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Adults facing chronic exclusion programme: evaluation findings: summary
- Authors:
- CATTELL Jack, et al
- Publisher:
- Great Britain. Department for Communities and Local Government
- Publication year:
- 2011
- Pagination:
- 8p.
- Place of publication:
- London
The Adults facing Chronic Exclusion programme (ACE) tests new ways of working with excluded people who do not access services in the community because their lives are chaotic and their needs are too complex. The programme comprised 12 pilots across England which began in 2007. The pilots differed in terms of the characteristics of their clients, the intervention, the cost of the service, and their outcomes. They were tasked with helping clients access local services and benefits, supporting them with transition points in their lives, and changing the way in which local agencies responded to their needs. In all cases the interventions offered support from a consistent, trusted adult who could advocate between local services and service users. This report summary outlines the findings of a 3-year evaluation of the ACE pilots. The evaluation looked at different outcomes measures including: accommodation status; employment status; use of health services; receipt of benefits; and offending and victimisation. The report summary concludes that the pilots were effective in achieving positive housing, health and well-being outcomes with the clients. The pilots reduced the cost of healthcare, but the positive outcome of securing accommodation and benefits for homeless people resulted in an overall net cost. The pilots demonstrate that long term, positive, outcomes can be secured for this client group, and that these interventions are likely to be cost effective.
Simple but effective: local solutions for adults facing multiple deprivation: adults facing chronic exclusion evaluation: final report
- Authors:
- CATTELL Jack, et al
- Publisher:
- Great Britain. Department for Communities and Local Government
- Publication year:
- 2011
- Pagination:
- 45p.
- Place of publication:
- London
The Adults facing Chronic Exclusion programme (ACE) tests new ways of working with excluded people who do not access services in the community because their lives are chaotic and their needs are too complex. The programme comprised 12 pilots across England which began in 2007. The pilots differed in terms of the characteristics of their clients, the intervention, the cost of the service, and their outcomes. They were tasked with helping clients access local services and benefits, supporting them with transition points in their lives, and changing the way in which local agencies responded to their needs. In all cases the interventions offered support from a consistent, trusted adult who could advocate between local services and service users. This report presents the findings of a 3-year evaluation of the ACE pilots. The evaluation looked at the following outcome measures: accommodation status; employment status; use of health services; receipt of benefits; offending and victimisation; and subjective health and well-being. The report concludes that the work of the pilots was effective and inexpensive. They were effective in bringing about better outcomes for the individuals, particularly in terms of health, and persuading local services to engage with the client group. Some of the pilots were highly replicable and half have received continuation funding locally. The lessons for public sector reform, particularly how to make services more flexible and collaborative, are discussed.
Age at onset and clinical features of late life compulsive hoarding
- Authors:
- AYERS Catherine R., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 25(2), February 2010, pp.142-149.
- Publisher:
- Wiley
Compulsive hoarding is a debilitating disorder, yet little is known about its onset or clinical features. Hoarding symptoms often come to clinical attention with older patients. However, no prior study has examined whether elderly compulsive hoarders have early or late onset of hoarding symptoms, whether their hoarding symptoms are idiopathic or secondary to other conditions, or whether their symptoms are similar to compulsive hoarding symptoms seen in younger and middle-aged populations. This study determines the onset and clinical features of late life compulsive hoarding, including psychiatric and medical relationships. A group of 18 participants over 60 with clinically significant compulsive hoarding were assessed using structured interviews, including the Mini International Neuropsychiatric Interview, Structured Clinical Interview for DSM-IV, Yale-Brown Obsessive Compulsive Scale, and UCLA Hoarding Severity Scale. Self-report Measures Included the Beck Anxiety Inventory, Beck Depression Inventory, Sheehan Disability Scale, and Savings Inventory-Revised. Psychosocial and medical histories were also obtained. Participants were asked to rate their hoarding symptoms and describe major life events that occurred during each decade of their lives. Results show that onset of compulsive hoarding symptoms was initially reported as being in mid-life but actually found to be in childhood or adolescence - no subjects reported late onset compulsive hoarding. Compulsive hoarding severity seemed to increase with each decade of life. Comorbid mood and anxiety disorders were common, but only 16% of patients met criteria for OCD. The vast majority of patients had never received treatment for hoarding behaviour. Older adults with compulsive hoarding were usually socially impaired and lived alone. In conclusion compulsive hoarding appears to be a progressive and chronic condition that begins early in life. Left untreated, its severity increases with age. Compulsive hoarding should be considered a distinct clinical syndrome, separate from OCD.
