A safe place to call home

An adequate standard of secure, affordable and appropriate housing is not a reality that we share equally. The coronavirus pandemic (Covid-19) has brought into sharp focus the fundamental relationship between health and housing: our homes are central to protecting our health.

Public Health Scotland has published a series a case studies showcasing trauma informed approaches to housing. Whilst these case studies were prepared prior to the pandemic; the messages remain relevant now and for the months and years ahead as we seek to recover from this public health crisis.

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"Home is a shelter from storms – all sorts of storms."

— William J. Bennett

I have been very lucky, growing up, I always had a safe, warm place to call home, with people that cared for me. This is not the case for a lot of children in Scotland. All too often, children are growing up in fear, hungry, in poverty, lonely and without stability. We know that experiencing adversity and trauma from a young age can have a devastating impact on a child’s development and outcomes in later life. Not having a safe and stable place to call home only makes things worse for children, young people and adults that have experienced trauma.

In 2018, NHS Health Scotland (now part of Public Health Scotland) worked with the Scottish Federation of Housing Associations, Glasgow and West of Scotland Forum and Healthcare Improvement Scotland to bring together social housing providers to start a conversation around the impact of adverse childhood experiences (ACEs) and trauma. Across four events, housing providers expressed that they wanted to increase their awareness of the impact of trauma and share ideas about how to provide trauma-informed services in order to respond to, and prevent, childhood adversity for families and communities across Scotland.

These early conversations highlighted the desire of housing staff to share knowledge, understanding and experience in order to support their tenants and ensure their houses are homes, where people thrive. The ideas and experiences raised were varied, and there was an appetite to learn from each other and to support best practice across the housing sector.

Housing staff are at the front line, engaging with people with complex issues, such as low income, debt, poor mental health or substance use, and helping them engage with services. Every day, housing staff are supporting vulnerable individuals and families to sustain their tenancies and improve outcomes.

Continuing to raise awareness with leaders in the housing sector is key to ensuring they have an understanding of the effects of childhood adversity and trauma. This will ensure they understand how the way the services they deliver can prevent the cycle of trauma and positively impact people living with trauma.

It takes time for staff to develop an understanding like this, of the causes and effects of trauma and adversity. We need to work together and share learning to ensure staff are supported when they work with vulnerable families so that they are looked after too and are able to work effectively. Strengthening personal resilience is vitally important for staff working directly with vulnerable families.

There are many things that housing providers can do. They can be a single point of contact for tenants, allowing strong relationships and trust to be built, and they can work with the tenant community to reduce isolation and widen job roles to include tenancy sustainability.

Building new, and strengthening existing, working relationships as well as developing local partnerships, enables staff to refer tenants to services and groups that may be able to offer suitable support quickly. It can help housing associations to work efficiently, share expertise and knowledge and design support. This could be around different housing options, income maximisation, addiction and mental health support groups.

Building on this feedback, NHS Health Scotland (now part of Public Health Scotland) worked with three housing providers to produce case studies that detail what they have learned about trauma and changes they have made to practice.

• South Ayrshire Council: The role of leadership in updating policy and practice and ensuring the wider workforce has an understanding of trauma and ACEs.
• Homes for Good: Highlighting the importance of a one point of contact and a guaranteed home for as long as it is wanted.
• Linstone Housing Association: Working closely with partner organisations to support tenants and to build community.

Public Health Scotland will continue to work with housing partners in order to address health inequalities in society. We will continue to seek to improve knowledge and understanding of how the impact of adverse childhood experiences and trauma can be reduced through the provision of supportive and effective housing services.

You can read the case studies in full here.

An SFHA webinar on this topic, recorded on 28 October, will soon be available to watch here.