“I am starting to feel like a human being again.”

Across the country, people experiencing multiple needs have benefited from services working better together. In this blog, Anne describes the support she’s received from the Cambridgeshire Chronically Excluded Adults service, which was developed using the MEAM Approach.

I have a law degree and had a career in business. I worked and lived in London and never imagined that I would become one of those homeless people you pass on the street. When I did, society stopped seeing me as a human being.

In London none of the services that I approached wanted to help me. When I was given a diagnosis of a mental illness all my credibility and professionalism was stripped away from me. I was treated as a problem by services rather than a person that was in need.

Hear Anne and Marie talk about working together in our video about the MEAM Approach

Hear Anne and Marie talk about working together in our video about the MEAM Approach

The severity of my mental illness stems from the refusal of services to help me including the police, social services and the local Mental Health Trust. I was misdiagnosed.

If I had been given the support I asked for when I first contacted services I would not have become homeless, would not have a criminal record, would not have spent time in hospital and would have been able to return to my chosen profession and be able to support myself. If I had been listened to and supported when I first asked for help, thousands of pounds could have been saved.

It wasn’t until I moved out of London to a quiet rural area where I was street homeless and hit rock bottom that anybody stepped in to help me. I became visible again.

Marie is a coordinator with the Chronically Excluded Adults Service, and has worked with Anne for several years. Here she describes how she approaches her work.

People experiencing multiple needs are often seen as problems and the help and support they receive is often defined by this. My role allows me to really get to know the person I am working with and from the outset support is tailored not only to their needs, but also their preferences.

There is no set ‘framework’ for working with clients and this approach ensures that they feel they have equal control over the support they receive. We work in the belief that we hold no authority over the client, and we discuss information about ourselves – such as hobbies and interests – in order to facilitate a strong working relationship.

We start with one goal that the client would like to achieve and work from there. We involve other professionals and regularly hold meetings to ensure that all agencies are working together to meet the clients’ identified goals. The client is always at the centre of any work or decisions made.

I was referred to the Chronically Excluded Adults Service. Before this, everyone I approached and asked for help failed me. They saw me as a problem, not as a person with problems who needed help to solve them. The CEA saw me as a human being and this is where I began my road to recovery. I had given up hope of ever being treated like an individual again.

At this point I was in prison. I was criminalised for not being completely compliant and I knew I had been misdiagnosed, but nobody would listen to me so they silenced me. I was visited in prison by Marie, the CEA co-ordinator and straight away she realised that I was in completely the wrong place – from meeting her, everything changed.

She returned my humanity, listened to the different problems I had and tackled them with me. She visited me in hospital two hours’ drive away, contacted services on my behalf and gave me my voice back because services saw her as another professional. The CEA service is well respected by other organisations, and this worked in my favour.

Marie worked with me at my pace to fulfill my basic needs. She accompanied me to appointments and meetings that I found difficult by myself. She supported me fully until I began to get my confidence back to start to try and recover my life. With the CEA service there’s no time limit, so I don’t feel pressured to be better instantly and I don’t feel like a solved problem.

I am starting to feel like a human being again.


If you think the MEAM Approach could help improve the response to multiple needs in your area, register your interest in working with us

A strong argument for putting Housing First

The Making Every Adult Matter coalition (Clinks, Homeless Link and Mind) has responded to Housing First: housing-led solutions to rough sleeping and homelessness, a new report from the Centre for Social Justice.

As a key contributor to this report, we welcome its publication and recommendations. A range of responses are needed to end homelessness and Housing First has a vital role to play. A successful Housing First model depends on having coordinated, cross-sector support in place for the range of multiple needs that people experience.

Housing First England

We welcome the report’s recommendation for a cross-government strategy on homelessness involving key departments such as the Department for Work and Pensions, Ministry of Justice and the Department of Health. At the report’s launch in Westminster today, Secretary of State for Communities and Local Government Sajid Javid MP said action was needed across government to tackle the social problems that accompany homelessness.

The report recognises the specific support needs of the 58,000 people with multiple and complex needs in England, and it’s positive that local areas using the MEAM Approach to design and deliver better coordinated support for people with multiple needs are featured.