Mental health, day services and community participation
- Author:
- GREAT BRITAIN. Office of the Deputy Prime Minister. Social Exclusion Unit
- Publisher:
- Great Britain. Office of the Deputy Prime Minister. Social Exclusion Unit
- Publication year:
- 2004
- Pagination:
- 8p.
- Place of publication:
- London
In discussions with the Social Exclusion Unit, people with mental health problems highlighted the important role of day services but often said that they should have a greater focus on providing access to mainstream services in the community rather than being ‘building based’. In 2002-03, health and social care spent £140 million on day and employment services for adults with severe mental health problems in England, but the money is not always invested in the types of services that best promote social inclusion. Direct payments allow people to purchase their own care, based on an agreed needs-led assessment. However, take-up by people with mental health problems has been low. Nine out of ten people with mental health problems engaged in volunteering said it gave them a sense of purpose and achievement, and more than eight out of ten said it had a positive effect on their mental health. Arts, leisure and sports activities can also have a positive impact on mental health.
Out of the picture: CAB evidence on mental health and social exclusion
- Authors:
- CULLEN Lesley, et al
- Publisher:
- Citizens Advice Bureau
- Publication year:
- 2004
- Pagination:
- 100p.
- Place of publication:
- London
Based on evidence from over 350 Citizens Advice Bureaux and some of the 100 specialist CAB mental health projects around the country, this publication catalogues the social exclusion and lack of support that blights the daily lives of the seven million people in the UK with mental health problemt. Only 18% are in work - the lowest employment rate of all disabled groups. Most have to rely on benefit income, making them some of the poorest people in the UK. But they are up against a benefits system that takes no account of their needs or the difficulties they face in managing their everyday affairs when they are unwell. Unsympathetic treatment by some Medical Service doctors and a system that focuses on physical symptoms and disabilities means that many mentally ill people fail to get the benefits to which they are entitled. Constant reassessment of claims can result in significant breaks in income and almost inevitable debt, exacerbating mental health problems. Many who believed they were protected from loss of income by insurance cover find themselves left high and dry by insurance companies who refuse to pay out on claims involving mental illness, and those who want to take out policies are sometimes excluded. People with mental health problems are also particularly vulnerable to high- pressure sales methods and offers of easy credit that can very quickly lead to unmanageable debt. Too often creditors respond with heavy-handed debt collection tactics instead of offering fair and sympathetic treatment.Those experiencing mental illness are likely to be trapped in poverty for longer periods than most, and persistent low incomes make it more difficult to take part in activities that might help reduce their isolation, further compounding their mental health problems. Lack of support with basic tasks such as claiming benefits and paying bills can lead to a downward spiral into poverty and social exclusion, on top of having to deal with the stigma of mental illness.
Timely intervention
- Author:
- McCURRY Patrick
- Journal article citation:
- Care and Health Magazine, 28, 29.1.03, 2003, pp.26-27..
- Publisher:
- Care and Health
Looks at the idea of Time Banks, which are now being used by GPs and social care professionals to promote self-esteem and better health and well-being of marganised individuals. The idea began in the US, with participants depositing their time the bank by giving practical and support to others.
Neighbourhoods with resilience to care: a viewpoint on developing the contributions of housing services for adults at risk of exclusion
- Authors:
- APPLETON Nigel, MOLYNEUX Peter
- Publisher:
- DH Care Networks. Housing Learning and Improvement Network
- Publication year:
- 2010
- Pagination:
- 22p.
- Place of publication:
- London
To improve the lives of adults who are at risk of exclusion, it is imperative to implement appropriate housing and related services. Inappropriate housing can reduce the ability of people with poor health or a disability to lead independent lives and participate in the community. As such, the providers of housing and housing related support have had a key role to play in the achievement of Public Service Agreement (PSA) 16 targets. This paper seeks to show those seeking to make a difference for people in these groups, be they commissioners, providers, tenants or service users, how they can use different structures to deliver health and well-being outcomes. The paper describes how the successful delivery of PSA 16 is going to require strategic planning across regional, sub-regional and local planning structures and the joint commissioning and procurement of services. This means that the successful delivery of PSA 16 is going to depend on a number of strategies coming together: the Joint Strategic Needs Assessment; Strategic Housing Market Assessment which is the local authority’s assessment of how the local housing market is functioning and an estimate of the housing and housing related support needs of vulnerable groups in the local area; and the Local Strategic Partnership, Local Area Agreement and the link to that from the Supporting People Commissioning Body.
