Where did it all come from?

Unusually perhaps, for a development that seems to challenge 'top down' policy-making, it was a string of UK government policy positions in the early 21st Century that underlay much of the original thinking and the practice of PIEs; and the unfinished business, where that left off, is where we may now need to go.

It was the DCLG's 'operational guidance' in 2010 (HERE) that first adopted the phrase 'psychologically informed environment' from a mental health journal article describing recent progressive developments in homelessness; with a follow up in 2012 that first began to tease out the elements of what then became PIEs One, or the 'classic' version (HERE). 

From this, over a period of some ten years or more of discussion and further development, the fuller framework of PIEs 2.0 began to come together; and even this, since its first publication in late 2017, has seen some continuous finessing. Much of that development is detailed here on the PIElink.

But the roots go even deeper. In late 1999, the Supporting People programme was announced, with an imaginative plan to re-structure the policy framework, funding and future regulation of 'housing related support' in the UK. This programme opened up much of the rapid development in social housing and homelessness services which later we were to summarise with the phrase 'psychologically informed environments'.

Then, in 2002, the UK government had issued 'Reaching Out ' a still more far-ranging policy document on social exclusion. This document challenged all existing sector, services and service models to look to the ways that their focus on their 'core business' might be inadvertently leading to deepening exclusion for those marginalised through complex needs that might not neatly fit the expectations and procedures of each service.

Between 2003 and 2010, when the pace of national guidance slowed to a halt, a string of further documents took the ideas of social inclusion and community mental health.

The Social Inclusion Unit issued a report specifically on mental health - Mental health : an action plan on social inclusion - and the Dept of Health issued radically revised guidance for services - Personality Disorder: no longer a diagnosis of exclusion - that described the previous treatment of personality disorder as 'therapeutic nihilism', and cast the issue instead in terms of exclusion from services. The National Institute for Mental Health (England) reported on the extent to which both homelessness services and 'ordinary' ('general needs') social housing services were managing mental health needs - often with little support..

After the financial crisis of 2008, the pace of policy development began to slow, to be replaced by the mantra of 'delivery'. One of these more practical programmes  (known technically as NI 149) led to extensive discussions between the mental health services' representative and the DCLG's homelessness directorate on social inclusion, mental health and housing. From these discussions it became clear that homelessness amongst those too chaotic to engage in mental health care was a major issue that needed addressing, and a secondary report was prepared, intending to argue for additional efforts in this area.

When the Coalition government came into office, the new government immediately scrapped all of the social inclusion programmes of the outgoing government. The secondary report however, not being part of that programme, was re-written, and able to appear as a distinct guidance document in its own right; and after some delay, the in-coming minister agreed to its publication - provided that it was only 'advisory' and that there was no additional funding attached. This report was often known as 'the complex trauma report', as it highlighted the extent to which complex trauma was found in the homelessness population, and the extent to which some services were developing effective responses.

After 2010, there was little or no central government policy on social inclusion or on homelessness for some years; now the mantra of 'devolution to local decision making' avoided any need to continue to guide development. The DCLG department suffered huge cuts in its staffing, putting an end to much dialogue between government and practitioners - but not before a second, follow up guidance was produced in 2012, in response to many requests from the homelessness sector for further guidance to spell out in more detail what 'psychologically informed services' in homelessness might look like.

With the risk of momentum fading and coherence dissolving, a few individuals from the writing teams of guidance 1 and 2 continued to develop the PIEs idea; and gradually the first real framework - PIEs 1 - came together, in a string of discussions and workshops. The first PIElink was created, as a resource and location for on-line practice sharing; and the 'Housing Care and Support' journal ran a special issue on PIEs (HERE)

Over this time, despite the lack of steer from central government, other new ideas began to gain some traction, most notably trauma-informed care, housing first, and the recognition of 'ACEs" - that is, the impact of early trauma and other 'adverse childhood experiences'. Meanwhile the PIElink was attracting readers and membership from outside the sphere of homelessness hostels and refuges, with outreach workers, housing first project staff, and some mental health services and other welfare provision; also from Europe and the United States.

There was a growing sense that the PIE approach could channel all these initiatives into a practical expression - but this required an expansion of some of the early versions of what issues a PIE might be addressing, and the development of the expanded account, PIEs 2.0. Much of this early development was summarised in a PIElink newsletter in 2016, with the title : Is the PIE evolving? - a summary of developments now given a page of its own on the PIElink, with a brief up-date (HERE).

Since then, the co-evolution of the emerging practice and the ideas behind PIEs has continued. The PIE concept itself is proving to be both flexible and quite dynamic, in generating new ideas. Like the services it describes, it's been constantly developing and learning. The Pizazz service audit tool, and now the PIE Abacus software, open new possibilities for developing and sharing emerging practice.

Only the three-way dialogue between practice, theory and policy making has not yet been re-made, at least in England. So the newly revived interest in service eco-systems and in a more pervasive systems change in some ways takes us back almost to the place where these developments began - with the calls in the Social Exclusion Unit's report for less fragmented, more 'joined up' services.

So for an account of where things are going and growing currently, see 'The future of PIE and the PIElink' :  HERE


Further background

PIElink pages - issues in historical sequence

'Joined up thinking' : HERE

The lasting legacy of Supporting People : HERE

PIEs 1 - the original core : HERE

Is the PIE evolving? : HERE

A single framework : HERE

Trauma- Informed Care and PIEs : HERE

Housing First and PIEs : HERE

Outreach, pathways, environments without buildings : HERE

From PIEs 1 to 2.0 : HERE

Cross-cultural dialogues : HERE

Whole systems as PIEs : HERE

Pizazz and the PIE Abacus : HERE

PIElink forums and 'SIGs' : HERE

Fresh directions : HERE

What's the big idea? : HERE

The future of PIEs and the PIElink : HERE


Library items

Wikipedia on Supporting People : HERE

Reaching Out (SEU report)  : HERE

This is not a pipe : HERE

Social psychiatry and social policy for the 21st Century (Part One) : the psychologically informed environment : HERE

On meeting the psychological and emotional needs of people who are homeless (DCLG report, 2010) : HERE

Psychologically informed services (DCLG report, 2012) : HERE

Housing Care and Support special issue on PIEs : HERE

The cycles of practice-based learning (video) : HERE

PIEs Ten years on: where are we now? : HERE

PIEs and Trauma Informed Care : HERE

PIEs and Housing First : HERE

American PIE ? : HERE

Constantly catching up with practice (video) : HERE

Roll out and 'top-to-toe' embedding of PIEs (forum summary video) : HERE