Emmanuel House’s partnership working

Mental health issues can be both a cause and a consequence of homelessness. Experiencing homelessness can also exacerbate existing mental health conditions or contribute to the development of new ones.

Many of our beneficiaries are more likely to have experienced traumatic events and adverse childhood experiences, such as physical or sexual abuse, domestic violence, or childhood neglect. These experiences can lead to various mental health issues, including Post-Traumatic Stress Disorder, anxiety and depression. Homelessness itself is a trauma, which further impacts wellbeing.

Addressing the mental health needs of vulnerable people requires a comprehensive approach that includes wrap-around care: housing support, mental health services and often substance abuse treatment. Partnerships with organisations like the Homelessness Specialist Mental Health Team are essential for our beneficiaries’ development and recovery out of homelessness.

How we work with homelessness specialists and mental health practitioners

Guy, Sam and Alexandra work in the Nottinghamshire Healthcare NHS Foundation Trust as homelessness specialist mental health practitioners.

They work with people who are homeless or at risk of becoming homeless and who have a mental health condition, which isn’t being supported by another secondary mental health team.

Emmanuel House’s support workers work closely with the team to provide specialist support for people who are in crisis.

Who do they work with?

Many of the people the Homelessness Specialist Mental Health Team work with have experienced complex trauma and may have experienced stigma relating to this, making it more challenging to access mental health services. Many of the people they support are scared of statutory services and there is often a distinct lack of trust. Sometimes they work with people who are neurodivergent and support people who are having a neurodivergent response to a neurotypical environment.

What do they do?

If someone is worried about a person’s mental health condition and isn’t in a crisis situation, they are encouraged to make a referral to the Homelessness Specialist Mental Health Team.

The team gets referrals from many different agencies, which can include refuges, the police, the probation service, hospitals and local charities such as Emmanuel House. People can also self-refer to the service.

The support is entirely centred around the person’s needs and the team’s flexibility is of paramount importance. They rarely invite people to clinical environments and are able to carry out mental health assessments wherever they need to be. This could include a walk along the river, a clinic room at a psychiatric hospital, on a park bench, or at service like Emmanuel House. Often neurodivergent people and people with complex needs need flexibility when it comes to the locations and times of their appointments.

The practitioners work in a trauma-informed way and assessments are motivational and interview-like in style. These assessments can also be as long or short as the person wants.

After the assessment, the practitioners might signpost to other specialist services or they might be referred back to their GP. They can’t prescribe medication, but they can discuss appropriate medication or therapies.

Whilst many people are in very vulnerable situations, they can sometimes be perceived as a threat to the community. The team works to minimise the risks presented to the community and vice versa. They often make referrals to the safeguarding team or the local police, but they will always try to work collaboratively with the person they are supporting, rather than without them.

Emmanuel House’s work with the Homelessness Specialist Mental Health Team

If our support workers are concerned about someone’s mental health, they can ring the Homelessness Specialist Mental Health Team to discuss a person’s specific situation before making a referral. This can act as a triage system. We often ask for advice and consultation, as well as services to signpost people to.

Filling out the referral form also enables our support workers to identify specific needs. For example, Post-Traumatic Stress Disorder is a disability and needs to be considered on a housing application. It also means that shared accommodation might not be suitable. Many of the people we support have experienced complex trauma, which might also mean they need to avoid housing situations, which trigger their trauma.

The relationships we have with our beneficiaries often rely on trust. When our support workers meet people who are struggling with homelessness and their mental health and we can arrange for a Mental Health Practitioner to meet them at Emmanuel House and encourage them to engage. If someone is experiencing unmanageable chaos, a mental health assessment can help them transition into independence and help manage the chaos.

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“We have a brilliant experience of working with Emmanuel House. Their work is person-centred, compassionate and effective. Like us, they’re super busy and we acknowledge the quantity and importance of their work.

We have a very collaborative way of working. We constantly check in on people that we have worked with and have open, honest conversations that are respectful and mindful of the people we support.

Guy Thomas, Senior Mental Health Nurse

Emmanuel House is able to facilitate assessments and provide a safe space for assessments, as well as provide water, food and a non-judgemental, compassionate environment during the meetings.

“For many years there’s been a need for a team of mental health specialists based within the healthcare trust. There are huge benefits to our partnership. We’re able to access their mental health expertise and we are confident that they understand the additional challenges faced by people experiencing homelessness.

The partnership between Emmanuel House and the Mental Health Practitioners means we are able to easily refer people to each other’s services and therefore achieve the best possible outcomes for our beneficiaries.

Maria King, Operations Manager at Emmanuel House

Guy said: “Last year, we were working with a young man who had significant cannabis use and neurodiversity. He would often lose his composure and because his ADHD was undiagnosed, the staff weren’t able to understand his very complex needs. He was struggling to sustain tenancies and was banned from most accommodation providers. He was sofa surfing and couldn’t find any appropriate accommodation.

“We referred him to Emmanuel House, who found him a room at a supported accommodation project outside of the city.

“After just a few days, he had moved in. He joined a local church and finally felt as though he had a place to belong. He had found acceptance, kindness and inclusion.”