Kerrie Portman is a Care Experienced person currently reading politics at the University of Cambridge. She has been homeless four times, which prompted her interest in politics and housing.
When you move into temporary accommodation, you’re just given an address and that is where you live now. You likely don’t recognise the street. It may or may not be near your job or college, that doesn’t seem to matter. You may not even know the town. Maybe someone from the council will meet you there with the keys or maybe you’ll be given a code for a key box. Maybe there will be furniture, maybe there won’t, and you need to sleep on the floor. Nobody will tell you where the nearest shops or bus stop are. Neither will necessarily be close. Maybe you’ll have friends or family to help you, maybe you won’t. Maybe they’re not safe. Maybe you have children dependent on you. Maybe the temporary accommodation will be livable, maybe not. Maybe you’ll need to share bathrooms and kitchens with strangers. Maybe you’ll have facilities for cooking or washing, maybe you won’t. Nobody seems to care whether there is or not; too many people think that a person being homeless means it's okay to treat them as a non-person. This is just where you live, except that any day the council can ring you and move you, who knows where, by the end of the day. This inevitably has a negative effect on people’s mental health.
As well as the impacts of homelessness on mental health, mental illness itself can be a contributing factor in a person becoming homeless in the first place. A study between 2018 and 2021 found that 83% of homeless people had a diagnosed mental health condition (1). Many more people will meet the criteria for a diagnosis without officially having one. Another study found that 26% of homeless respondents cited their mental illness as a contributing factor in their homelessness, and the National Health Executive reported that those with mental illness are twice as likely as the general population to have been homeless over a year. Even though homeless people are very likely to struggle with their mental health, it is even harder to get mental health support while homeless. On top of the national difficulty with accessing these services, being homeless involves sudden and sometimes frequent moves. The lengthy processes of registering with a GP, getting an appointment with the GP to ask for a referral, being seen for an assessment and then being placed on a long waiting list for therapy will be inaccessible for a homeless person who frequently moves and is sent back to the beginning. These rigid systems are not designed for homeless people or anyone with complex needs. Worsening this, in my experience of being homeless in multiple councils, there is never anyone assigned to provide advice on how to navigate these systems or what help is available. Some Housing Officers will ensure I have a roof over my head, but aside from that, I’ve received no support, even at times when I’ve nearly died whilst being homeless. Anything I have found, I’ve stumbled across by accident.
Housing First, which provides a home and support for homeless people without any conditions attached, has been central to homelessness policies in Finland, France, Denmark, Canada and has been adopted by parts of the US and UK (2). Housing First projects have been found globally to reduce chronic repeated homelessness, struggles with addiction, contact with the criminal justice system and improve participants’ mental health. A study in Lisbon found that participants in Housing First projects saw a 52% reduction in admissions to psychiatric hospitals. In the UK, a study reported that 52% of participants reported ‘bad’ or ‘very bad’ mental health before using Housing First projects, but after a year, this fell to 18%. Housing First is being introduced to the UK, but needs wider implementation.
As well as the moral argument of helping people, it doesn’t make economic sense to leave homeless people without mental health support. It will cost the NHS more in treating the physical health issues of untreated mental illness, such as self-harm, addiction and suicide attempts. It increases the barriers to education and employment, which will cost more in benefits. It increases contact with the criminal justice system. It makes it harder for people to exit homelessness and increases their chances of becoming homeless again.
I’ve been homeless four times in my life, and it was only after the most recent time that I was offered any form of housing security. I’ve never had any support in dealing with the trauma of having been homeless, which was a factor in its repetition. When I was homeless, a lot of people treated me like a non-person or with open contempt, which was a factor in the suicide attempts I had when homeless. All the local statutory services ignored these. Even as a housed person now, I still struggle daily with C-PTSD. Finding a local homeless women’s support group and being treated like a human made the world of difference. Homelessness is near impossible to describe, and even when I told people I was homeless, most people didn’t seem to understand. Everyone expected me to be able to do everything a housed person could do. I still struggle to find work because I don’t have enough experience due to being chronically homeless since leaving Care. I fell significantly behind at university due to being homeless most of the academic year, so I cannot complete my degree. Even when being lucky enough to gain some form of housing security, not having holistic support leaves me worrying I’ll never have a positive future. It was quite peculiar how many people expected me to be fine as soon as I got my flat. I legally stopped being homeless when I signed the tenancy contract, but the experience did not go away.
The government needs to ensure that everyone placed in temporary accommodation has urgent access to therapy to support them and set them up with the best chance of exiting homelessness and staying housed, which is morally and economically the best outcome.
[2] https://homeless.org.uk/areas-of-expertise/housing-first/
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