‘We want to help break that cycle of homelessness’

Sheffield City Council is working to change nine of its homeless and supported accommodation services by placing psychology at the centre of what they do. A specialist company, run by Sam Chu, is working to make staff more psychologically aware.

Chu, who trained as a forensic psychologist, set up Paradigm Psychological Services, which has been contracted for three years to provide services that will embed a psychologically informed approach for around 110 members of staff across eight sites that support up to 500 residents. She and her colleague, Misbah Dar, have been supporting staff in reflective practice and training them in how to work in a psychologically informed way around how trauma can manifest itself and the complex needs of many homeless people.

She has previously helped develop these psychologically informed environments (PIEs) in services in Yorkshire, the North West and the Midlands: 'We've got a really empathic approach and want to support staff to increase resilience and job satisfaction. A lot of service users find it difficult to fit into services often because they've had complex trauma in their history which contributes to the development of personality difficulties or disorders.

'We're working with staff to help them think about how early trauma relates to the development of attachment difficulties and problems with relationships, and how those affect their ability to engage with staff in services and develop trusting relationships. We aim to place emphasis on what happened to people rather than thinking what's "wrong" with them.'

For the rest of their time working within these services Paradigm will provide reflective practice sessions periodically for staff and will also assess the impact of the training. 'We're hoping to look at outcomes for staff in terms of increased resilience, improved job satisfaction, reduced staff sickness, among other things, and also the impact that has on service users. We want to look at positive move-ons for service users – fewer flare-ups, fewer evictions, and we want to help break that cycle of homelessness.'

The council's Strategic Commissioner for Mental Health, Melanie Hall, a registered social worker with a history of working within mental health teams, said Paradigm's application to run the service stood out. 'We had real interest locally and nationally to deliver this service and Paradigm were absolutely outstanding. The great thing about Sam's approach is that she co-produced the content of her training with the people who were going to receive it.'

Hall said many supported housing providers deliver some psychologically informed environment training in-house and thus staff skills vary between centres. Training also often consists of one-off sessions and does not include ongoing reflective practice sessions.

'Until now we haven't seen any local authorities who have thought of whole-system change to embed a new culture of working across all local services working with some of our most complex and vulnerable clients.' Hall said she hoped the programme would have a positive impact on staff sickness rates and the experiences of service users.

'We need to make sure that we don't just see a woman as a woman in a housing project but that we see her as someone who has suffered significant trauma, who may also have physical, mental health and family issues. If you don't see the person as a whole we end up seeing them as "the person who lives in number three". We see that on the wards where people get treated by diagnosis because we haven't had enough psychological input into some of the staff and it becomes very easy shorthand.'

Ann Ellis, Strategic Commissioning Manager for the Council's Housing Independence Service, said the services involved in the project included short-term supported accommodation services for people who are homeless and a refuge for domestic abuse survivors.

She said: 'People with the most complex needs, who may have been rough sleeping or in prison, can be very conflicting in their behaviour towards staff. We were looking at best practice around how to improve sustainability and engagement in services with the growing needs of the client groups.

'We've got some men-only services, some women-only and some are mixed. The service users all have different presenting challenges but are often coming from similar traumatic backgrounds and that understanding, and understanding of the staff and their needs, was what stood out to us in Paradigm's programme.'

Councillor Chris Peace, Cabinet Member for Health and Social Care at Sheffield City Council said: 'We're committed to being a 'mentally healthy city', and as part of our ambition to achieve this we're supporting our most vulnerable adults so that they can become more included citizens in our community.' 

To see our original article on the project visit tinyurl.com/ycgr67xv