Dorothy’s story – what more can we do to help break the cycle?

It is almost Christmas but this can often be a time of year that brings individual crisis to the fore.

Dorothy (name changed) presented at my office at the start of the week. She was street homeless as the local authority had decided a few days earlier that their 56 day duty of care to her had expired, at which point a person’s license does not cover a temporary placement (I believe she had received one extra night over the statutory period).

Dorothy was upset, and due to the stress of now being street homeless, she had lapsed on her medication and treatment, and had a desperate focus on her homelessness situation. She was threatening to take her life. Dorothy gave consent for us to seek support for her situation.

We arranged for Dorothy to meet the mental health crisis team. I have not yet learnt what action was recommended.

However Dorothy presented at my office again within 48 hours, she said she had self-harmed, was threatening to take her own life and expressing her desperation for a temporary bed.

My office once again made an appointment with the mental health crisis team.

Dorothy visited the council offices again, and due to her crisis, has now been offered a further night in temporary accommodation. I hope it stabilises her immediate crisis.

These events cover approximately eight days. In that time the loss of her temporary accommodation has now seen one individual- I call her Dorothy -spiral deeper in to crisis. It has:

  • involved two sessions with the mental health crisis team,
  • seen a substance misuse problem take a wrong turn,
  • seen the housing service re-engage with Dorothy on an emergency basis, due to her now being in crisis.

I do not know if the help and support which is now offered can return Dorothy on to a path that helps her to start resolving her problems.

What I do know is that in the space of eight days Dorothy’s situation has been made worse at a financial cost – to the health system (crisis and substance misuse) and with a return to emergency intervention by housing services. I am however sure that the outcome could have been different – and cheaper overall – if Dorothy had not lost her temporary accommodation.

I do not know Dorothy’s full story – nor her personal history. I can guess she is no angel, but it is not my role to judge. Indeed I am sure that her history might contain a lot of contextual information that could explain this dreadful situation.

But I do know that we need to do more to help prevent such crisis from arising. In particular to strengthen the support made available to help individuals while in temporary placements. That can help avoid these points of crisis, especially for people who consequently face street homelessness.

I am also sure the demand on such services currently outstrips the supply which is a challenge to statutory services.

Dorothy’s story will be unique to her. Yet the general scenario is not unfamiliar. Three other homeless cases presented to the office in this same period. I have a lot of questions that I want to ask statutory partners about policies, procedures and operational cultures.

To everyone who engages in what I think is one of the biggest political and social crisis of our age – let us try even more to rise to the challenge.

We must not be afraid to ask the question:

“What more can we do to help break the cycle?”.

To those of us fortunate to have a home and warm bed this Christmas let us be thankful.

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