‘Sleep out, string and a strong coffee — Psychologically Informed Fundraising’…

25.11.2022: Writing this week’s PIE blog, as the lead for Psychologically Informed Environments (PIE), at the national youth homeless charity; Centrepoint, I am reflecting on a very busy couple of weeks, the highlight of which was helping at one of Centrepoint’s biggest fundraising events of the year — ‘SLEEP OUT’. I had the pleasure of being joined by Adelle Berman (PIE Trainer) and Victoria Robinson (Psychotherapist, Centrepoint Health Team), as seen in the blog picture above, at the Oval Cricket Ground in South London, where we joined the Fundraising and Events Team(s) at Centrepoint. Although it was a very late night(!), we didn’t have to sleep out at the event and had the luxury of returning to our warm beds unlike those taking part in the event, and of course many homeless young people across the UK.

‘Sleep Out’ is a fundraising event, which has been run for the past 17 years at Centrepoint (albeit with a brief break during the COVID-19 pandemic). This year’s event aims to raise £250,000 and had over 200 individuals from a variety of backgrounds taking part (c.f. https://twitter.com/centrepointuk/status/1593345620248363009). There are also activities throughout the night aimed at helping participants to understand more about the work of Centrepoint in addressing youth homelessness (c.f. https://sleepout.centrepoint.org.uk/). The ‘Sleep Out’ challenge doesn’t exactly replicate what it is like to sleep rough if you are a homeless young person because participants had warm clothes, sleeping bags and a ‘roof’ over their head albeit a very draughty and cold one as the sleeping area at the Oval wasn’t fully enclosed. However, the purpose is to give those taking part an idea of the real situation that homeless young people can find themselves in whilst also raising money through sponsorship. On the night, I was genuinely impressed by all the participants that attended being willing to give up their time to sleep in uncomfortable conditions and raise vitally needed funds for Centrepoint’s work — thank you all!

Centrepoint (2022) statistics show that around a quarter (24%) of the homeless young people that access our supported accommodation services have previously slept rough. This is a shocking figure when you consider the specific dangers, risk and associated trauma that sleeping out in the cold on the streets of the UK can result in particularly as a vulnerable young person. When I was reflecting on this, I couldn’t imagine how frightening or challenging, especially in the UK winter cold or rain, sleeping rough would be for an young person under the age of 25 years. Would you even get to sleep that night? Or would you be awake all night in a state of anxiety or hyper-vigilance to potential threats? What might be the impact on your psychological wellbeing as a result?

Moreover, at the start of ‘Sleep Out’ our Fundraising Director Julie Milnes highlighted another shocking figure that the number of young people facing homelessness this Christmas was around 30,000 (see campaign link here: https://twitter.com/centrepointuk/status/1594737408049823746). To put that figure in context, she noted that this was more than the capacity of Oval Cricket Ground (around 27,500) and when I later looked at the stadium seats (and had our PIE blog photo taken at the end of the night), I could really appreciate the significant size of that number. I was left wondering how in a modern G20 country this was something that was happening. Of course, Centrepoint is working to #EndYouthHomelessness but we cannot do this alone. We therefore need awareness of this issue more widely, an understanding of how this affects the psychological (and physical well-being) of this generation of young people, and a concerted effort by those in positions of power or influence to address the systemic challenges that are perpetuating the issue of youth homelessness.

Of course, ‘Sleep Out’ is not as traumatic for the participants and does not recreate the psychological trauma that that a young person experiences when sleeping rough. ‘Trauma’ refers to events or circumstances that are experienced as harmful or life threatening and that have lasting impacts on mental, physical, emotional and/or social well-being (SAMSHA, 2014). Moreover, Terr (1991) notes that there are two basic types of trauma, ‘Type 1’ — witnessing or experiencing a single event and ‘Type 2’ — repeated exposure to extreme external events such as ongoing physical or psychological abuse, neglect or household dysfunction. Trauma also has three basic elements; the event is unexpected, the person is unprepared and there is nothing they can do to stop it happening (i.e. it is beyond their control).

