Lambeth Council’s Routes to Independence Pathway project has been announced as one of the top three winners in this year’s London Homelessness Awards. Dr Caroline Bradley works for Centrepoint as a Clinical Psychologist. She is also the Principal Clinical Psychologist for the Lambeth Well-being Service that sits in the pathway. We asked her to tell us more about her role.
This is a very exciting project; we are an innovative new team and as far as I know no one else does this in exactly the same way as us. We look to create spaces that are psychologically and trauma informed, taking account of elements such as acoustics and encouraging the young people to help co-produce these, making decisions based on their views, for example with our therapy rooms.
We also prioritise reflective practice for all staff in the pathway, helping them to understanding their own biases, reactions and the impact of working with complex young people on their wellbeing. The key worker is central, so when direct work isn’t possible, we build a team around the staff member not the client; this is not just signposting but prioritising the relationship to allow the key worker to deliver every day the things the young person needs. For this to happen effectively, the key worker can need support, so we enable them to think psychologically about the relationship.
When Lambeth decided to review the pathway, we realised that we had to create a mental health service that was absolutely designed around the individual. The only thing our clients had in common was housing instability – the variety of people in the pathway was huge and statutory services were really struggling.
Our view is that when you’re in the pathway, you’re in the team. So, we work with people rather than just signpost to other services. All our staff are highly trained and work in very flexible ways with colleagues and young people.
As a result, referrals are very straightforward. We ask, “who is asking what for whom?” and then work with the staff member to make meaning out of the referral request, rather than simply taking on a client to get them off the list and setting the case up for failure. The system is designed to discourage tick boxing and instead to offer thoughtful and tailored intervention. There are far fewer barriers to seeing the mental health specialists in our team and we aim to work fast, as long waiting lists create problems for engagement. We are embedded in the teams.
One of my clients is a young person who has been through every system that exists; special schools, offender units, special units, supportive accommodation. She was living with ten girls all of whom had their own difficulties and strengths. We started by doing reflective practice with the staff – how do they cope, how do they de-escalate difficult situations, how do they act quickly, how do they negotiate incidents, etc. As a result, our young person felt more secure and valued that staff reacted more calmly and consistently when she was upset. It was not all straightforward and her engagement with my team fluctuated. After she got a flat she disappeared for a while, but our outreach approach meant that the team made contact with her and our flexible approach meant I could see her immediately as she had not discharged. Although she was 18, because we work with both adults and young people, we didn’t have to stop support or transfer her care to another team. She is now engaged in weekly therapy work, as well as working with our substance misuse worker. In our approach, the therapy room is not the frame, the individual worker holds the frame.
It is great that this approach and enhanced flexible working has been recognised in the London Homelessness Awards.
For more information about Lambeth’ pathway go to Lambeth rolls out bespoke programme to support young people’s housing needs – Love LambethLove Lambeth or Young people | Lambeth Council