Written by Josie Ashdown on 15th November 2023
At Bench Outreach, as with many homelessness services, the majority of the people we support struggle with their mental health. For some, this is due to the impact of poor living standards or homelessness; for others, mental illness has been with them for their whole lives. Often, mental illness is a direct result of childhood trauma.
While our main job is to make sure people are housed securely, support work is varied and helping clients through a mental health crisis is something we do all the time.
However, we are not mental health professionals. Much like how if a client was being attacked we would call the police, or if they were having a medical emergency we would call an ambulance, we have to turn to professional mental health practitioners to help in a mental health crisis.
Here is just one story of a client’s attempts to get support in a mental health crisis.
Client Story
Trigger warnings: mental illness, self harm, suicide. Client’s name has been changed.
Please note we are aware of the safeguarding implications of this case and have supported the client accordingly.
Sophie was under a lot of stress and trauma due to a long history of abuse. She was in an abusive relationship and it was impacting her mental health significantly. She was already diagnosed with a number of mental illnesses.
Sophie was self-harming and suicidal. She went to A&E several times late at night because she was scared of what she might do. She was taken to hospital on many occasions after suicide attempts. At that time, police were still accepting mental health welfare calls – on many occasions, her support worker had to call the police to check on her, and they took her to A&E.
On many of these trips to A&E, she was patched up and sent home, sometimes with a web address printed out on a piece of paper for a self referral. When she actually was admitted, she would be waiting in a bed in A&E for a space in a mental health unit for days or weeks- in a department that was already stretched, taking up a bed without any specialist support. This worsened her mental health significantly.
When she was finally admitted to a mental health ward, she witnessed first hand the impact of under-staffed, underfunded mental health services. Sadly, with the unit unable to provide the standard of treatment professionals know patients need, a level of neglect was common and the extremely vulnerable patients were often not properly supervised.
Sophie was in a mental health ward when she cracked her own skull, hitting her head against a wall in frustration and desperation. This behaviour was known to be a risk for her, and she was not stopped from being able to do this. She was then told she didn’t need to go to hospital for several days, until her face started bruising and swelling – it was only then that she went to A&E and it was discovered she had fractured her skull. She self-discharged from the ward soon after as she felt she was better off at home with no support.
What does this mean?
There has been a well-documented increase in mental health issues and mental illness in the UK over the last few years. This is, we suspect, largely due to socio-economic factors; poverty has become a UN-recognised crisis and the constant strain of providing for oneself and one’s family with services on their last legs means people are struggling. They are not getting the early intervention support that would prevent a crisis. The safety net has been worn to threads.
This is one case, but I had naively assumed that a person who was that severely mentally ill would be able to access high quality, timely care. If vulnerable adults with multiple and complex needs, who are actively self harming and suicidal AND have a support worker to advocate for them, are not getting appropriate mental health care, the sector is truly in crisis.
It also means that other professionals – GPs, social workers, charity workers, housing officers – are inadvertently becoming counsellors and managing clients and patients who desperately need specialist care which simply isn’t accessible. Throughout Sophie’s experience, a support worker (not a mental health professional) was taking calls almost daily from her disclosing suicidal intent and traumatic self-harm.
Who this affects
This affects everyone. It particularly affects those who can’t afford private therapy or treatment, which is the majority of the population. The ripple effects on communities are not going unnoticed – families are struggling to cope with children who are mentally ill, who can’t go to school and are missing out on an education; trauma survivors are living with PTSD symptoms which may never be treated; A&E departments are not able to cope with the number of people who come back every few days in a mental health crisis.
It disproportionately affects the most vulnerable who are unable to navigate these systems without support – that includes our clients at Bench Outreach and Housing First. Important essentials in mental health wards start to slip. Just one example is this recent report of patients being denied access to period products in a mental health unit. When mental health services are chronically underfunded and stretched, even basic needs are not being met.
Staff can become disillusioned and burnt out. Anyone in a caring profession will have had moments of compassion fatigue – when you don’t have the capacity to empathise with the people you are helping – and those seeing emergency mental health cases day in day out without the resources to provide the care that’s needed will be affected by this too. Many will leave the profession.
What can I do?
Find out about your local area. Looking out for each other within local communities is really valuable. Are there any services you can benefit from locally? Could you volunteer, offer any skills or donate anything to help people who are struggling?
Get informed on what politicians are promising and whether it’s going to scratch the surface of this crisis. We have a general election coming up, so it’s a great time to put pressure on your local MP to support mental healthcare reform and proper funding.
Make sure you are registered to vote and don’t forget you will need photo ID.
Bench Outreach 
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