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Brent Dual Diagnosis
Project
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Service History • 1998 Brent Mind establish service 5 placements
• 2000 Additional 6 BME placements
• 2004 Supporting people housing related funding
• 2005 Remodel, introduction of structured groups
• 2006 New provider St Mungos add specialist input
Stakeholders
• Brent PCT ( 70% funding /
referrals ) )
• Supporting People ( 30% funding )
• Paddington Churches ( Houses the service )
• St Mungos ( Manages the
contract )
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Aims of the service
• Assist people who need support in the community around mental health and substance use issues.
• Reduce compulsory hospital admissions.
• Reduce severity and frequency of risk behaviour by promoting harm reduction around substance
use.
• The service values people for who they are and share their vision of achieving independence.
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Aims of the Service
• Promotes Social & life skills, Tenancy sustainment, Personal development and the belief that recovery is obtainable.
• Promote recovery and maximise wellbeing, supporting tenants to meet their long term aspirations.
Dual diagnosis / homelessness
• Historically ( prior to being referred to the service ) clients spend long periods in a transitory state revolving through various short term accommodations.
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Transitory accommodation
• Family Home (Breakdown)
• Independent Tenancies (Failed)
• Hospital (Revolving door lack of move on provision bed blocking )
• B & Breakfast ( short term to address lack of move on provision)
• Supported Accommodation (Short to medium ) • Prison ( to a far lesser degree )
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Impact of remaining on the homeless threshold
• Lack of integrated service provision
• Viewed as hard to engage / problematic
• Vulnerable to exploitation
• Entrenched substance use
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Service Profile
• 18 Months Tenancy / 6 months Floating Support• 2 week trial period ( attending day programme )
• Groups AM Daily Tenant meeting, current affairs, self development , Tenancy sustainment & Drug group
• Groups PM DailyArt class, Relaxation , Shiatsu, Tai Chi, Life skills cooking
• 1 – 1 Sessions Weekly Keyworker, Substance use & Psychotherapist
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Substance use Role
• Bridges the historical gap in service provisions• Sign posts and introduces tenants to external drug
agencies • Substance use interventions tailored to the individual
(harm reduction) ( Peek into abstinence )
• Weekly engagement in group and 1 – 1 sessions• Inspire tenants to practice abstinence through informed
choice
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Psychotherapy role
• Provide a safe environment where Clients areencouraged to talk about and explore their feelings, behaviour and inner conflict.
• Find new ways in which to alleviate stress
• Clinical supervision / reflective practice which provides a forum for frontline staff to present, discuss and share ideas and thoughts on how to holistically address the complex issues faced by clients.
Outcomes of the service
• Move on • 20% Moved into Independent
accommodation ( private rented)
• 75% Moved into lower supported accommodation ( self contained )
• 5% Moved into medium/high support
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Outcomes
• Hospital admissions greatly reduced • Greater awareness of substance use in
relation to mental health.• Increased talk & alternative therapies• Engagement of service user across a
wider range of issues • No evictions planned moves
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Innovations & User Involvement
• There is a scarcity of Dual Diagnosis services
( Locally or Nationally ) that are effective.
• The Project provides a structured supportive
environment that considers clients needs beyond medication and Housing.
• Engages clients holistically using a range of
interventions , models and informative groups
Innovations & User Involvement
• Tenants that have moved on have access to daily
programmes as well as specialists.• Local user involvement – includes
• Service User Magazine – Quarterly “Your vibes today”
• Workshops & Forums – Q&A’s
• Action Plans & Outcomes Stars
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Why Replication ?
• The Service profile in terms of high levels of engagement ensure that vulnerable adults can address issues within a supportive rather than punitive environment.
• Floating support ensures that the transition from high to low / independent living is consistent.
• The theory that clients ( any clients ) are hard to engage will not and does not hold
Why Replication ?
• Local and National services will be able to network and benchmark, ensuring a consistent approach in working in the community with clients with complex needs.
• The question of who treats what and when will be addressed through integrated working.
• The belief that recovery is possible will ensure services work with clients where they are and not where they are expected to be.
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