Homelessness and mental health

10 December 2015

Homelessness

As the nights get colder and darker, it is timely to talk about a fundamental factor which greatly influences people’s mental health: housing. 

Affordable and safe accommodation brings stability and security; provides a gateway to access health services like GPs; enhances social and community inclusion; and provides the basis for the right to private and family life. Put simply, a home is vital for good mental and physical health, allowing people to live in safety, security, peace and dignity.

Whilst there is no such 'right to housing' in itself, the right to an adequate standard of living, including housing, is recognised in the UN Covenant on Economic, Social and Cultural Rights.

Of course, there are numerous factors which can cause people to become homeless, many of which are beyond individual control, such as lack of affordable housing, disability and poverty. But what really needs to be highlighted is the two-way relationship between homelessness and mental health.

Homelessness and mental health often go hand in hand, and can be a self-fulfilling prophecy. Having a mental health problem can create the circumstances which can cause a person to become homeless in the first place. Yet poor housing or homelessness can also increase the chances of developing a mental health problem, or exacerbate an existing condition. In turn, this can make it even harder for that person to recover – to develop good mental health, to secure stable housing, to find and maintain a job, to stay physically healthy and to maintain relationships.

It is a fundamental fact that single homeless people are much more likely to have mental health problems compared to the general population. In 2015, 32% of single homeless people reported a mental health problem, and depression rates, for example, are over 10 times higher in the homeless population. Unfortunately, other psychological issues such as complex trauma, substance misuse and social exclusion are also common.

This mental health inequality could be resolved through various measures, both within and beyond housing policy. So what changes in policy and practice should be made?

Recognising that homelessness is a public health issue

Targeted prevention focussed on this particular group of people is crucial. The homeless population currently struggle to access healthcare and tend to rely on A&E at crisis point, which costs £85 million a year. In the words of Rick Henderson, chief executive of Homeless Link, we need more "multi-disciplinary NHS and housing teams who target housing, health and substance misuse issues in unison".

Investing into research, design and training for psychologically informed environments

Put simply, this means that staff who work with homeless individuals in shelters, hostels or health services, must be aware of their emotional and psychological needs, wellbeing, and put their safety first.

Maintaining the entitlement to housing benefit for unemployed 18-21 year olds

Scrapping this benefit in 2017 will increase the risk of homelessness for many young people.

Reinvesting in social housing

Over 50,000 families in Britain are now considered "statutorily homeless" and sheltered indefinitely in B&Bs, and the pressure is growing even greater for local authorities to provide a roof over their heads.

Improving gender-sensitive approaches for women across the housing and health sectors

Rates of substance misuse are currently higher among homeless women, and greater provision of sanitary products is needed to improve their physical and mental wellbeing.

Homelessness increases the risk of poor mental health, severe ill health and disability, lower educational attainment, long-term unemployment and poverty. There is no simple measure to resolve all these problems, but the prevention of poor mental health is the key place to start.  People cannot, and should not, be expected to make the journey out of homelessness without the right treatment and support.

In addition, our government should prioritise mental health across all policies, including housing, but also in social care, welfare, education, employment, the criminal justice system, and so on. In doing so, we will be taking the necessary steps to build a fairer, more inclusive society, ensuring that people have the support they need to realise their potential, contribute to their communities, and to lead dignified lives.

The relationship between housing and mental health is therefore so important that it cannot be overstated, yet is still largely neglected. Unless we address the fundamentals of mental health in policy and practice, we are never likely to get on top of the homelessness crisis.