Publish date: 13 December 2023
West London NHS Trust is playing a vital role in transforming the lives of rough sleepers.
The Rough Sleeping and Mental Health Programme (RAMHP) was launched just over three years ago by a number of partner agencies including the Mayor of London and the GLA.
The aim of the project is to improve access to mental health services for rough sleepers across 16 London boroughs.
Teams of mental health practitioners have been working directly with rough sleepers so they’re better equipped to reconnect with society.
Jeremy Mulcaire is the project leader at the Trust. He said: "The Trust put in a successful bid and we were invited to set up this small team of community psychiatric nurses, approved mental health practitioner (social workers), an occupational therapist and a consultant.
"It's a tri-borough initiative, so we cover Hounslow, Ealing, Hammersmith and Fulham."
The RAMHP team works closely with homeless charities in each borough and goes out overnight or very early in the morning to speak with rough sleepers about their mental health and the support available to them.
Jeremy said: "What we do is start at 10pm and the shift could finish at 2am or 3am, or we go out at 6am and try to locate people when they're bedded down and we can engage with them."
On 31 March this year the project celebrated three years since its launch.
Jeremy explained: "It was initially set up to assist those rough sleepers specifically with mental health difficulties who have become disconnected with mental health services and all other services including their GP.
"It rapidly became evident that it wasn't just their mental health problems we needed to address but their physical health problems too."
Jeremy said he and his team have met people with untreated TB living on the streets.
Through the partnership with St Mungo's RAMHP has been able to get many of the rough sleepers into accommodation and help them register with a GP.
However, without a fixed address this can be difficult. Jeremy explained: "I can't stress the importance of having stable accommodation, be it temporary.
"With St Mungo's we would say ‘let's get them into a hostel tonight or tomorrow morning’, we then go back to the office and start searching their health records to see if they're known to us."
Jeremy said it's become 'all too common' for a homeless person to be rejected by a GP surgery due to having no address.
To combat this, RAMHP and its partners have created a 'credit card', which a rough sleeper can present to a GP surgery.
Jeremy said: "Previously they would turn up to a GP surgery and the practice manager might say ‘you've got to have an address before we register you’.
"That's actually against the law, so we had these cards printed, which states their entitlement to access health services."
He added: "Since we started we haven't heard of anyone who came under our care who has been refused registration with a GP."
It was also quite normal for rough sleepers to attend A&E for common health problems, including a cough, so presenting rough sleepers with cards explaining their rights has helped alleviate the pressure off frontline services.
RAMHP has also been working closely with the police, substance misuse teams and inpatient services and where necessary the team has authorised on the spot mental health assessments and helped facilitate hospital admissions if needed.
One of the biggest challenges facing the team is how they help people with no recourse of public funds. This often involves people who are 'subject to immigration control', who have no entitlement to state funds/ benefits because they're not British Nationals.
According to Jeremy, you need housing benefits in order to receive local authority or private accommodation and without this a person will find themselves on the street unless a charity offers to house them for free.
Through the work of RAMHP, Jeremy said the outcomes for individuals have 'considerably improved' and they've gone on to reconnect with health services and community facilities including housing and improved their health and wellbeing.
One of the success stories is a man called Peter (Not his real name) who was homeless for 20 years before engaging with the newly formed RAMHP team.
A year after the team engaged with him he now remains well and receives regular support regarding his mental and physical health.
Jeremy explained: "He phones up and asks ‘are you coming to give me my treatment on Wednesday?’ and we have managed to reconnect him with his family after five years of no contact."
To find out more about the RAMHP team and the incredible work they do follow the link below.
Background:
RAMHP was initially a pilot scheme funded by the GLA for two years, but since then it has been funded by West London NHS Trust in Ealing, Hounslow, Hammersmith an Fulham.