“Strong, with milk and 2 sugars please…”
By: Dr Helen Miles
Tags: Young People, Mental Health, Systems Change, Homelessness

07.06.18: This week I had the pleasure of visiting the Centrepoint services in Yorkshire; in Bradford and Barnsley, and was treated to a proper ‘Northern welcome’ from my wonderful hosts and a wonderful respite from the traffic jams of London life in the Yorkshire Dales. Centrepoint is responsible for the whole homeless pathway for young people in these areas, and I was shown around a range of services, from first stage 24 hour supported accommodation services through to final stage floating support. I even visited a very unique farm based service, based on the psychological principles of a therapeutic community. Every staff member I met was welcoming (and offered me tea; I drank A LOT of Yorkshire tea!), and I saw some amazing examples of psychologically informed environments (PIE) in practice; too numerous to pick out for this short blog.

However, one overarching thing really stood out for me this week (apart from the quantity and quality of the tea I drank!), and because it has led to examples of PIE in action, I will focus on this. Specifically, it was the relationships that staff had with the young people, each other and local stakeholders. Many of the staff I met had worked within the homelessness sector for many years, and had a huge amount of experience and local knowledge. This had led to their feeling of being empowered to make decisions and actions to directly benefit the young people they worked with. It also led to a clear ‘team’ ethos and supportive approach, which translated into a ‘surrogate’ family atmosphere in many of the services and supported the development of therapeutic attachments with the young people they then worked with within the services.

Furthermore, there were some shining examples of PIE in action in the physical environment(s) (discussed in my blog last week) in a couple of the services I visited. When I walked into these my immediate thought was; “wow; this is a lovely space and yes I could live here”; the ultimate measure of PIE. They were welcoming, well decorated and cared for, felt safe and were co-produced with the young people and staff. Staff and young people took pride in their environment, and would ‘just get on’ with maintaining the spaces themselves (e.g. keeping the paint work up to date). I also really liked where staff had put positive messages of hope and encouragement with stencils on the walls for the young people (and themselves), and where work was underway with the young people to make the outside spaces into gardens.

In another service, the positive relationship with the local child and adolescent mental health services (CAMHS) had led to informal agreements for a local psychologist to visit the service to see young people (rather than expect the young people to attend a formal ‘clinic’ which is known to reduce engagement), and also to offer reflective practice groups to staff, in order to support them when they were working with young people with particularly complex mental health needs. I also noticed staff going ‘above and beyond’ with young people and utilising skills that I think aren’t in the job description for a Supported Housing Officer (SHO) such as hairdressing(!), but would be a powerful engagement tool with young people, and something that increases their self-esteem and positive self-image. The formation of these positive relationships or attachments with young people to develop a ‘secure base’ (c.f. Bowlby, 1967) was also further evidenced when I witnessed a young person (ex-Centrepoint resident) in crises get back in touch with his previous keyworker, and how quickly support was offered and accepted by them leading to a positive outcome.

I finished this week visiting a service in Barnet in London, which was also very welcoming, and I could see that despite the difference in location, there were similarities in the approach that the team were taking. They too were highly supportive of each other, very experienced, reflective within their practice, often going ‘above and beyond’ for their young people, and were developing positive relationships with the local community. Although these staff didn’t feel quite as empowered in their local decision making as in the Yorkshire services, the foundations of a PIE service centred on the value of relationships was in evidence. It made me reflect on how important it will be to encourage the sharing of good practice and the recognition of our similarities between services within Centrepoint as an organisation, in order to take forward the PIE approach. I was also left feeling positive that the ‘pieces of the PIE’ are already starting to fall into place. After all, as Arthur Wing Pinero apparently once commented; “Where there is tea, there is hope….”