Mental ill health is a major contributing factor in making people homeless and can also be a consequence of being homeless. Up to seventy per cent of people who use homelessness services have a mental health problem.
Many homeless people have been victims of abuse as children and, as a result, find it difficult to make and keep personal relationships. Alcohol and substance abuse, relationship breakdowns, bereavements and periods spent in prison are also common. These issues are compounded by low educational levels and poor physical health.
Homeless people require more flexible models of care to help tackle a range of needs. These models can include providing outreach services directly to homeless people where they live and stay, and working with other specialist homeless support.
The Government has made the mental health needs of homeless people a priority and the mental health network believes an important moment has arrived for concerted action on the mental health of homeless people.
While the report highlights where the NHS is getting services right, there is still work to be done. This includes:
• Mental health services are best provided closer to where homeless people are – for example, in drop-in clinics or hostels
• Services need to be better at staying in contact with homeless people once they use them – for example, by having a named contact in charge of homelessness health
• The NHS needs to work more effectively with other, often specialist services such as alcohol dependency clinics.
The joint report has a series of vital questions that mental health trusts, health and wellbeing boards (HWBs) and clinical commissioning groups (CCGs) should be asking themselves to ensure support for the homeless is as good as it can be.
For trusts the questions include:
• What training do staff have in the needs of homeless people?
• What adjustments do you make in services for their needs?
• How well are services integrated with others?
For CCGs and HWBs, they include:
• How many homeless people are there are in the area and what needs they have? Do we use both statutory and non-statutory data sources?
• Are the mental health needs of homeless people’s mental health adequately reflected in the Joint Strategic Needs Assessment?
• How are the views of homeless people themselves and of homelessness service providers integrated into the design, planning and delivery of services?
Mental Health Network director Steve Shrubb said:
"As leaders in mental health, we have to recognise that the way we support homeless people has to improve. We must up our game.
"Homeless people have some of the most complex physical and mental health problems that many professionals will ever encounter.
"Across the country, a lot of good work is being done. But we have to get this right everywhere. The new mental health strategy provides us with an opportunity to do so and we must take it.
"Services need to be provided where homeless people are. We need to get better at maintaining relationships with people once they make contact. We also need to work more effectively with other services.
"This report provides the questions NHS leaders need to be asking themselves to make sure homeless people get the priority they need."
Peter Cockersell, St Mungo’s Director of Health and Recovery, said:
"While the links between homelessness and poor mental health are well established, it remains very difficult, however, for homeless people with substance use and mental problems to get mental health treatment.
"We welcome this report as it includes examples of current practice that really works for people with complex needs. The focus must be about prevention and recovery – helping people rebuild their lives through the right support at the right time in the right place. Nobody with a mental health condition should end up sleeping rough. We would strongly urge people to read the report and act on it."
Have your say on this story using the comment section below