Homelessness, Mental Health and Multiple Disadvantage

This module lays the foundations for the programme: homelessness as a housing problem and much more, the full spectrum from rough sleeping to hidden homelessness and people at risk, and why person-first language matters. It draws on Corey Keyes's dual continua, the Welsh Adverse Childhood Experiences study led by Mark Bellis, and the shift from managing homelessness to ending it, with five things leaders do.

This module looks at the latest homelessness figures for Wales and England, how each nation counts, and what the numbers cannot tell you. It covers England's rough sleeping snapshot and temporary accommodation, Wales's monthly management information, hidden homelessness, the shifting the burden pattern, and a short history of homelessness law from 1977 to 2026, keeping the person behind every number in view.

This module reframes multiple disadvantage as complex systems rather than complex people. It draws on Hard Edges, the 2015 study by Glen Bramley, Suzanne Fitzpatrick and colleagues for Lankelly Chase, to explore poverty plus, the overlapping domains, gender, and who is most affected and where. It then sets out the features of coordinated support, including the MEAM Approach, and a matrix for locating your own service.

This module explores the two-way relationship between mental health and homelessness, and the cycle in which mind and home can pull each other down, with every stage a chance to step in. It covers what people may be living with, the Office for National Statistics estimates of deaths of people experiencing homelessness, Samaritans safe messaging guidance, barriers to care, and the no wrong door approach in Wales's Mental Health and Wellbeing Strategy.

This module gives leaders an overview of mental health law and services, from the Mental Health Act 1983 and the Independent Review chaired by Sir Simon Wessely to the Mental Health Act 2025. It looks honestly at racial disparities in detention, compares Wales and England, including the Mental Health (Wales) Measure 2010, and focuses on discharge from hospital as the point where homelessness and mental health law meet.

This module looks at record drug poisoning deaths in England and Wales, what co-occurring conditions are, and why mental ill health and substance use must be treated together, as NICE guideline NG58 sets out. It explores why people use substances and the stigma cycle, then turns to systems: Dame Carol Black's review, six questions for boards, homelessness as a wicked problem after Rittel and Webber, and Avanti's rapid sensemaking work on homelessness in Wales.

This module sets out harm reduction as a service and policy approach that keeps people alive and connected to help. It covers five principles, four established tools, the WEDINOS drug testing service in Wales, practical steps for housing and hostels, common objections, what is lawful where in England and Wales as at late 2026, a matrix for leading when evidence and public support diverge, and licensed drug checking by The Loop.

This module traces Wales's shift from gatekeeping to prevention, from the core duties in Part 2 of the Housing (Wales) Act 2014 to the Homelessness and Social Housing Allocation (Wales) Act 2026. It looks at the new duty to ask and act, plans without sanctions, how psychologically informed environments can help, rapid rehousing, the monthly figures read as flow, and how England's legal route differs.

This module sets out homelessness law and policy in England, from the Homelessness Reduction Act 2017 and its fifty-six day prevention window to the tests that still decide access to the main housing duty. It looks at Everyone In, the National Plan to End Homelessness published in December 2025, the Renters' Rights Act 2025, how England and Wales compare, and why no discharge into homelessness tests partnership.

Housing First offers people with long histories of homelessness and multiple disadvantage a settled home first, with flexible support around the tenancy. This module traces the model from Sam Tsemberis and Pathways to Housing to Finland's national strategy, sets out Homeless Link's seven principles and why fidelity matters, and reads the evidence and costs from England's regional pilots honestly, including what the model needs to work in Wales.

For people who have lived with trauma, a service's building, rules and relationships are never neutral. This module sets out SAMHSA's six trauma-informed principles and the history and five elements of psychologically informed environments, from Johnson and Haigh to the 2012 good practice guide and PIE 2.0. It explores behaviour as communication, boundaries that are clear without being punitive, and practical ways to make exclusion the exception.

People who have lived through homelessness, mental ill health or drug use hold knowledge that services cannot see about themselves. This module uses Baljeet Sandhu's three forms of expertise, a spectrum of lived experience roles and the core qualities of peer support, and reads White and colleagues' 2020 meta-analysis honestly. It covers paying people properly, what good peer roles need, and lived experience across the commissioning cycle.

Adults facing homelessness, mental ill health, substance use and exploitation often live with risks that become easy to normalise. This module sets safeguarding law in Wales and England side by side, then explores self-neglect, the Mental Capacity Act 2005 principles, professional curiosity and Lord Laming's respectful uncertainty, exploitation, recurring review findings and managing risk together. It is an overview for leaders, not legal advice.

People facing multiple disadvantage rarely need one thing, yet the services they rely on are funded, commissioned and measured separately. This module looks at who is in the system, at the Plymouth Alliance for Complex Needs and England's Changing Futures programme, and at why systems change slower than people. It sets out five tools for integration, five steps for building a partnership, and new duties to collaborate in Wales and England.

Work in homelessness, mental health and harm reduction is meaningful, and it also leaves a mark. This module distinguishes vicarious trauma, secondary traumatic stress, compassion fatigue and burnout, drawing on McCann and Pearlman, Figley, and Maslach and Leiter, and explores moral injury from Shay and Litz. It covers ProQOL, Schwartz Rounds, supporting staff after a death, and the commitments that make wellbeing an organisational responsibility.

Services for people facing multiple disadvantage are measured constantly, yet much of what is counted describes activity rather than change in people's lives. This module uses Mark Friedman's Results-Based Accountability, Bevan and Hood's three kinds of gaming and the risk of cream-skimming, and sets out five outcome domains. It explores measuring to learn as well as to judge, the person's own measures, reading the value case honestly and questions for boards.

Knowing what works does not change anyone's night; acting on it with others does. This capstone applies the topic to two cases: The Thistle in Glasgow, the UK's first sanctioned safer drug consumption facility, and the deaths of people experiencing homelessness in England and Wales. It draws out lessons for boards, five shifts toward the person, a matrix to place your organisation, board questions and a plan for your next ninety days.