'A stepping stone to moving on': home supports women with severe mental health issues

Being able to do her own washing and having responsibility for her personal possessions symbolised the freedom Michelle Stevens* wanted but was denied in institutional care. Stevens’ severe mental health problems meant she was in and out of residential care and mental health wards for a decade. She recalls staff shouting at her and living circumstances that were “very closed up and not nice at all”.

Today, however, Stevens says she is “much happier and freer”. She has a bedroom in a large double-fronted Victorian house – and she loves the garden at her supported living home in West Norwood, south London, which is run by social care provider Certitude. “[It] is cleaner than other places I have been, and has nicer facilities,” says Stevens.

She enjoys socialising – with the 11 other residents and locally – and for the first time in three years, she does her own washing and is trusted with her belongings.

The women-only housing is designed for those with enduring and complex mental health issues who may be stuck in restrictive environments. Certitude provides support while First Priority, a housing association, manages the tenancy agreements. The home opened in September 2016 and residents, who are mostly in their 30s and 40s, benefit from individualised support that is rarely offered in residential or inpatient care.

The therapeutic approach involves a focus on fitness – reflecting growing awareness of the link between physical and mental health – and enabling women to connect with the community.

Liz Durrant, Certitude’s director of mental health, says the home bridges the gap between where the women have come from, and where they need to be. “The aim is to provide a stepping stone to moving on and living more independently.” The aspiration, she adds, is that “they feel like valued members of society”.

The project reflects the need for more community-based mental health support. Nationally, there have long been worries about the lack of local and more independent housing support for people with mental health issues. The Care Quality Commission recently said that a lack of mental health services means more patients are having to be sectioned to get help.

Early results at the home, which supports women for up to five years, are promising. Of the 12 women, one has moved into her own flat and two have gone into longer term supported living. Eight residents have started voluntary work and vocational courses since moving in, and one is studying food hygiene and health and safety. The women suggest the home “gives you more freedom and is less restricting”, and that it offers “security and independence”.

The scheme is part of the Integrated Personalised Support Alliance (IPSA), an approach in the London borough of Lambeth that aims to reduce long-term mental health inpatient provision. The IPSA has saved almost £2.5m since 2015 [pdf] through cutting down on residential or inpatient provision. The partners – Certitude, Thames Reach, the South London and Maudsley NHS foundation trust, Lambeth clinical commissioning group and Lambeth council – operate under a single contract and performance framework, ensuring that everyone works to the same end: people’s recovery, not organisations’ targets.

Durrant says the collaboration is key to the home’s success and helps unite local mental health organisations.

The process begins with the alliance identifying a woman in long-term care who might benefit from the new approach. After a fresh needs assessment and asking if she would like to move, staff start visiting the prospective resident. When she is ready, she stays for a night or two; moving in is gradual, tailor-made to each individual.

Staff agree a plan of support with each woman to help her feel comfortable and safe – and to get to know staff and the surroundings. An occupational therapist visits two days a week and while all the women have access to NHS mental health services, the aim at the home is to ease social isolation, and support people to get out locally and see friends and family. Rebuilding relationships is crucial. Several of the women say they were too ashamed of their previous surroundings to encourage visitors.

For someone who has not been out alone for years, the goal of the plan might be regular shopping trips. One resident is aiming to pass her maths GCSE, another wants to get fit.

Facilities and furnishings at the property are of a high standard, the large bedrooms are all ensuite, and communal spaces include shared kitchens and a large garden. Stevens says that “more places like [the home] need to exist”; thanks to this kind of support, she says, “there’s a good road ahead”.

* Name has been changed

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