Agenda item

TR and Aileen Edwards gave a presentation on Mental Health and Housing. 45% of people with mental health issues are in insecure accommodation. 78% of homeless have mental health issues. 60% identify housing as a trigger. Mental Health survey last year shows a national trend for issues with temporary housing.

Social determinates of health: housing, employment, debt. Want different people with mental health experience to get together with professionals and decision makers. Don’t want to duplicate work, know this project can feed into other things. Want Bristol to be the lead on best practice. Understand that this is not going to be all-encompassing. Needs buy in to effect change.

Team has developed a Matrix of Mental Health and Housing Security to identify risk. Reaching people who don’t access services is very difficult. There is a lack of awareness over domestic violence and how this interacts with housing. There are also cultural issues, different language or attitudes towards mental health. Underestimating the impact of social isolation. PIE – psychological informed environment. How the physical environment impacts on individual and community.

Recommendations:

Housing First could expand to include MH element.

Floating support service for tenancies need to be protected, saves in long run.

Early intervention with children and young people to ID risk.

More info about where you can go for advice / services.

Physical design improvement to improve mental health.

Need more champions, collective work would be better, too much silo at the moment.

Members congratulated presenters for an excellent piece of work. It is timely as the One City Plan is ramping up, with a real focus on joining up the thematic boards such as Bristol Homes Board and Health and Wellbeing Board. Last month was the better lives programme, looking at specialist provision. BCC now has a fund for supported housing projects and housing association. There is a need for single person accommodation to support the pathway. On December 13 there is an ‘Upstream’ meeting about how physical design affects physical and mental health, e.g. access to green space. After that meeting, there will be more data available to build on.

PW Shelter did research with MIND on the mental health / housing link. It’s important to do practical things to help people to settle, e.g. DIY skills to ensure tenants feel safe in their homes. There’s concern in the advice community about expectations of the public. Advice is very important for prevention. North Bristol advice centre are working with GP surgeries to provide advice with great success, but not sure how sustainable. Want to work in partnership, but there is a possible block to this in future with how the CCG funding plans will work.

Members discussed the governance of the BHB in terms of adopting / promoting the recommendations in the report. BHB formal adoption is helpful, but other boards will be asked to hold and monitor (e.g. RAG rate), so influence is important. The recommendations should also be taken to the Health and Wellbeing Board and referred to in the One City Plan. The expectation is for stakeholders to accept recommendations, as they were involved in the work to develop them in the first place.

Recommendations are largely about lower needs groups. There is nothing currently on primary / secondary care for high needs individuals. Mental Health budget stretching has raised the threshold for care. There are many people with significant mental health issues that cannot qualify for services.

We are looking at whole mental health system in terms of cradle to grave and wider determinants. Not about services / transactions. Adverse child experience is key. The crisis pathway is insufficient. There are gaps between primary / secondary care. E.g. diabetes support is in GP now with better outcomes, could be done for mental health.

Mental health is underfunded. 25% of presenters have mental health issues, but only get 13% of the funding.

CCG is going to recommission health services, in future they will go to hubs rather than within GP surgeries. Universal credit is going to be big problem implementing, especially disability premium. Advice service does not have funding to support applications. NHS and LA have uneasy relationship around available funding. Want to prevent passing the buck, systems thinking, how we can work together. There is a mental health investment standard being implemented in the NHS. Any increase to physical health programmes must be matched to mental health.

There will be a review of home choice and the housing allocation system next year. It is a complex issue that should not be rushed. Biggest challenge is a lack of revenue funding, so it is good to hear more funding available. Better lives programme set out priorities. Supported housing for particular identified needs. BCC is trying to avoid out of area placements. Need mixed and balanced communities. New developments need to include supported housing alongside general needs. Estates that reflect existing communities, not just mix of affordable / market, should be ages, abilities, etc. Community led housing. People not given something by service provider, but empowering people to help themselves, especially as part of shared group. Sense of community or being part of something helps anxiety and depression. Way professionals deal with issues is often top down, ground up approach helps.

It was RESOLVED that Bristol Homes Board endorsed the recommendations within the report and requested 6 month updates on progress