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Mental Health and Homelessness Market test

Manchester City Council

We estimate there are around 100 people in Manchester who have a combination of at least 2 of the following: impaired executive functioning, acquired brain injury/alcohol-related brain damage, neuro-divergence, mental illness, foetal alcohol syndrome, substance misuse and complex trauma - who also often experience multi-exclusion homelessness. These people are not having their (statutory, Care Act) needs met. They often cycle in and out of hospital supported/temporary accommodation and bounce around services. They can be refused services such as psychological therapies because they are drinking/taking drugs to self-medicate. Sometimes people get stuck in homelessness services which are intended to be short-term/temporary, including being placed in hotels. Others move on from temporary services, only to lose their tenancy and then start the cycle again. Repeated failures of services and housing insecurity compound the trauma people have experienced and diminish their capacity for hope and trust. Case studies show these people can have poor outcomes while consuming a high level of resources from health and social care providers, housing / homelessness teams, police, voluntary sector partners and others, most often at crisis points. This group may also access multiple health settings in varying states of distress or engagement including A&E / use of ambulance, acute settings for physical health treatments, and/or mental health hospital settings for short or long-term stays. Health colleagues often find people in this group very hard to discharge from hospital as these citizens can present with distressed behaviours and may have been evicted from accommodations, so housing and/or care providers refuse to support them. Case studies and research also show that with the right support, people can move on with their lives. There are examples of specialist services elsewhere in the country which successfully work with people in this group, taking a long-term, therapeutic appr

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