The report rightly notes that helping people into employment is an important long-term goal for Housing First, but the priority should be to help people turn their lives around. The case studies in the report are succeeding because they are able to help people manage their needs. Giving someone a home to call their own, and the co-ordinated, flexible support that helps them to keep it allows them to engage positively with health, care and support services where they were previously unable to do so.

We look forward to working with our partners to promote the messages in this report, and Homeless Link’s Housing First England project will continue to support the adoption of high-quality Housing First approaches across the country.

New funding improves support for the most vulnerable people in local communities

The Making Every Adult Matter (MEAM) coalition – formed of the national charities Clinks, Homeless Link and Mind – has today welcomed £2.78 million in new funding from the Big Lottery Fund to significantly expand support for people with multiple needs across England over the next five years.

Big Lottery Fund - lottery funded

People with multiple needs face a combination of problems including homelessness, substance misuse, contact with the criminal justice system and mental ill health. Working together, the MEAM coalition charities support local areas across England to develop effective, coordinated approaches to multiple needs that can increase wellbeing, reduce costs to public services and improve people’s lives.

This is achieved using the MEAM Approach, a framework to help local areas better coordinate services for people facing multiple needs, and by providing support to local areas that are part of the Big Lottery Fund’s Fulfilling Lives: Supporting people with multiple needs programme.

The new grant will enable MEAM to:

  • Significantly expand the number of areas that it is supporting
  • Bring together data from MEAM Approach and Fulfilling Lives areas to make a strong case to government about the impact of local interventions for people with multiple needs
  • Share good practice across the MEAM Approach and Fulfilling Lives networks
  • Ensure that more individuals are empowered to tackle their problems, reach their full potential and contribute to their communities.

MEAM will work closely with people with lived experience of multiple needs to deliver this programme, and to ensure that they are involved in the plans developed by local areas.

Recruitment for new staff across the coalition charities has been launched alongside a ‘register your interest’ process for areas wishing to use the MEAM Approach and benefit from the support made possible by the new funding.

Oliver Hilbery, Director of the MEAM coalition, said:

“We are delighted to be working with the Big Lottery Fund and all the local partners on this new phase of our work. Together we want to build on the wealth of expertise that exists in current MEAM Approach and Fulfilling Lives areas and draw this learning together into a powerful case for national change. For too long, people with multiple needs have received a poor response from local services that are designed to deal with one problem at a time. We are committed to working with local areas and with government at all levels to change that for good.”

Baroness Claire Tyler, Chair of the MEAM coalition, said:

“We strongly welcome the support from the Big Lottery Fund for this expansion of our work.  We know that by using the MEAM Approach local areas can improve the lives of some of the most disadvantaged people in our society.  I’m very excited that more areas will now be able to develop joined-up services that respond to individuals’ needs and aspirations. This new funding will significantly extend the reach and impact of the MEAM coalition and allow us to ensure that learning from local areas is used to shape national policy responses.”

James Harcourt, Big Lottery Fund Deputy Director of Responsive Programmes, said:

“We are very pleased to have made this award to the Making Every Adult Matter (MEAM) coalition. Through their previous work with the Fulfilling Lives programme and their own network of MEAM Approach areas they have shown themselves to be committed to changing the way that people with multiple needs are supported in local areas. This new funding will allow us to bring together the two networks and reach even more people”


You can learn more about the MEAM Approach by watching our new video about local areas’ experiences.

Health Select Committee urges action on suicide prevention

When someone takes their own life, the consequences – for that person, their family and their loved ones – are deep and permanent. Suicide can be prevented, and we have a responsibility to do everything possible to ensure that people receive the support they need at times of distress or crisis.

In an interim report published this week, the House of Commons Health Committee sets out the evidence on suicide prevention, and makes a powerful argument about the inadequacy of our current systems of support:

“Approximately one third of people who end their lives by suicide have not been in contact with health services in the year before their death. However, this is not because they are in some way ‘unreachable’—on the contrary, we should regard all suicides as preventable. In Liverpool we met a bereaved mother who said simply ‘my son wasn’t hard to reach—it was the services that were hard to reach’. If such a high proportion of people in need of help are not accessing current services, then we must adapt the services we offer.”

