Homeless People Mental Health Unit (E.S.M).

Berlin, October 2005María Isabel VázquezFrancisco Recalde

Homeless People Mental Health Unit (E.S.M))

The Equipo de Atención Psiquiátrica a The Equipo de Atención Psiquiátrica a Enfermos Mentales Sin Hogar-Homeless Enfermos Mentales Sin Hogar-Homeless People Mental Health Unit (E.S.M):People Mental Health Unit (E.S.M):

– Was created in May 2003 Was created in May 2003

– Provided by:Provided by:

Madrid Mental Health Services (SERMAS).Madrid Mental Health Services (SERMAS). The general division of Social Services of Madrid The general division of Social Services of Madrid

Community Social Services Advisory Community Social Services Advisory CommissionCommission

Homeless People Mental Health Unit (E.S.M).

The team consists of:The team consists of:

– A psychiatristA psychiatrist– Two nursesTwo nurses– Four youth and Four youth and

community workercommunity worker– A psychologist (part A psychologist (part

time/2 days per time/2 days per week)week)

– A social workerA social worker

2006

sep-03

jun-05

SERMAS PRI SEMI New Team

Homeless People Mental Health Unit (E.S.M).Objectives.

– To improve mental To improve mental health services for health services for homeless peoplehomeless people

– To facilitate integration To facilitate integration of mentally ill patients of mentally ill patients into mainstream into mainstream services.services.

– ACT+REHABmACT+REHABmRehabilitation

Outreach

Training

Dg,treatFollow-up

Coordination

.....

Target PopulationTarget Population

Mentally ill homeless (+dual)Mentally ill homeless (+dual)– Severe, enduringSevere, enduring– OldOld– Phisical RiskPhisical Risk– Street PeopleStreet People

18 years old18 years old Living in Madrid cityLiving in Madrid city Not being attended in mainstream Not being attended in mainstream

mental health servicesmental health services

Enduring Severe Mental illnessEnduring Severe Mental illness– Negative SyndromeNegative Syndrome– Handicap/DisabbilitiesHandicap/Disabbilities

HomelessHomeless– LifestyleLifestyle– SocialSocial

DrugsDrugs StigmaStigma BarriersBarriers

– PersonalPersonal– ProfessionalProfessional

CoordinationRehabilitation/supportPolitical/educationalTrainnig

Coordination Pannel

Individualised treatment programs

Mentally ill Homeless

People

Street TeamsC.Acogida/

Asociaciones

Mainstream Mental Health Services

Mentally ill Homeless

People

EMERGENCYROOMS

Psychiatric Ward Units

E.S.M

DNI, Housing... Diag, treatment ...

S.Services ESM

COORDINATION PANNEL

Mainstream SocialServices Socio sanitary

resources

COORDINATED WORK

DETECTION OF MENTALLY ILL HOMELESS PEOPLE

BY U.M.E.S.Social Report for the E.S.M

FIRST COORDINATED INTERVIEW

Inicial visit of social worker and psychiatrist

to the client.OBJECTIVES

•Engagement and Preliminary Diagnosis.

ESM:Engagement

Follow up workDiagnosis

Medical treatment administration

COMMON GROUND:INDIVIDUALISED

TREATMENT PROGRAM:Individualised work

Follow up work and evaluationFamily contact ....

UMES:To facilitate and take

clients to different resources

To obtain documents, social benefits

SOCIAL- HEALTHINTEGRATION.

Integration of mentally ill Homeless people into

mainstream mental health and

social services

CP CPCP

C.P: Coordination Pannel

Social- Sanitary Social- Sanitary IntegrationIntegration Rehabilitation/SupportRehabilitation/Support

– Structured long term individualized planStructured long term individualized plan– Critical Time/CrisisCritical Time/Crisis

Out streetsOut streets Mainstream Mental Health/SocialMainstream Mental Health/Social

SubteamsSubteams Coordination PannelCoordination Pannel

– Social ServicesSocial Services– MENTAL HEALTH ServicesMENTAL HEALTH Services

CoordinatorPsychiatrist

Outreach Rehab

PsychiatristSocial Worker

Nurses2 Y.& C. W.

PsychiatristSocial Worker

Psychologist2 Y.& C.W

Street WorkMedicationFollow-up

Care

Low DemandSafe Havens,Shelter

Housing

TransitionI.R.P.

Coordination

Street workIndividualised/”Taylored”plans

Social Services•Street Teams

•Shelters•NGO´s

Rehabilitation Model/ACT

Mental Health C.PMental Health C.P

Monthly meetingMonthly meeting– July 2005July 2005

Mental Health ServicesMental Health Services Continued Care plansContinued Care plans

– WhoWho– WhenWhen– HowHow– NeedNeed– Follow upFollow up

Rehabilitation SubteamRehabilitation Subteam

Low Demand– Centro Abieto– Puerta Abierta

Transition FIR. CASI Sociosanitary Resources Mental Health Services Other Housing

TREATMENT ComplianceAwarenessRelapse

DAILY LIFESkills Training

DRUGS

Outreach

Rehabilitation

SUPPORTCounselling

Does it work?Does it work?

????????? ????????? – Short time experience

BarriersBarriers Develop a range of housing, Develop a range of housing,

stable, long term, and adapted to stable, long term, and adapted to different patterns of patientsdifferent patterns of patients

DrugsDrugs