‘Psychologically Informed Environments — A PIE is not the panacea of all ills…’

18.12.2020: For my final blog of 2020, as the Lead for Psychologically Informed Environments (PIE) at the national youth homeless charity Centrepoint, I have been reflecting on the whole of this past year. Obviously, COVID-19 has dominated this period, and once again as I write the blog this week, my children are back self-isolating from school as cases are increasing in London highlighting that until the vaccine is rolled out more widely, the risk of Coronavirus remains ever present. COVID-19 has changed our lives in so many ways this year, effecting our personal and professional lives and has meant that we have had to adapt and find levels of resilience that perhaps we did not even know we had in order to cope. Our delivery of a PIE by the end of this year has certainly been different to what we planned and expected at the start of the year! However, despite these challenges I feel encouraged that we have managed to achieve the things we have done.

For example, the embedding of reflective practice across much of the organisation (both regularly in our ‘frontline’ teams and ‘ad hoc’ in our support teams), the changes to the physical environment within our services that has either taken place, or are planned to take place, and the PIE training that we have managed to deliver (either face to face at the start of the year, or online most recently). There has also been an improved focus on staff well-being and the start of changes to policies and procedures to be more PIE informed, as well as the collaboration with and inspiration from our PIEineers (young people) to bring about these changes or with external students to complete research projects relevant to youth homelessness. This would not have been possible without so many staff in the organisation embracing PIE and working together with our small (but increasing in the New Year!) PIE team. At times, this has felt like a significant challenge but at other times, the rewards and benefits have made any challenge worth it.

However, whilst reflecting on what we have managed to achieve this year with PIE, I have also been reflecting on the fact that I do not have a ‘magic wand’ and that a PIE is sadly ‘not the panacea of all ills’. In other words, despite being a major proponent of a psychologically informed approach to working within the homelessness sector, even as a psychologist I have to accept that PIE is not the ‘cure’ for all of the challenges and issues that will face our charity in 2021. For example, as many of us hope to sit down with our families and friends (albeit within current COVID-19 restrictions) for a Christmas break, many of our staff will continue to work throughout the Christmas period providing valued and essential support to vulnerable homeless young people in our supported accommodation services or in our other ‘frontline’ services (e.g. Rough Sleepers Team, our national Helpline: 0808 800 0661). Our ‘support’ teams will also be working over this period to ensure that our ‘frontlines’ can continue to function, and our amazing volunteers and donors/supporters will provide much needed additional resources to make Christmas bearable for some of the most vulnerable young people in the UK (c.f. https://centrepoint.org.uk/volunteer).

We know as an organisation that this year, due to COVID-19, many vulnerable young people won’t have the same opportunity to sit down in a safe and secure home with family and friends, and that this year could be the worst homelessness crises in our charity’s 50 year history. Latest known figures for 2018/2019 note that 110,000 young people approached their local authority for help because they faced homelessness and Centrepoint estimates that as many as 23,000 young people’s lives could be at risk this Christmas (c.f. https://centrepoint.org.uk/). We have seen an increase of around 50% in calls to our Helpline this year from young people in crises with no-where else to turn, compared to call volumes prior to COVID-19, suggesting that the most recent figures on youth homelessness are likely to be a significant underestimation. Young people have been particularly vulnerable this year because many have been forced to leave their accommodation as those they are living with may have been shielding. They may also have not been able to continue to ‘sofa surf’ with friends due to COVID-19 restrictions or family environments that have been under more significant pressure during the pandemic may have broken down or become unsafe. Hence, youth homelessness is sadly on the rise in 2020 (c.f. https://twitter.com/centrepointuk/status/1318539826589728769).

Moreover, because of COVID-19, many of the opportunities or ‘paths out of homelessness’ available to our young people have diminished. We know that education, employment and training (EET) provides an opportunity for a future away from homelessness for many people, of whatever age, but COVID-19 has highlighted the impact of digital poverty when education has been moved ‘online’ and face-to-face learning ceased. Even if you have a laptop and working Wi-Fi, many of our homeless young people are living in accommodation services where this environment can make it more challenging for them to continue to complete college courses and access online learning. There are also increasing rates of unemployment in the UK, as many sectors struggle to remain financially viable (e.g. retail and hospitality), again with young people often on zero hours contracts the most effected (c.f. https://www.theguardian.com/society/2020/oct/07/covid-generation-uk-youth-unemployment-set-to-triple-to-80s-levels).

However, even without COVID-19, young people in the UK today face multiple forms of structural disadvantage. For example, they face a disproportionate risk of poverty and destitution, reductions in welfare benefit entitlements, and discrimination in the housing and labour markets (Homeless Link, 2018: https://www.homeless.org.uk/facts/our-research/young-and-homeless-research). All these factors put young people at particular risk of homelessness and insecure housing. Young people accessing homelessness services often experience other multiple disadvantages before even considering the actual impact of the homelessness. For example, relationship breakdown, educational and employment exclusion, contact with the criminal justice system, poor physical or mental health, and substance use issues. These experiences are often rooted in adverse childhood experiences (ACE’s) including trauma resulting from abuse and/or violence and neglect (Centrepoint, 2019; Homeless Link, 2018; 2019; https://www.homeless.org.uk/sites/default/files/site-attachments/Youth%20Homelessness%20scoping%20report%20July%202019%20pdf.pdf).

