We support people facing Severe and Multiple Disadvantage (SMD) in Nottingham City. Our project team delivers a combination of frontline delivery providing direct support to a large cohort of beneficiaries; and strategic input via a range of partners regarding the provision of appropriate and specific SMD services in Nottingham City.

Severe and Multiple Disadvantage (SMD) is generally considered to be an experience of two or more of the following sources of disadvantage simultaneously; mental health issues, homelessness, offending and substance misuse. (MEAM 2018)

Homelessness includes sofa surfing and staying with friends or family. For those having contact with the Criminal Justice System, this could be as a survivor, perpetrator or both, with domestic abuse being a highly prevalent issue. Substance misuse may involve alcohol, illegal, or prescription drugs; and mental ill health includes various diagnoses ranging from anxiety and depression, to schizophrenia and personality disorders.

We work in partnership with other organisations across Nottingham City. These include City Council and NHS Teams, housing providers, police and probation, women specific services and addiction support services. The School of Social Sciences based at Nottingham Trent University, is our academic partner.

Our frontline delivery team is made up of Personal Development Coordinators (PDCs), and a number of specialist posts including a Psychologist, CBT Practitioner, and Housing First Support Workers. All of these roles deliver a very high level of support, helping people to navigate the complex system they are often faced with when trying to access help. Support is given with housing applications, the need for medical intervention is identified (including Mental Health Assessments), access to addiction support services is arranged, and for those serving time in prison, a 'meet at the gate' approach is taken. The team offer a fully cohesive approach, which means that people are less likely to 'fall through the gaps' in the system. Support is tailored to the individual, and is ongoing, reactive and adaptive.

Our work to influence system change is underpinned by an extensive programme of research, which always includes the views of people with direct experience of SMD. Our team is involved in consultation work both locally and nationally, influencing approaches to commissioning and service development. There is also a focus on specific areas of work including the impact of SMD on women, and the need for psychologist-led support.

We will continue to deliver frontline support work with our existing beneficiaries until we close at the end of June 2022. We stopped taking referrals permanently at the end of October 2021. Nottingham City has recently been awarded funding via the MHCLG and the National Lottery Community Fund, as part of a new programme called Changing Futures. This funding will be used to support people facing SMD in Nottingham City in the future. Changing Futures won't offer a direct replacement to our project, but it will be informed by our learnings and approaches. Find out more here