Photo by Stephen Arnold on Unsplash

In Feb 2019, Lincolnshire Street Outreach Team met Jan rough sleeping in Spalding town centre.

During the time SOT was working with Jan, we learned that he was an open case to Polish Children’s Services and both his parents had a history of alcohol abuse.

Jan sustained damage to his brain when he was a young child, when he was attacked by local youths. As a child, he had received support from mental health services, and been involved with youth probation services. Jan came to the UK with his sister and father when he was 18 years old.

The SOT worker who met Jan spoke Polish, so an assessment was completed and contact established with his older sister. She told us Jan had been reluctant to find employment and when he had not found a job, he was asked to leave the home he shared with her and their father.

Jan became a well-known figure in Spalding Town Centre and several times local people took him into their homes for periods of time. One person tried to support Jan to make a benefit claim, but he didn’t attend the follow up appointments necessary to progress his claim.

Wellbeing concerns

In Sept 2019, Jan was taken to Boston Pilgrim Hospital where an Adult Social Care assessment took place; the Social Worker mentioned Jan had suffered trauma but did not make a referral to Mental Health Services.

In late 2019 Jan was again taken to hospital. A mental health assessment was carried out – the conclusion was that it was clear how vulnerable Jan was while living on the streets of Spalding, but they were unable to detect signs and symptoms of any serious or enduring mental health issues.

A capacity assessment was also carried out and it was deemed even though Jan was making unhealthy decisions to return to the living on the streets, he had capacity to be able to make that decision.

“Water was falling on his sleeping bag and he still did not move”

In early 2020, it was decided that SOT would make a referral to the Vulnerable Adult Panel (VAP) at South Holland District Council. During this month Severe Weather Emergency Protocol (SWEP) was in put in place, so SOT and the local PCSOs offered to support him to go to the council, but he did not go.

At the VAP meeting in February 2020, I spoke about the difficulties of trying to get Jan to engage – he would often not respond and it was hard to say if this was due to him having poor English skills, unwillingness to engage or just not being able to respond.

It was mentioned that Jan’s sleeping bag was positioned under a split in the guttering and water was falling on his bag and he still did not move. Jan had been beaten up twice since the New Year, and the police and SOT were concerned that he may become a victim of modern slavery.

The outcome of the VAP meeting was that the Crisis Team would visit Jan.

Things reach crisis point

On the day of this visit, SOT were unable to locate him. A local shop manager told us Jan had been taken to hospital the week before, as she had found him wet through, shivering, drifting in and out of consciousness. He could not remember when he had a hot meal or a hot drink (a member of the public was fortunately able to translate).

The Crisis Team was unable to wait so it was agreed that SOT would give him a letter inviting him to attend the hospital for a physical and mental health assessment. Two weeks later, SOT located Jan in a wet-through tent, sleeping on a very wet mattress. He agreed to be supported to go to hospital.

On arrival at A&E, Jan was unable to stop itching; when he removed some of his outer garments they were heavily infested with body lice. Jan had to be supported to the shower and it soon became apparent he was unable to do this without staff giving him directions and miming the actions of what to do in the shower.

“We stayed with Jan for nine hours”

Jan was triaged for his mental health and the assessor quickly concluded Jan was in catatonic state. It was arranged for Jan to be seen by a Mental Health professional and a translator. We stayed with Jan for nine hours—as long we possibly could—to try and reassure him.

Approximately 18 hrs after arriving at A&E, Jan was deemed to be mentally unwell and placed under Section 2 of the Mental Health Act for a 28-day assessment period on a mental health ward.

When I last had contact with the ward, they informed me Jan remained mute. Assessments are being looked into to see if Jan does have a learning difficulty, and gain clarification from a MRI scan to see whether he sustained a frontal lobe injury from his childhood attack.

While Jan is still waiting for a longer-term outcome, it is positive that he is finally in a place where he is safe and his mental health is being cared for.