The referral is accepted and attempts are made by the

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The referral is accepted, and attempts are made by the assessment service to meet him at his sleep site. When contact is made, the mental health social worker who attends with an outreach worker elicits from Oleg some further ideas that appear to relate to a delusional belief system – this includes a fear that there is a plot to target him with poisonous gas and steal his blood. When further attempts to engage him with mental health services or accept accommodation fail, he is referred for assessment under the Mental Health Act. He ends up being admitted under section, initially for assessment and then for treatment. The inpatient team assess him as suffering from a schizophrenic illness and he is treated with anti-psychotic medication, he also accesses psychology and occupational therapy. His symptoms significantly respond to treatment. With Oleg’s consent, outreach are able to remain involved, and attend occasional ward rounds. On discharge the outreach team are able to support his application to supported semi-independent accommodation outside of the area where he is an inpatient, which he qualifies for as a ‘verified rough sleeper’. George is a long term rough sleeper, referred to mental health services by an outreach worker who is concerned that he consistently refuses offers of help or shelter, even in extremely cold weather. George readily engages in conversation with the outreach workers and others in the neighbourhood where he is well known. The outreach worker is questioned by the mental health team as to what evidence there is to indicate that mental health problems might be impacting George’s decision to decline help. The answer refers to how
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Homeless Link Homelessness guidance for Mental Health Professionals 23 extreme and risky a situation George is placing himself in, but there is little that indicates that his decision- making is impaired. The outreach worker is directed towards the MCA screening tool in the guidance and offered advice about what might be relevant to consider. With this support, the outreach team continue to meet with George and openly explore with him their concerns about the dangers he is placing himself in. George engages with these discussions, acknowledges the risks, and suggests that he would agree to accept help if his physical health were to deteriorate or if the weather was particularly bad, but he still declines assistance for now. The outreach team are still worried for his welfare but feel more confident that they have done everything they can and accept George’s choices. They continue to visit him regularly and make it clear that they can still assist if he changes his views. The following winter George accepts a place at the severe weather emergency (SWEP) shelter when there is a particularly cold patch of weather. Following this he appears more willing to consider alternatives to sleeping out and is supported by the outreach team to apply to the council for more permanent housing. No further role for mental health services emerges.
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  • Fall '19
  • Poverty, mental health professionals

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