In addition, there have been real reductions in resources and funding available to address these complex issues in the past decade due to social policies and priorities over this period. For example, various professionals have highlighted that austerity policies introduced by the current UK Government since 2010, has increased homelessness (e.g. https://www.bmj.com/company/newsroom/austerity-policies-lie-at-heart-of-soaring-homelessness-and-related-health-harms-argue-experts/). Most concerning is the evidence that the impact of such austerity policies has had the greatest effect on young people (Centre for Analysis of Social Exclusion, 2015). For example in 2018, prior to COVID-19, 30% of people accessing homelessness services in England were aged 16–25 years, despite this age group only accounting for 12.3% of the total population (c.f. Homeless Link, 2018; https://www.homeless.org.uk/sites/default/files/site-attachments/Youth%20Homelessness%20scoping%20report%20July%202019%20pdf.pdf). There is also evidence that many of the welfare reform changes introduced over the past few years have impacted significantly on young people, such as young people being at a higher risk of benefit sanctions than older claimants (e.g. https://www.lse.ac.uk/International-Inequalities/Assets/Documents/Working-Papers/III-Working-Paper-15-Inequalities-in-the-application-of-welfare-sanctions-in-Britain-de-Vries-Reeves-and-Geiger.pdf).

There has also been a reduction in funding available as well as a shift in statutory funding priorities over recent years following austerity, which also contributes to the challenges that charities like Centrepoint are facing in the future. COVID-19 has also brought further significant challenges to revenue sources, with restrictions placed on mass gatherings and fundraising activities with both individual donors and corporate partners. Consequently, even despite the adaption of our amazing fundraising team this year to online events (e.g. https://www.eventbrite.co.uk/e/centrepoints-ultimate-christmas-pub-quiz-with-russell-kane-tickets-129851805245?aff=erelexpmlt), not only will we have an increased number of young people requiring help and support, we are likely to be facing a reduction in our income, which then affects our capacity to meet their housing, psychological or practical support needs. Therefore, our Christmas fundraising appeal has never felt so important or essential this year (c.f. you can find out more and donate here: https://centrepoint.org.uk/turningpoint).

Consequently, when I have been thinking about PIE this year, I have had to remain mindful that whatever system wide change a PIE approach may be bringing about within the organisation, we are also working within a wider external system that can effect and influence our PIE. For example, this may be the increasing demand for a psychologically informed understanding of the complexity of the homeless young people presenting to our services or the increased need to support our staff who are managing these challenges. This may also be how we ensure that the approach we are taking to dealing with practical issues (e.g. property improvements, policies and procedures) or research opportunities remains relevant to the current situation and COVID-19 compliant. Moreover, being psychologically informed also means considering how we use evidence to change this wider system we are operating within. Hence, our organisation has continued this year to highlight important policy issues and campaigns addressing youth homelessness. For example, our briefing on the issues of COVID-19 and youth homelessness (c.f. https://centrepoint.org.uk/media/4220/1-youth-homelessness-coronavirus-phase-2-briefing.pdf), which has noted the wider system changes to welfare and housing policies that are needed in order to reduce youth homelessness (e.g. https://twitter.com/centrepointuk/status/1331607496620974080 or https://www.thetelegraphandargus.co.uk/news/18867179.centrepoints-plea-government-youth-homelessness/). Without wider system change, PIE can only do so much to address the challenges noted above around youth homelessness.

However, whilst noting the above challenges facing the sector with regard to youth homelessness in the future are significant, what PIE has shown this year is that is can be an important part of making positive change. A PIE approach recognises these challenges, and acknowledges the emotional and psychological consequences of these both on those that use our services and those that deliver them. As a result, PIE can offer reflective spaces to consider the best way to address these challenges, helping us to be honest and mindful with each other, and to understand our limitations within the wider system. It can also help us to work better within our teams and share learning or improve communication. PIE also encourages us to engage in continuous learning and improvement, and to ensure that all our staff have the appropriate support and training to build on their existing skills, knowledge and experience to improve outcomes for young people.

A PIE approach can improve the physical spaces that young people and staff work within, in order to provide them both with psychological safety and security, and enable vulnerable young people to have a real chance to move beyond their past traumatic experiences and #changethestory. PIE also argues for the use of evidence-based approaches to drive change to wider social policy and ensure that we are utilising ‘what works’ within the homelessness sector. Finally, and arguably most importantly, PIE also highlights the importance of ‘relationships’ both those formed between staff and young people, as well as those formed between staff and our external partners or stakeholders. By working together, perhaps we can start to address the challenges highlighted above and work towards our overall strategic aim to #endyouthhomelessness.

Consequently, whilst a PIE may not be the ‘panacea of all ills’ or the ‘cure’ for all these challenges, it does provide us with hope that we have some key ingredients in order to face them. It is perhaps rather like a ‘cook book’ or set of guidance, which can be helpful to utilise moving forward. Of course, our success over the next phase of our journey will depend on how well we can combine these ingredients inside and outside of the organisation, and most importantly how much we can build relationships and work together. Whilst I am no longer the only ‘psychologist in the village’ within Centrepoint, our PIE Team cannot do everything alone. Therefore, I want to end this blog by thanking all those within the organisation (staff and young people) or outside of it, that have contributed, embraced, promoted and helped us to embed a PIE approach within Centrepoint over the past year. We still have some way to go, but on reflection I think even despite the challenges of COVID-19 this year, I am proud of how far we have come already and grateful to all those who have made this possible. Therefore, I look forward to whatever the New Year brings, as I know that I have support and encouragement to keeping ‘baking our PIE’ in Centrepoint in 2021…