Just the fact of having her made my anxiety less
In 2021, Justlife hired a Health Engagement Worker (HEW) to work specifically with people who have been placed out of area (OOA). The role was a pilot, established in agreement between Justlife and Brighton and Hove City Council (BHCC) to address the needs of people experiencing homelessness being placed by BHCC in neighbouring East Sussex.
The role has now come to an end, and we have published an evaluation of the impact it had for our clients. This blog summarises the findings.
Out of area placements are on the rise across the country. In March 2022, 28%, or 26,620 of the 95,060 people in TA, were placed outside of their home area. We hear worries about out of area placements, and what they mean for people in TA, from organisations across our network.
People experiencing homelessness, who are placed out of area, often have the same needs as those placed within their home area but lose much needed support when they move to a different local authority. The idea driving the OOA HEW role was that at least some of that support would continue. As well as the regular health engagement support, the role would also support people to move back to Brighton, if that was their wish.
For this evaluation, we spoke to eight individuals who had been placed 10 to 30 km away from Brighton, a relatively short distance that nonetheless had a big impact.
Three main concerns came across from the interviews:
Being far from the support of friends, family and trusted support services came up as the biggest concern. People felt lonely, isolated and struggled with mental health in an unfamiliar environment. The journey to see family was prohibitively expensive for some, while others found it difficult for health reasons. People also struggled to access much needed support services such as GPs, health appointments, and therapeutic activities.
It’s a 16-mile ride by bus for me to get to see my son. Until I got my bus pass it was costing me an absolute fortune.
My GP is Arch Healthcare and they’re in Brighton, and it’s tricky for me to come over to Brighton. My body hasn’t been able to heal and so every time I go out and do anything it’s quite challenging. Getting on a bus to come over to Brighton is a big deal.
Not having been given a choice on location was also raised as an issue. Our interviewees had been given very little notice and no choice about whether to stay in Brighton, although some said they were asked, but their views weren’t taken on board.
They [the Council] asked me questions like, do I wanna stay in Brighton, I said yeah, would you go to Newhaven, ‘no I’ve already done that’, and they said Eastbourne, I said no again, and then it came to my kick-out date, and they said ‘oh we’ve got a place for you in Eastbourne’
Another main concern was not knowing how long they were going to be there. The sense that the placement away from their hometown was transitory meant that many didn’t want to establish new networks or roots and so felt in a state of limbo.
The Council pretty much wiped their hands off me when I was in Eastbourne
I just feel so insecure. I just want somewhere where I’m settled
Three of our interviewees also talked about the positives of being placed OOA. They cited being closer to family in their new accommodation and getting away from disruptive environments in Brighton. It is important to note that these individuals had a host of other support needs.
I am very, very, very happy to have Izzy on my side, because half of the times, what I say to these people and get through to these people, they don’t listen. They don’t care. It’s people like Izzy that they listen to
Izzy helped the clients with a broad range of needs, from filling out forms for PIP or Universal Credit applications, accompanying them to health and other appointments back in Brighton, sorting out essentials such as bedding and shopping, picking up medicine, encouraging positive interests such as creative writing, and just keeping them company. In addition, eight of Izzy’s 19 clients were supported to move back to Brighton.
The geographical distance made accessing appointments in person extra challenging and having Izzy’s support often made the difference between attendance or disengagement. It was also clear that Izzy was instrumental in being a trusted familiar face. Having a trusted person to talk to was essential for those who found themselves without support in unfamiliar environments.
Being placed OOA created additional support needs for most of the interviewees, even for those placed a relatively short distance away. Most of the interviewees felt isolated and forgotten about and found it a daily struggle just to keep going, being in an unfamiliar environment without the support of established networks of family, friends and services. This affected their mental health negatively. Attending health appointments was hampered by the distance; for many they would not have happened without Izzy’s support.
It is however not always bad to be placed out of area. The individuals who told us they didn’t have a problem with the OOA placement, cited getting away from disruptive environments in Brighton and being closer to family in their new accommodation. This only highlights the importance of a sense of belonging in a community or a place, and when that gets disrupted, some continuity of support.
Having a trusted support worker follow vulnerable people who are placed out of area helped these individuals remain engaged with services, settle into their new accommodation, continue to attend health appointments, and ultimately move back if that was their wish. These people are all happier, healthier and less of a burden on the public purse.
The use of OOA placements has risen nationally by 344% since 2010. With the increased pressures on homelessness services, as the cost-of-living crisis is taking a hold, it is likely to continue to rise. We need support services that evolve with these changes. While the challenges each local authority faces looks different, we hope these lessons can inspire creative support solutions beyond Brighton.
