Melissa Noel Project Manager, Camden Kaleidoscope Project, Depaul UK Melissa Noel Project Manager, Camden Kaleidoscope Project, Depaul UK. Steve McKinlay, Regional Manager, Depaul UK.

Implementing the PIE approach at Depaul UK Camden Kaleidoscope PIE in Practice Implementing the PIE approach at Depaul UK Camden Kaleidoscope

Depaul UK Camden Kaleidoscope High Support Accommodation for young people with mental health and complex needs 7 bed accommodation Issues ranging from psychosis, self harm to personality disorder

Five principles of PIE- “Psychologically Informed Services for Homeless People” Feb 2012 Physical Environment and social spaces Managing Relationships Psychological Framework Staff Training and Support Evaluation

Putting these Principles into Practice The lens through which all staff work and plan the physical environment Physical Environment Staff Attitudes/Approach Staff Tools Reflective Practice Outcomes and Evaluation

Physical Environment Use of colours-calming colours-greens/blues Homely environment with art and plants Residents involved in decoration/set up of the garden No directive signs in communal spaces-staff to speak directly to residents if there are issues or concerns

Staff Approach and Attitudes CBT perspective- interactions between core beliefs, thoughts/feelings and behavior/emotions No labels, only descriptions/explanations of behavior Focus on past relationships and attachments

Staff Tools Chain Analysis-most commonly used ABC chart with staff and residents 0-100 scale Case Studies- TB-self harm KM

Reflective Practice Reflective time in team meetings-weekly Reflective Learning log after incidents 3X monthly reflective practice sessions-project workers, managers, and project manager-CAMHS provided Very effective to monitor/discuss staff reactions/feelings towards working with residents

Evaluation Staff evaluations pre/post training, 6mo, 1yr-showing positive change in attitudes towards facilitating change Reflective practice 6 month evaluations- worthwhile space-logistical suggestions/whole group Client Surveys Outcomes so far- Decrease in individuals incidents/client alerts-emergency services Increased engagement with external services/medication Resident retention-KM particularly Goal based progress/outcome star

Challenges Staff buy in Slow progress Connecting outcomes directly to PIE- recording use of tools in keywork/client alerts on database

Case Study KM Born into an unstable chaotic environment - father left before birth, mother had children removed and placed in care. Mother had personality disorder and was seen as incapable and this builds on the sense of a lack of being able to take responsibility which is behavior KM exhibits. Before moving to CK, KM had been in care since age 10 and recently had been evicted from all medium support accommodations in the YPP. Since she moved in her behaviour: Self-harming Throwing items Damaging room Verbally aggressive towards staff Self destructive mood/thoughts Outburst anger: banging, screaming, breaking things, punching herself, talking to herself

Strategies and Outcomes Staff applied chain analysis and cbt to help KM identify what triggers her behaviour, what she could have done differently and therefore starting to change her behaviour. Positive reinforcement and achievement chart-highlighting and reflecting on positive behaviour Validating emotions but discussing choices in support/behavior Outcomes Maintaining accommodation Engaging with medication and mental health services and diagnosis of BPD