Coronavirus London: The complex needs of traumatised rough sleepers

Coronavirus London: The complex needs of traumatised rough sleepers

A recent On London podcast featured part of a phone interview with Laura Pilcher, who is lead manager of Martha Jones House, a 50-bed Thames Reach hostel for street homeless men and women in Vauxhall. The signal wasn’t great, which meant some of what Laura said didn’t come through clearly enough to use in audio form. To make up for that, here’s a slightly fuller Q&A account of our conversation, which was so enlightening and left me full of admiration for the work of Laura and her colleagues.

Question: How has the coronavirus outbreak changed how you do your job?

Answer: There is an increased need to make sure everybody that’s in the hostel absolutely needs to be here and that we’re accommodating the people who are the most in need of 24-hour supported housing. That involved us looking at our cohort and moving on people that could manage with less support, so that we could accept those that really do need the high level of support we provide here.

We support people with really complex needs. Martha Jones House accommodates men and women who have experienced lots of trauma and multiple disadvantage, and because of that have lots of needs around substance use and their mental health, and often physical health needs and offending issues as well. In order to effectively support that client group, it requires the input of lots and lots of different agencies.

So we work closely with GP surgeries and nurses and mental health teams and substance use teams to offer the right support to keep everybody well. The idea is that we are supporting people to address their needs so they can be more independent. What has happened as a result of Covid-19 is that all of our support services in-reach have stopped. So there are no other services currently providing support within the hostel, so as a team it is now just us. That’s the big change.

Q: That sounds pretty dramatic.

A: It is quite dramatic. So, pre-coronavirus, in the hostel, there would be various teams based in the hostel or visiting the hostel, and that has dramatically reduced. The nurses who work across homeless services in Lambeth, and are utterly wonderful, are still able to offer weekly clinics at Martha Jones House but all of the other services are no longer coming into the hostel. Some are still providing some support, for example by phone, but the nature of the sorts of people that we’re trying to support means there is a limit to how effective that can be.

The job for the core team at Martha Jones House has become significantly more challenging and more difficult. The need is actually higher than it was before all of this for the residents, because everything about their lives has been so disrupted. They have more needs that we have to try and address, and there are less services to address those needs, so as a team we’re left with a really difficult situation. There are people who have very complex needs that need lots and lots of support, and it is now just the team here doing that.

Q: Can you explain a bit more about the impact the coronavirus has had?

A: If you think about people who are homeless and, for example, have substance use needs, the way that they fund that substance misuse is to beg. And people can’t beg at the moment, so they can’t fund their substance use in the usual ways. That has interrupted their habits and meant that their behaviour has become more challenging, as they are more distressed. They use substances as a way of coping with the trauma they’ve experienced. If you take away those substances, they are left with all of this trauma and distress that they don’t have another way of coping with. So there is more challenging behaviour and more incidents in the hostel, and the team are having to respond to that on a day to day basis.

Q: Looking at the efforts being made to help London’s rough sleepers overall, dare you hope that in the longer term some good might come of this?

A: I hope that this situation has made the government think about the numbers they are working with that they identify as rough sleepers and that the need is significantly larger than they have been willing to acknowledge before. I hope that that remains, post-coronavirus.

Photograph of Martha Jones House from Thames Reach.


Categories: Analysis

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