The Rough Sleeping and Mental Health Programme (RAMHP) is a two-year pilot programme which aims to support increased access to mental health services for people sleeping rough in 16 London boroughs, by building teams of mental health practitioners that work directly with outreach services.
Imperial College Health Partners has supported the RAMHP at each stage – from working with the Mayor of London and City Hall to help shape the programme, to supporting Mental Health Trusts to co-develop bids for funding with local stakeholders, and taking on the role of Programme Coordinator.
In 2019, there were 8,885 people sleeping rough in London (CHAIN). About half of those people have mental health needs, but many do not have access to the specialist support and treatment they need. These needs can often be complicated by a dual diagnosis with drug or alcohol use, and a collaborative and integrated approach is essential to providing effective support.
By connecting the mental health and homelessness sectors, we are helping to build specialist RAMHP teams that can support people, help them navigate the health system, and allow outreach teams to engage with people to help get them off the street. We are also building avenues for cross-sector learning and establishing relationships across London that will support an integrated approach to care.
The RAMHP is funded by the Mayor of London and the Ministry for Housing, Communities and Local Government (MHCLG), who will give £2.35m over the next two years to the programme. This includes funding for four Mental Health Trusts to build specialist teams – West London Trust, Central and West London (CNWL), North East London Foundation Trust (NELFT) and East London Foundation Trust (ELFT).
Building cross-sector services requires systems to change and transform, so partnership working is at the heart of the programme. Representatives from 16 councils within the four Trusts’ regions have been crucial to designing the shape and roles of the specialist teams, as have the outreach teams from charities that include St Mungo’s, Thames Reach and Single Homeless Project.
It is also essential that the programme is guided by people with lived experience of sleeping rough and having mental health needs. The RAMHP’s Codesign Advisory Group of experts by experience will influence at a service and programme level throughout the pilot. The group is working with ICHP and Making Every Adult Matter (MEAM), a coalition of charities, to ensure that codesign and participation by experts is meaningful and valuable for all those involved.
To promote a culture of learning and improving, a Community of Practice will be developed by and for the new RAMHP team members, giving them a space to share their experiences from the four different regions and encouraging best practice.
ICHP’s involvement began at the start of 2019, advising City Hall. We used our relationships within the system to bring experts from the homelessness and mental health sectors into the initial conversations, while our expertise in data analysis supported City Hall in assessing which areas in London had the greatest need.
We were appointed Programme Coordinator later that year, and have since helped the four regions mobilise their teams during the recruitment phase and progress towards business as usual as teams start in their posts.
We have developed Regional Steering Groups in all four areas, facilitated pathway mapping sessions to collaboratively understand the existing landscape and develop the new service pathways, and continue to coordinate the cross-sector and cross-regional development that will enable the system to transition to a sustainable model of funding at the end of the pilot.
Since March 2020 there have been RAMHP team members in post in all of the regions, working on the ground with outreach teams and providing support to people sleeping rough.