"4) A Piece of the PIE
Claire Ritchie has worked with rough sleepers for over 15 years. She works for Lambeth council and is responsible for administering the Homeless Prevention grant. She commissions, monitors and reviews a range of services for rough sleepers.
What's your idea? Rough sleepers have a range of complex needs. A significant number of them may have experienced trauma, when a negative past experience such as abuse or neglect impacts on their current behaviour. This can lead to heavy drinking or self-harming, for example. My idea is to develop a social enterprise that supports services to implement an approach which takes into account the psychological and emotional needs of rough sleepers. The technical term for this is creating a psychologically informed environment (PIE).
How does PIE work? It can be defined as an approach that takes into account the emotional needs of service users. If you understand, for example, why someone is behaving in the way that they are then you can start to have a different conversation with them, which often leads to different outcomes.
How far have you taken this work? The idea has arisen from the exciting work taking place in a project developed in partnership with Thames Reach and South London & Maudsley NHS Foundation Trust. We have used PIE techniques to try and change rough sleepers' behaviour. The Waterloo Project, a 19-bed hostel, was refurbished to create an environment that encourages openness between staff and residents, such as open work spaces and lots of natural light. It is about changing relationships and working styles so that existing services and techniques are more effective in getting rough sleepers back to a better life.
Does this require new staff? No, people can be supported to deliver this approach. It's not about having specialist staff. The therapists I work with could go to a hostel tomorrow and help train staff in PIE techniques, which I think would improve practice and outcomes.
What do you need to get this off the ground? I need to get investment from health commissioners and show the savings that can be made. There was one rough sleeper who over six months was in and out of A&E 200 times. After being in the Waterloo Project he now goes once or twice a month, which is still too much but it is a significant change. Every A&E presentation costs around £137 so you know that saves health service an awful lot of money."