Anyone can be traumatised but it is often not the event per se, rather how we are supported to process it by our support networks that determines our response and the associated consequences. The amount of traumatic experiences, particularly in our early life (e.g. Adverse Childhood Experiences Study: ACE’s; Anda et al, 2010) also increases our risk of longer-term physical, psychological and social problems. Trauma can also cause feelings of shame and powerlessness, which can lead to secrecy, avoidance and negative behaviours to cope (e.g. substance use). Finally, the impact of trauma can continue beyond the actual trauma experience; it can shape the way a person views themselves, others and the wider world and can be an organising principle for that person’s life (i.e. they are always trying to manage it and/or avoid the impact of it).

In the case of the ‘Sleep Out’ participants, whilst this could be a single challenging event, they are expecting it, preparing for it and if they did not want to do it, they can leave at any time. Thus, it is arguably not a traumatic experience in the same way as the experience of a homeless young person sleeping rough. What is does create though is the experience of not being at ‘home’, in a safe, secure and warm bed. Participants are unlikely to sleep ‘well’ at the event, so the next day they are tired and potentially impacted psychologically by the experience. Thankfully, unlike the homeless young people that Centrepoint supports, they can return ‘home’ the next day and recover from the experience hopefully feeling good for having participated and raised money that will directly help homeless young people in the UK. This made me reflect on the importance of a PIE in creating that sense of ‘home’ for young people when they come into a Centrepoint service, possibly after having slept rough, in order to allow them to psychologically recover and reach their full potential in the future. It also highlighted to me that events such as ‘Sleep Out’ are perhaps taking a ‘psychologically informed’ approach to fundraising as they allow participants an opportunity to try to connect to the real experiences of a homeless young person — to perhaps ‘walk a little bit in their shoes’ for just one night. Arguably, such an ‘experiential’ or ‘immersive’ approach to our fundraising is more effective than just more abstract messaging (i.e. talking) about the impact of sleeping rough on young people.

So why were Adelle, Victoria and I at ‘Sleep Out’ (clue — it wasn’t just to get hold of one of Centrepoint’s orange raincoats we are modelling in the blog picture above!)? We actually had the pleasure of facilitating one of the breakout sessions on the night; ‘The Life of PIE’. Whilst we did not have a small lion or sailing boat, or even any actual pie’s (!) what we did have was a lot of orange string (and several coffees to keep us going!) in order to facilitate an exercise we do on our Centrepoint PIE training day called ‘Attachment Strings’. This exercise was designed with the young people that co-produced the Centrepoint PIE (i.e. the PIEineers), and is an interactive exercise that tells the story of the journey to Centrepoint of a ‘typical’ young person: ‘David’, who finds himself homeless aged 16 years, following family breakdown and leaving the social care system. It is designed to highlight the many challenges that a young person might face even before the age of 16 and why they may end up homeless. Moreover, it creates a visual representation of these challenges in order to facilitate further discussion about what might be the impact on them, particularly in terms of how they view themselves, relationships with others (such as figures in authority) and the wider world.

For example, the case study covers multiple social care placement breakdown, family breakdown and loss of contact, the stress of moving schools, vulnerability to anti-social peer groups and substance use, exploitation by others, contact with and failure to access support from wider statutory services (e.g. social care, criminal justice service, mental health services), and most powerfully the number of individuals that might come in to but have also left ‘David’s’ life. Each relationship breakdown is highlighted with a piece of string between ‘David’ and the other person, which is dropped by them when they leave. Ultimately the exercise ends with the person playing ‘David’ standing in the middle of the circle holding a huge amount of string but alone, apart from his current ‘Social Worker’. It is a very powerful exercise, used to demonstrate the key role of relationship breakdown in underpinning homeless.

This exercise also highlights how when ‘David’ or any other homeless young person comes to Centrepoint, it is to be expected that they will struggle to form relationships with our staff, including his key-worker. Because of his lack of secure attachments in early life (Bowlby, 1967; 1976), ‘David’ will likely have a view of himself as worthless or unlovable, believe that other people are not to be trusted as they will just leave him, and that the world is a hostile or scary place — not somewhere he wants to engage in to access life opportunities (e.g. education, training and employment) and reduce his risk of future homelessness. As a result, our frontline staff are truly amazing in how hard they work to engage the homeless young people in our services, which is often not an easy task! As one of our PIEineers noted, ‘it takes time to build trusting relationships, especially if we have been hurt before’.