There are many reasons that people commit suicide, and they are often difficult to identify and separate. Nonetheless, we know that people experiencing multiple needs face greatly increased risks. St Mungo’s interviewed forty people with experiences of rough sleeping, and found that one in four had considered or attempted suicide while homeless. Research by the University of Manchester also suggests that people using heroin have rates of suicide at least three times higher than the general population, with official data suggesting that women are particularly vulnerable.

It’s especially concerning that this year the Howard League for Penal Reform reported the highest number of people in prison taking their lives since records began in 1978. The rate of self-inflicted deaths in prison is over 12 times that of the general population. There is widespread concern at the levels of isolation, violence and lack of constructive activity in prisons, with not enough being done to address the mental health and substance misuse needs of people in custody.

The Committee makes a number of welcome recommendations for action, ahead of the expected publication of a revised Government suicide prevention strategy in the new year. In particular, they call for measures to identify those most at risk in the community, particularly in non-traditional settings where the voluntary sector can play an important role.

The report notes the elevated risk that people face when leaving mental health services, and the Committee recommend that all patients being discharged from inpatient services should receive follow-up within three days rather than seven. Alongside this, they highlight the need for liaison psychiatry – the provision of psychiatric support in hospital settings such as accident and emergency – to be adequately staffed and resourced.

We very much hope that the Government acts on these recommendations, and that the forthcoming strategy takes into account the wide range of factors – homelessness, substance misuse and contact with the criminal justice system – which can contribute to heightened risk of suicide. A strategy alone is not enough, though: it is the responsibility of all of us – as practitioners, policymakers and citizens – to ensure that people receive the specialised support they need, when and where they need it.

Dame Carol Black’s review is a welcome contribution to the debate on employment

In July 2015 the then Prime Minister David Cameron asked Dame Carol Black to undertake an independent review into the impact that drug and alcohol problems and obesity have on employment outcomes. In this blog we respond to the findings of the review, which have been published today

MEAM welcomes Dame Carol Black’s long-awaited review as an expert opinion on how we can improve the services and systems that should support people with drug and alcohol problems towards employment.

Many people with multiple needs have substance misuse problems and the report has implications for how they are supported to overcome barriers to work. We agree with her conclusion that treatment, the benefits system and employers all have vital roles to play.

Effective substance misuse treatment is vital to helping people move towards work, but as the report acknowledges, providing treatment alone is insufficient to achieve better employment outcomes. Instead, it needs to form part of a wider approach that addresses the full range of people’s needs, such as resolving housing challenges and improving skills.

As the report recognises, the journey to recovery “can take many paths [and] have some false starts”. It’s therefore welcome that the review has carefully considered the effect that problems with housing and contact with the criminal justice system can have on people’s ability to move towards and secure employment.

The report recognises that the benefits system must do more to recognise the needs of people facing drug and alcohol problems. We particularly welcome the recommendations to design an enhanced Jobcentre Plus drug and alcohol offer for benefit claimants, and trial the use of peer mentors with personal experience of recovery in Jobcentres.

As the report also notes, to be effective this must form part of a wider joined up approach to health and work across government. This echoes recommendations MEAM has made previously that Department for Work and Pensions and its partners should “provide appropriate, flexible and personalised support to help people with multiple needs move towards independence.”

Finally, there is a corresponding role for employers in supporting people with drug and alcohol problems, as well as providing employment opportunities. The report makes a number of constructive recommendations on encouraging good practice and addressing negative stigma.

The MEAM partners have carried out extensive work on how to support people experiencing multiple needs into employment, closely informed by the experience of practitioners and people with lived experience, and we were glad to assist the review team in drawing on these perspectives in its research. We also wholly support the response our partner Collective Voice has made on behalf of the substance misuse treatment sector.

We are grateful to Dame Carol Black and her team for their thoughtful contribution on this topic, and for engaging constructively with us throughout the process. We hope the DWP uses the findings of this important review to improve the support provided to people facing the most significant barriers to work.