Pathways to Recovery A Community Based Model

1. Pathways to RecoveryA Community Based Model Supporting homeless women living with mental illness: from homelessness to independent living.

2. July 2010 – June 2011: 13,142 beds were occupied at BMWF equals 13,142 times a woman slept in safe accommodation

3. B Miles Women’s Foundation Inc. • A newly formed business entity following the amalgamation of two previously separate organisations: • City Women’s Hostel – opened in 1989 and B Miles Women’s Housing Scheme – 1985 • Both organisations provided accommodation and support to women in Sydney who were homeless and living with a mental illness.

4. Presentation • Briefly describe BMWF amalgamation and SVMH partnership. • STVMH - clinical support • Data – 2008 – 2011 outcomes • Questions

5. B Miles Women’s Foundation – Housing and Support Options program • SHS funded service – NSW FACS • At risk of homelessness and living with a mental illness Medium term low supported accommodation • 12- 18 months – 14 single and 3 share properties 3 months aftercare. CHD WHC x 10, BH x 1, MH x2 • Tenants linked in with clinical support • Meet weekly with their support workers • Social inclusion - activities

6. B Miles Women’s Foundation – High Support program • Provides short term accommodation to women at risk of homelessness and living with a mental illness. • Six beds with twenty four hour on site support • Tenants regularly meet with support worker • Previously generalist homeless women’s service • 2005 mental health specific

7. Partnership History • BMWHS & CWH formed a partnership in 2005. • MOU – both services mental health specific - commitment to develop a smoother pathway for women exiting hospital care towards long term housing. • MOU SVMHS 2007 – on site clinic • Appropriate referral systems to new geographic location • Established relationship with management and staff across services

8. CWH Temporary Auspice • 2008 BMWHS experienced a crisis in governance • FACS – presented option of auspice by CWH Management Committee • Good conditions – similar vision, target group, existing partnership, human resources knowledge • Temporary auspice • Staff welcomed the change - uncertainty eased

9. Aims • Sustainability – one cohesive structure • Recognised the need for a fully integrated merger • Change Management processes • Aim - ensure women are appropriately supported in transitioning from homelessness to long term independent housing

10. BMWF amalgamation • Advantages : human resources, less duplication, economic • Referrals – 9 annually • Women have an opportunity to stabilize via a structured program, preparation and exit planning (established community networks) • Collaborative approach/ share information/ flexibility • Can return to access programs

11. Previous Mental Health Relationship • 2005 - CWH made 44 calls to Mental Health Acute Care Service (ACS) - close to 1 per week. • in the same year, only 5% of women separating from CWH achieved referral to medium long term housing. • many ACS interventions resulted in women being hospitalised, often with police assistance. • a survey of CWH staff indicated ACS staff were reluctant to attend calls & did not consult CWH staff • there were minimal recovery based interventions (such as mental health rehabilitation) • residents who attended mental health intake often experienced long waits with little follow up.

12. The Aim of Building a Mental Health Partnership • reduce the incidence of referrals to crisis services such as the acute care & police • reduce number of admissions to the mental health inpatient unit • enhance the recovery process for homeless women living with a mental illness. • maximise opportunity to achieve independent living

13. Planning and Implementing Solutions • management from both services agreed to improve care to shared clients • a service agreement was developed and a formal partnership was established • the partnership outlined specific commitments between the two services.

14. The Agreement: BMWF commitments • prioritize referrals from the SVMHS inpatient unit over any other referral agency. • staff would attend education on mental health topics conducted by the SVMHS and stipulate experience in working in mental health as an essential criteria for employment. • provide holistic programs to assist women in their recovery. • commence a mental health consumer participation program. • provide resources to support the operation of a weekly mental health clinic located on site at BMWF high support program.

15. The Agreement: Mental Health commitments • dedicate resources (including a liaison clinician) for the operation of a weekly clinic on site at the hostel. • provide relapse prevention support, arrange linkages to other departments within the hospital such as rehabilitation and housing services and arrange medical reviews as required • provide support, education, training and supervision for BMWF staff and residents on a weekly basis

16. Table 1: Separations to medium or long term housing and referrals from BMWF high support to acute care service

17. Sustaining change • The following data is monitored and regularly reviewed: • number of referrals for acute care mental health services. • number of BMWF (HS program) separations to secure long term housing. • number of high support residents who access the weekly on site STVMHS clinic.

18. Benefits of Partnership: STVMHS • Support at each stage of transition • Weekly Clinics – consumer and staff support • NGO and Government collaboration – crucial link for access to appropriate treatment • Opportunity to continue clinical support while client is linked up in new LGA

19. Pathway to Recovery Mental Health Unit St. Vincent’s Mental Health Service High Support Medium Term Low Support Independent living Other

20. Housing Outcomes 2008-2011 • 29 women supported through partnership July 08 – June 2011 (NDCA data records) • 21 continue to live independently • 1 living with family • 1 returned to homelessness • 6 currently accommodated in the program

21. Stages of transition • 2008 eight accommodated – all living independently (five occasional social support, two regular support) • 2009 seven accommodated (six living independently - social support) (one living with family) • 2010 eight women (all living independently – social support) • 2011 six currently accommodated

22. Length of homelessness • 6 @ imminent risk • 4 1 – 3 months • 6 3 – 6 months • 3 6 – 12 months • 4 1 – 2 years • 3 2 – 2-5years • 3 5 years +

23. What has worked? • Prevention! • Focus on support throughout transitions • Support from mental health service • Clinics/ information sharing and education • Working collaboratively in preparing women to move where there is less support • Holistic approach- clinical, alternative treatments, social inclusion opportunities through activities • Sense of community

24. Contact: B Miles Women’s Foundation High Support Program 02 93604881 kara@bmiles.org.au PO Box 1132 Darlinghurst NSW 2010 Housing & Support Options 02 93170400 zed@bmiles.org.au 345 Gardeners Rd Rosebery NSW 2018 Website – www.bmiles.org.au