King's College London

Strengths-based, low caseload approach to integrated health, housing and practical support for people experiencing homelessness with multiple complex needs in temporary accommodations (hostels): a multi-centre, open, cluster randomised controlled trial with embedded economic and qualitative process evaluation

Residents of temporary accommodations for people experiencing homelessness (PEH) are some of the most clinically and socially vulnerable persons in society. Yet there is no national guidance that informs care delivery in this setting.

The REACH intervention involves a dedicated team of a mental health practitioner and a care navigator offering intensive in-reach support to residents of temporary accommodations with multiple complex needs. REACH care team will offer focused support to residents for up to 12 months to diagnose, treat and refer people to improve their physical and mental health, wellbeing, as well as provide practical skills for recovery and employment. Temporary accommodations are randomised (divided) into two groups with residents in one group of temporary accommodations receiving REACH care in addition to usual care and residents of other temporary accommodations continuing to receive usual care.

Trauma-informed - being aware of the impact of past trauma when offering care - and strengths-based - recognising and building on people’s strengths and interests- are key principles based on which REACH care will be delivered. REACH aims to bring positive impact on multiple dimensions of health and wellbeing including reduction in A&E visits, ambulance call outs, repeat homelessness and improvement in quality-of-life, housing, employment and criminal justice related outcomes. We will get input from residents, care team and stakeholders about the intervention and find out if it saves money for the health and care system.