Matthew, now in his 60s, was raised by a single mother in a poor area of Glasgow. He joined the Royal Navy when he was 16 and travelled across the world for several years, until his mum became ill. He left the Navy and took care of her until she died. He started drinking and by the mid-80s his life had changed to the point where he was often rough sleeping.

By the time Golden Key’s Housing First team met him, Matthew had been street homeless in Bristol for more than 10 years, prompting an outreach worker to refer to him as “one of Bristol’s longest-term rough sleepers”.

Matthew had a long history of trauma, including the early death of his mother, and experiences of life sleeping rough. Trauma impacted severely on his mental health and, as well as long-term alcohol dependency, Matthew struggled with very high levels of anxiety and issues around trust.

In addition to a history of repeated involvement with the police, Matthew was living with a number of serious physical health conditions. He received no benefits and owned nothing other than his clothes, because he found that having belongings was “too much to think about”.

Matthew’s anxiety was made worse by being indoors or being around other people. This meant that past attempts to go into accommodation had been too challenging, and were ultimately unsuccessful. Housing First provided a different approach, and the distinctive wraparound, intensive support offered by the team meant that this time was different.

When the Housing First team met Matthew they asked what he thought was stopping him from living in a flat. He described his struggle with being inside, saying: “I can’t cope with four walls”. This was a barrier to finding accommodation and to his attendance at healthcare appointments. He knew he needed to change but couldn’t imagine feeling safe or comfortable indoors.

The Housing First team worked closely with a St Mungo’s outreach worker to build relationships and develop trust with Matthew. After initially supporting him to access appropriate healthcare, the team started to talk about accommodation. Importantly, the Housing First accommodation process gave Matthew choice and control – he could decide whether or not to take up any offer, knowing that it would not impact on further offers of support.

The Housing First team worked closely with LiveWest (the housing provider) and the outreach team in order to find a suitable flat, and the team spent a lot of time with Matthew in the area: visiting local shops and the doctor’s surgery; setting up a bank account; getting familiar with bus routes; and supporting him to apply for benefits.

Many organisations were willing to adapt their usual processes to help Matthew access the support he needed, including: health teams holding appointments at short notice; the housing provider waiving deposit requirements and quickly making accessibility modifications to the flat; the bank adapting processes to set up an account; occupational therapists providing specialist furniture; and the British Legion providing carpets and curtains.

On the day he moved in Matthew was very anxious, and for the first few days he slept on the floor. However, after years of avoiding four walls, he has now settled into life indoors and enjoys having his own bed. He keeps the flat very tidy; a habit he says is from his time in the Navy. Matthew is seeing a local doctor for his health issues and is working towards getting a pension. The British Legion continues to support and seek befriending options for him.

Matthew had years of cycling through homelessness services, as well as the courts, prison and probation services. Since being housed he has had no contact with the criminal justice system at all.

Matthew’s story highlights the importance of flexibility and a person-centred approach in working with someone with complex needs. He has experienced a life of trauma and multiple disadvantage but, with the holistic support provided by Housing First, he has been able to move away from the streets and can now access the support and safety he needs.