr Allan Tyler interesting too and wondered about boundaries – would the researchers have learned more had they participated in the actual drinking? There was also a very good talk by our very own Dr Michelle Cornes ably assisted by Darren O’Shea and Jo Coombes.

Michelle presented a case study called the Gutter Frame challenge which tells of the barriers people have to overcome if they want to access services following discharge to the street.  Finally, I must also offer my compliments on the superb buffet provided at lunch time, and of course the chance for some networking too. This is really important for us, and I was thrilled to be approached by a research manager from a leading charity who invited me to join a new advisory group being set up on peer research. All in all, a very worthwhile and enjoyable day.

Alan Kilmister is a Peer Researcher and Expert by Experience with the Policy Institute’s Homeless Hospital Discharge Project

Discharged home with no home to go to

Peer research is a distinct type of service user involvement extending the expertise of lived experience into research. In peer research people with direct experience are involved in designing, delivering and shaping research (Revolving Doors, 2016).The Homelessness Research Programme at the Social Care Workforce Research Unit is currently running two research projects involving peer researchers. The first is looking at specialist primary care and the second at hospital discharge arrangements for homeless people. Both projects recently ran training and induction days for their peer researchers. In this blog James Fuller and Alan Kilmister (Peer Researchers on the Hospital Discharge Project) describe how they became involved in peer research, how their experience can make a difference and why striving for impact and change must be at the heart of this kind of participatory methodology. (1,372 words)

James: I am currently working as a support worker in a ‘day centre’ for homeless people in London. The main motive for throwing myself into the hospital discharge research project is a strong sense of righteous indignation at the way the people who use our service are routinely returned there by hospital staff who should know we have no accommodation – the clue is in our title!

One man has been delivered to our car park three times this year, on two occasions in a taxi, always clutching his transparent bag of medicines and still wearing his ward wristband. All we can do is get him to see our wonderful specialist nurse at the earliest opportunity (she can only fit us in one day a week) and use our best first-aiding to tend any wounds.

In the dark days I was myself discharged from hospital detox onto the street, which meant I couldn’t access even daytime rehabs, not having a secure address in what had been my local borough for more than five years. I was back in detox six months later. In the interim I was put out of the Emergency Investigation Unit of a well-known London hospital in pretty short order and with nowhere to go. Such experiences stick in the mind. Continue reading

Providing formerly homeless people with the support that they need

Maureen Crane, Louise Joly and Jill Manthorpe introduce the final report of the Rebuilding Lives study, published today. (678 words)

Full reportHomeless people clearly need homes but in order to keep them and to rebuild their lives they also need access to resettlement programmes that offer long-term support. A major new study by Unit researchers provides detailed evidence of what works in helping formerly homeless people to sustain a tenancy and avoid further homelessness.

We maintained contact with a group of 297 homeless people over five years after they were rehoused. We were fortunate enough to gain funding from the National Institute for Health Research (NIHR) School for Social Care Research to undertake this ground-breaking study. In the Rebuilding Lives study we investigated their experiences, the ‘ups and downs’ of settling down and building a more settled life. It is the largest and only UK study of its kind. One major finding is that just giving someone who has been homeless a tenancy is not the sole solution to homelessness, as many formerly homeless people are still vulnerable during the first few years after being rehoused. Many experience problems living independently, and require ongoing support from housing, health and social care services – help many do not receive. Continue reading