Page 6 - TSAB Adult B FINAL (1)

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was not given a formal mental health illness diagnosis at that time nor was he open to a mental health
team. The plan identified by the psychiatric liaison team was for an urgent referral to adult social care
for housing needs and to register with a General Practitioner (GP) to enable his methadone and insulin
prescribing in Area B. Josh was also asked to keep in touch with substance misuse services (SMS) in
Area A to update them of his address and circumstances. Josh was to be seen again as a follow up for
his diabetes and to present himself to the homeless service in Area B on the day of discharge. There is
no evidence that a social care referral was sent by the hospital staff on this occasion.

5.8. Josh duly presented himself to the Housing Group Homeless Service in Area B. He relayed his recent
history of homelessness and stated that his Employment Support Allowance would start the next day.
He stated that he would have access to monies to pay for a self-funding tenancy. The homeless
housing coordinator informed Josh that, as his local connection was to Area A (had open tenancy and
an open housing benefit claim in Area A) he could not access emergency housing in Area B. Josh was
informed of the need to provide ID to the accommodation provider as part of the application process.
Josh stated that he had no ID as it had been left in the ‘crack house’ in area A and that he could not go
back there. The homeless advice coordinator reiterated that he would not be able to access self-
funded accommodation without ID. Josh got agitated and left.

5.9. Josh returned to the homeless service two days later and asked to see a different advisor. He was
accompanied by a friend who is believed to be an ex-girlfriend. The same information was reiterated
to Josh. At this point Josh stated that if they were not prepared to help him, he would take an
overdose of his insulin there and then. Josh could not be persuaded to refrain from this and duly
injected himself and left the building. The homeless advice coordinator called the police and
ambulance service. The ambulance service could not be dispatched until Josh was located. Following
an intensive investigation and search that involved the housing team viewing the CCTV, police, Mental
Health Street Triage team and security guards in the shopping centre, Josh was located an hour and a
half later in a local pharmacy. Josh was conveyed to hospital by ambulance. Josh told the ambulance
crew of his circumstances and that he could not get help, as the reason for taking the overdose. He
stated he was feeling suicidal.

5.10. Josh remained in the acute hospital for four nights. He initially refused to engage with any medical
intervention and treatment, he was assessed as having the mental capacity to make decisions regarding
his care and treatment. Josh did later engage and accepted treatment.

5.11. Josh was assessed four times on the ward by the psychiatric liaison team. Again, he was found not to
have any formal mental health diagnosis but was responding to the stresses of being homeless and that
he could not be housed in Area B.

5.12. Josh had been referred to Adult Social Care for a need’s assessment by the acute hospital. It was agreed
that he should stay on the ward until the social worker visited him on the last day of his admission. It
does not appear that this assessment by the social worker took place. The visit by the hospital social
worker to the ward would have been due to have taken place within 72 working hours. The referral
had been sent on a Friday with ward staff thinking that Josh would receive a visit on the Monday.

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