Special report: New start for the homeless that saves lives – and money
A one-to-one mentoring scheme is helping the most needy residents of one affluent city break out of a cycle of drugs, alcohol, family breakdown and sleeping rough
Emily Dugan is social affairs correspondent for The Independent, i and Independent on Sunday. She was previously a news reporter for The Independent on Sunday. Her investigations into human trafficking have twice been awarded Best Investigative Article at the Anti-Slavery Day Media Awards and her human rights journalism was shortlisted for the Gaby Rado Memorial prize at the 2012 Amnesty Media Awards.
Sunday 16 February 2014
Tommy Rice had been homeless in Cambridge for more than 20 years before he finally got real help. Addicted to alcohol and heroin, he was habitually kicked out of night shelters and forced to sleep in one of the city's car parks.
A year ago he met someone who changed everything. That man was Tom Tallon, who runs a project in Cambridgeshire that has found a new way of reaching homeless people with the most complex needs.
"I'm totally clean now," Mr Rice said, rolling up his sleeves to show arms with no fresh needle scarring. "Look!" He lives in a flat with a garden, "the first place I've had in my life", is receiving methadone treatment for his heroin addiction and is gradually coming off the booze.
The method that got him there is simple: assign a worker to the most hard-to-reach homeless people and help them to navigate through the health, justice, addiction, mental health and housing systems until their life is better. Called Making Every Adult Matter (Meam), it has been established by a coalition of charities to revolutionise the way Britain deals with the cases 60,000 of homelessness that are hardest to solve. The bespoke service sounds costly, but two years on in Cambridge it saved taxpayers an average of almost £1,000 a month per homeless person – money not spent on emergency treatment, housing and policing.
A report out this week analysing the pilot in Cambridge, along with two others in Somerset and Derby, shows the Meam model can bring down public spending on individuals by more than 20 per cent on average, as well as dramatically improving their quality of life.
Mr Tallon and another caseworker, Liam Stewart, act as a personal assistant and counsellor rolled into one for Tommy Rice. They make sure his appointments do not clash (and that he gets to them), as well as lobbying on his behalf for housing, rehab and other practical concerns.
"I thought I was going to spend the rest of my life on the street," Mr Rice said. "I haven't had help like this in 20 years. They can sort me out with my [methadone] script or my housing or setting up my bills. I'd be screwed without them."
Oliver Hilbery, national project director of Meam, said of the system: "Everything day to day pushes people back to service models that we know are ineffective. This allows you to push for a flexibility of response."
Nurse Anthea Parsons and Meam project leader Tom Tallon (right) with a client Mr Tallon, who runs the project in Cambridge, said: "There should be no reason for my role. In theory, all the services should work together in harmony but they have their own focus. Often with a complex client there are six or more services they're working with, such as police, mental health, the GP, addiction programmes and housing all pulling in different directions. Often you might have three appointments across the city at the same time and you have to decide between your liberty, health and survival. My role is to organise things so that doesn't happen."
Making appointments happen can also involve more prosaic action. Mr Tallon explained: "We drive people to appointments if we need to, and if we can't find them and it's something important, we traipse round the streets to find them, stick them in a car and take them there."
Over the past four years, Mr Tallon and two colleagues have worked with 45 people in Cambridge. Some are off their books after eight weeks; others take more than three years to get back on track, but almost all have seen their lives improve.
The savings in money spent on policing, emergency NHS care and highly staffed shelters have also been dramatic, according to an independent report on the Meam model out this week from Pro Bono Economics and FTI Consulting. After two years on the programme, the cost of each client to the public purse had gone down by 26.4 per cent in Cambridgeshire, a saving of £958 per client per month.
"By getting people engaged with treatment and improving their well-being, their offending goes down and their interaction with the criminal justice system drops through the floor," said Mr Tallon.
"Planned treatment rather than emergency treatment in hospital is also cheaper."
Tim Battrick, the author of the report, said: "There's no magic solution that saves money instantly, but if you follow through with this then you can save a lot. Even if this didn't save money, it's a worthwhile thing to stop people being homeless. The fact that it does save money is a bonus."
At Cambridge Access Surgery, a GP practice dedicated to homeless people, lead practice nurse Anthea Parsons said she has noticed a difference in the patients that Mr Tallon and his team work with. "Clients often hadn't had any medical treatment for quite a while and a lot were not good at attending appointments. Now they do. I can think of one person in particular who comes regularly to replace dressings, and we're beginning to heal their wounds."
Improving their access to healthcare prevents these patients from becoming another of the city's grim statistics. The average life expectancy of a homeless person in Cambridge is 44, compared with 80 in the city's population as a whole.
In a memorial garden behind Riverside homeless centre, a semicircle of wooden posts with 98 plaques on them bear the names of homeless people who have died in Cambridge since 2007. Another 56 still need to be added to bring it up to date. "Without help, that memorial just gets bigger and bigger," Mr Tallon said.
Emma Hyde, a Senior Support Worker at a Cambridge homeless night shelter and hostel Emma Hyde, 40, is a project worker with homeless people at Jimmy's Assessment Centre in the city. She said: "I was sleeping rough in Cambridge for six years. I used to have a really good job in Formula One journalism, and within six months I got breast cancer, my husband walked out and my father died. I was very ill and on my own and I hit the bottle."
Pregnancy helped her to give up alcohol, and for the past five years her life has been back on track. But she believes intervention of the kind offered by Mr Tallon would have saved her much faster. "Not everyone is a tick-box, and some people will never settle in a hostel system. People either spend years navigating through it or die. Having someone like [Mr Tallon] to act on your behalf makes all the difference."
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