Independent living for the most excluded: case studies of local authorities and third sector organisations working together to help vulnerable groups into homes and jobs
- Authors:
- GREAT BRITAIN. Cabinet Office. Office of the Third Sector, GREAT BRITAIN. Cabinet Office. Social Exclusion Taskforce
- Publisher:
- Great Britain. Cabinet Office
- Publication year:
- 2010
- Pagination:
- 20p.
- Place of publication:
- London
The socially excluded adults public service agreement (PSA 16) aims to ensure that the most socially excluded adults are offered the chance to get back on a path to a more successful life, by increasing the proportion of at-risk individuals in settled accommodation and in employment, education or training. PSA 16 focuses on 4 client groups who are particularly vulnerable to multiple forms of disadvantage: care leavers; offenders under probation supervision; adults in contact with secondary mental health services; and adults with moderate to severe learning disabilities. In 2009 the Office of the Third Sector and the Social Exclusion Task Force investigated 4 places where local authorities have used Supporting People funding to help individuals from PSA 16 groups into jobs and homes, to inform understanding of the third sector organisations which provide these services. This publication describes these 4 case studies, sketching the organisational structures in each place and the ways they help PSA 16 groups and giving contact details for each. The case studies are: Norwood in partnership with Redbridge Local Authority working with adults with learning disabilities; Foundation Housing with Leeds City Council working with ex-offenders; Tyneside Cyrenians and Newcastle City Council working with ex-offenders and people with mental health problems; and St Basils and Birmingham City Council working with young people who have been in care.
Lead professional roles to improve outcomes of socially excluded adults (PSA 16): final report
- Authors:
- JONES Naomi, SHELDON Ruth, PENFOLD Clarissa
- Publisher:
- Great Britain. Cabinet Office. Social Exclusion Task Force
- Publication year:
- 2009
- Pagination:
- 103p., bibliog.
- Place of publication:
- London
This is a summary of a study aimed at understanding what factors contribute to good lead professional practice in delivering PSA16 outcomes. The Socially Excluded Adults Public Service Agreement (PSA) 16 is part of the 2007 Comprehensive Spending Review and aims to increase the proportion of socially excluded adults in settled accommodation and in employment, education or training. The lead professional is a key element in the delivery of these outcomes and takes responsibility for ensuring that a client’s needs are identified and met as fully as possible. There are currently named lead professional roles for three of the client groups who are the focus of PSA16: personal advisers working with young people leaving care; offender managers working with offenders under probation supervision; care co-ordinators working with mental health service users. There is currently no named lead professional role for people with learning disabilities. Findings highlighted the importance of: enabling more face-to-face contact, both between professionals and service users and between professionals themselves; creating trusting relationships and shared objectives between service providers and professionals, through addressing practical and cultural barriers; ensuring that targets and assessment processes are meaningful and relevant to front-line staff and service users; developing commissioning processes which are evidence based, systematic, open to small innovative providers and strategic rather than reactive and responsive to local need; ensuring that all aspects of service commissioning, management and evaluation have more involvement from frontline staff and service users.
The socially excluded adults public service agreement
- Author:
- EISENSTADT Naomi
- Journal article citation:
- Housing Care and Support, 12(1), April 2009, pp.6-8.
- Publisher:
- Emerald
The Social Exclusion Task Force, based in the Cabinet Office, works across government to ensure that the opportunities enjoyed by the vast majority of people in the UK today are extended to those whose lives have been characterised by deprivation and exclusion. The Task Force recognises that much has already been achieved through investment in public services, tax and benefit changes, and the national minimum wage. However, intensive collaborative support is needed for the most vulnerable individuals and families, whose difficulties are complex and persistent. The development of the first public service agreement (PSA) for very vulnerable adults is a major step forward in addressing the needs of some of the most disadvantaged citizens.