1. Homeless Mental Health and Counselling Westminster

2. CNWL Mental Health Service Great Chapel Street Medical Centre Offering drop in mental health and substance misuse assessment, support and treatment to homeless people in Westminster. Assisted by Consultant Psychiatrist Dr Sara Ketteley all day Tuesday. In this way able to provide a primary and secondary mental health service for people. jconolly@nhs.net2

3. MH Provision Mental Health and Risk Assessments Diagnosis Treatment Care Plans Follow up reviews Onward referrals if necessary jconolly@nhs.net3

4. Times available Advisable to phone in advance: – However usual times are: Monday - Friday 10-1 and 2-5. – (NB Not available on Wednesday mornings). Referral to Dr Ketteley are via initial assessment with me and then by appointment on a Tuesday. jconolly@nhs.net4

5. CLCH Homeless Health Counselling Services Person has to be: – Homeless – Temporary/insecure accommodation – In Westminster Person doesn’t have to be: – Addictions free – MH issues free jconolly@nhs.net5

6. CLCH Homeless Health Counselling Services Self-Referral – ‘ Drop In’ Individual Counselling Great Chapel Street Medical Centre Monday – 10am to 12.00 Friday - 10am to 12.00 -‘ Drop In’ Anger Discussion & Support Group -Connections St Martins Monday – 13.00 to 14.00 jconolly@nhs.net6

7. One to One Appointment based Referral Only 1. The Passage Day Centre, Tuesdays, 9.00 – 12.00, 2. Dr Hickey Surgery – Tuesdays 9.00 -5pm, 3. The West London Day Centre Wednesday 9.00 – 12.00, 4. Great Chapel Street Surgery Wednesdays, 10 – 5pm, 5. King Georges’ Hostel - Wednesday pm 6. Montfort House - Pending jconolly@nhs.net7

8. Referral Only Groups Life Narrative Writing Workshop – pending – To help people put their life journeys into perspective and to integrate their: past present future. Schema Therapy Group -Pending -To help people recognise how their fundamental needs were unmet - leaving them to develop ‘maladaptive’ Schemas (MAS) and to meet their needs DESTRUCTIVELY going from CRISIS to CRISIS -To identify their MAS -To Heal their MAS jconolly@nhs.net8

9. Self-Referral based Groups 1.Women Only Discussion & Support Group Pending 2.Second Anger Discussion & Support Group Pending 3.Leavers Group Pending jconolly@nhs.net9

10. A Pre- Counselling Approach This is based on recognition that some people are not ready to change and engage with change processes at a particular moment(Prochaska et al 2006). There are different stages of readiness to change requiring different approaches One very useful approach is the ‘Pre-treatment’ ( Levy, 2013) Co-construction fundamental to Pre-Counselling jconolly@nhs.net10

11. Co-constructed Psychological Change 1.Counsellor able to: 1.Engender trust and hope 2Reduce Individuals ‘stress response’ 3Enter the persons’ world in a ‘non-judgemental’ manner 4. Understand that world in all its complexity ( understand boundary transgressions, negotiate boundaries appropriately) 5. Construct a common language, ( including ability to emphatically challenge 6. Develop common, realistic goals (short, medium, long term) 7. Develop common realistic change process & supports 8. Make use of professional Supports/resources jconolly@nhs.net11

12. Co-constructed Psychological Change ctd. Homeless Person able to: 1.Develop & tolerate trust 2.Reduce their ‘stress response’ 3.Allow someone into their world 4.Take the risk of HOPING, for something better, and not being let down (again) 5.Develop a perspective on their life journey 6.Recognise early unmet needs and their (now) destructive responses to these 7.Believe that with appropriate support they can REPLACE these. 8.Engage with change process jconolly@nhs.net12

13. References Levy, J.S. ‘ Pretreatment Guide’, 2013, Loving Healing Press Inc. Prochaska, Norcross and Diclemente, 2006, ‘ Changing for Good’, HarperCollins, New York. jconolly@nhs.net13