Our frontline staff also have a critical role in modelling and building positive attachment relationships, by ‘doing what we say we will do, when we say we will do it or saying why we cannot’. It is only through these positive support relationships that ‘David’ and other young people like him, view of themselves, others and the wider world can be repaired. As Cockersell (2018) argues, it is the “every day magic of normative relationships [that is] key to mental health and resilience”. In other words, creating psychologically safe and secure relationships is the ‘Bread and Butter’ of the PIE approach to homelessness. Without acknowledging the psychological consequences of being homeless and giving young people psychological support or access to specialist psychotherapeutic interventions (c.f. https://centrepoint.org.uk/what-we-do/health/) if needed to process and overcome these, a place to stay is only a great start but it does not repair the psychological damage that often results from the experience of being homeless. As a result, Centrepoint being a PIE means we are more than ‘just a roof over your head’ if you are a homeless young person.

In this exercise, we also asked participants to reflect on their own experiences by the age of 16 years. For example, how many strings would they be left holding compared to ‘David’? The answer is always more. This highlights how this wider network of friends and family attachments that we can trust and rely upon reduces our risk of homelessness should our social circumstances change and we face this threat. It also highlights the key role of relationships in our lives, and how this maintains our psychological wellbeing as we believe we are of worth/loveable, others can be trusted and we can manage with whatever the wider world may throw at us.

At ‘Sleep Out’, we did the exercise three times across the night. Each time it was clear that participants were visually moved, particularly those who played the part of ‘David’ and were left holding all the strings whilst the others sat down. The exercise stimulated lots of discussion and questions after, with many participants who understood young people could be homeless hopefully having a better understanding of why this can happen as well as the psychological consequences, which can continue to impact a homeless young person even after they are housed. It was a pleasure to run the session with my colleagues Adelle and Victoria, as it also gave them an opportunity to highlight to participants their key PIE roles within the organisation in ensuring staff have psychologically informed training and young people have access to psychotherapy to process any trauma associated with their homelessness. I am also very grateful for their support as I would also never have coped with managing that many bits of tangled up string without them!

Overall, I thoroughly enjoyed taking part in ‘Sleep Out’ this year. It was very tiring and I nearly lost my voice by the end (!), but being able to bring PIE to the event highlighted the importance of linking our team’s work to Centrepoint’s fundraising strategy. Enabling donors to connect with the emotional experience of being a homeless young person is a powerful tool in raising well-needed funds for the charity to continue our work. This ‘psychologically informed’ approach to fundraising was also a feature of the other breakout activities of the ‘Sleep Out’ event. For example, our wonderful Helpline Team provided example calls received for participants to listen to, in order to understand the crises that young people can often present in when homeless or at risk of homelessness, and moreover how our compassionate, empathic and knowledgeable advice workers then support them. Another session was entitled #WalkinTheirShoes (c.f. https://centrepoint.org.uk/intheirshoes?utm_source=ac&utm_medium=social&utm_campaign=mob-tool), which highlighted the difficult decisions that homeless young people face in the UK right now particularly in the current cost of living crises. Centrepoint young people also attended to share their stories in a Q&A session (c.f. https://twitter.com/centrepointuk/status/1593361921280864256).

Lastly, I have to give thanks to our brilliant fundraising and events team(s) who arranged and ran a fantastic (and arguably very psychologically informed!) ‘Sleep Out’ this year! Readers of this blog do look out for future Centrepoint fundraising events, such as our ‘Judy Garland’ event in aid of our Independent Living Programme — for details and to get your tickets see here: https://nimaxtheatres.com/shows/judy-no-place-like-home/. And of course, as we continue our PIE journey in Centrepoint, our team will continue to support future fundraising events and activities in whatever way we can, although hopefully somewhere a little warmer next time!