Improving Mental Health Outcomes for those Accessing Homelessness Services
Aneurin Bevan University Health Board
Introduction:
This project sought to improve mental health outcomes for individuals experiencing homelessness in Gwent by developing psychologically informed environments (PIEs). Recognising the high rates of trauma, mental health issues, and barriers to care within this population, the aim was to enhance service-user outcomes and staff well-being through a trauma-informed, system-wide approach.
Methods:
A phased improvement programme was implemented using Plan-Do-Study-Act (PDSA) cycles. Phase One introduced a mental health triage hub in partnership with local councils and ABUHB. The approach combined direct psychological intervention with workforce development, training, and reflective practice for staff. Phase Two expanded this work through Big Lottery funding, introducing universal and targeted PIE interventions across Gwent’s housing sector. An outcomes framework captured system-level data, service-user experience, staff feedback, and value-based measures. Interventions included low- and high-intensity support, staff training, and integrated multi-agency working.
Outcomes:
The intervention led to notable improvements:
- 83% of service users reported timely access; all felt listened to and understood.
- Statistically significant improvement in service user mental health (CORE-10 data).
- 50% reduction in evictions and one-third reduction in police callouts.
- Staff reported increased confidence, competence, and well-being.
- More appropriate and efficient use of specialist mental health services.
Learnings:
Delivering trauma-informed care within a PIE framework improves both individual outcomes and system efficiency. Shared ownership, robust partnerships, and enabling environments were key to success. Referring service users thoughtfully, rather than automatically absorbing need, emerged as a marker of effective, person-centred care. Data challenges in tracking homeless populations highlighted the need for improved cross-system information sharing.
What Next?
Phase Three will focus on scaling up replicable elements (e.g. complex needs MDT, trauma-informed training), standardising effective practices, and embedding proactive, value-based outcome measurement. The goal is to determine whether sustained PIEs reduce homelessness long-term by improving stability, service access, and readiness for independent living.
