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MIND THE GAPS
Meeting the needs of people with co-occurring substance misuse and mental health problems
ANNEX D
MIDWAY PROJECT
A partnership approach to housing support
Midway was set up in 1996 for individuals with mental health problems, who were in psychiatric hospitals and their discharge would lead to them becoming homeless. Midway planned to support individuals making the transition from hospital to independent living in the community. To do this required the establishment of a tri-partite agreement between housing (who would provide accommodation,) health services and Turning Point Scotland.
In the initial set up protocols it was envisaged that service users would have a mental health diagnosis only. However it quickly became clear that these diagnostic criteria alone would exclude many potential service users as the majority of referrals had either a co-existing mental health and substance misuse problems or other complex needs. The project evolved to support service users with these complex needs and often chaotic lifestyles. Providing a flexible and individualised service for all has been the primary focus for Midway.
Midway endeavours to support individuals to maintain a tenancy through practical input and emotional support. This encapsulates all aspects of daily living and assistance in accessing mainstream services and benefits. Placement within Midway flats is temporary and service users are supported to access mainstream permanent tenancies from housing providers. The average length of stay is six months.
Working in a participative way with other professionals involved in an individuals care has further ensured that individuals progress to a mainstream tenancy. Midway has established close links with Social Work Services and health care providers. These relationships have ensured that service users continue to function at their optimum level with the knowledge that support networks are in place whenever a problem arises. This goes a long way to reducing anxiety in individuals and ensuring success of placement.
A good example of the successful move on of an individual is the case of Mr A who was referred to the project in February 2002 and offered a temporary flat in late February of that year. Mr A had little experience of managing a tenancy and living alone due to long term institutional care throughout his teens in a 'list D school' and in adulthood within prison, the state hospital and general psychiatric hospitals. As well as psychiatric and offending histories Mr A used drugs. At time of referral he was on methadone reducing regime and was still using cannabis. All these elements combined excluded him from majority of services. Prior to the placement, contact was made with a social worker, a community psychiatric nurse and consultant psychiatrist who were all involved in supporting this individual. All agreed to ongoing support and to Midway staff being the main link between all services and service user. Support plans were drawn up with the individual which clearly identified his needs and input needed from all those with responsibility for his care. His assessed needs included resettlement support, monitoring of mental health episodes and accessing benefits. In the August of that year Mr A moved into a permanent secure tenancy with Glasgow city housing. Midway continues to support him on an infrequent basis with Social Work Services and community psychiatric staff having a greater involvement now.
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