Meeting the needs of vulnerable clients in the Borough of Richmond
This project started in 2018 as a result of a campaign launched by Citizens Advice nationally in England and Wales that showed how mental health problems make it harder for clients to cope with practical issues such as claiming benefits or dealing with debts, housing or employment, and how these issues can aggravate their mental health problems. A national survey of GPs also led to a report showing that many GPs did not know where to refer their mentally ill patients to help them deal with the practical problems that concerned them. This research strengthened the case for better co-ordination of mental health services with agencies that provide advice and support to tackle these practical issues. Locally we decided to follow up the national campaign by examining the impact of our clients’ mental health problems on their ability to cope with their day to day lives and on the obstacles that get in the way of us providing them with effective support.
What are the problems?
As a result of this examination we produced a short report with case summaries of our clients’ experience to illustrate four main problems that we identified :
- Clients needing professional help to improve their mental health before they can cope with practical problems
- Clients receiving treatment for their mental health problems not being referred, or signposted, to advice agencies such as ours for help with practical problems
- Organisations failing to accept that people with mental health problems are vulnerable
- Organisations requiring claims for benefits or services to be made online
What are the solutions?
We presented our report to the Advice Forum, a body established and chaired by Citizens Advice Richmond whose membership includes Richmond Council and a wide range of local advice agencies. In discussions at meetings of the Forum in December 2018 and March 2019 solutions were developed to the problems that we had identified.
- Signposting clients to appropriate local mental health services
Healthwatch Richmond, which champions the interests of patients in the borough, has produced a comprehensive directory of all the services in the borough, including mental health services. This indicates that patients looking for help to improve their mental health can apply direct to Richmond Wellbeing Service to find the most appropriate mental health service to meet their needs locally.
- Signposting patients with mental health problems to other local services
Several solutions are being considered. It is hoped that GPs in the borough will benefit from national funds that NHS will be providing to encourage “social prescribing” initiatives for GPs and other health professionals to refer patients to local services other than medical services to help them in their daily lives. Funds have also been offered by competitive tender through the Richmond Community Independent Living Service for an organisation to develop a single publicly accessible Information Hub to cover all the services available in the borough; but the organisation will not be chosen until November. In the meantime we are discussing with Richmond Council whether its Care and Support website can be developed to provide information and contact details for a wider range of services.
- Persuading organisations to change their procedures for people who have mental health problems or are vulnerable for other reasons
We need to provide convincing evidence to organisations that our clients’ mental health problems make it difficult for them to meet normal requirements. So for the next meeting of the Advice Forum in June 2019 we are preparing a General Mental Health Evidence Form for health professionals who have been working with our clients to complete to confirm the difficulties caused by their mental health problems. However it is clear that organisations like the DWP, Richmond Council and local Housing Associations all accept that people may be vulnerable and need special treatment for a variety of reasons apart from just mental illness. So we are also assembling for the next meeting of the Advice Forum the different criteria that these organisations use to identify whether people are vulnerable and need special treatment. Our aim is to help advice agencies in the Forum to see what further evidence may be needed to support other reasons for their clients to be considered vulnerable and offered special treatment.
- Persuading organisations to provide alternatives to communication online
Locally, and more recently, nationally, the DWP has accepted that some Universal Credit(UC) claimants either need extra help to make their application online or need to apply by phone and have their claim processed without a personal online account. So Citizens Advice Richmond has received government funding to recruit a special group of advisers who are dedicated to helping these claimants apply for UC up to the point where they receive their first UC payment. This group will also help UC claimants considered to be vulnerable for other reasons, as mentioned above.
Secondly we have updated our handout How to Get Online (see Recent Campaigns – How to help people in the Borough learn how to get online) for the special group of advisers to give to clients who want to learn how to get online or to improve their digital skills.