Multiple needs of street homeless

Most long-term street homeless people tend to have multiple needs, so it's important for agencies to work together, and recognise that every individual is different.

Introduction

Just providing housing will usually not be enough to enable a person to move on, but neither will drug treatment nor help with work and training, or any other form of support provided in isolation.

Shelter encourages the use of Multi Agency Assessment Panels (MAAPs), and other ways of ensuring good joint working.

Part of good joint working is, where appropriate, sharing data and we are supporting the development of common databases.

Problem drug and alcohol use

Many street homeless people have problem drug and alcohol use. To meet their needs there should be a broad range of provision. Some people who have moved to abstinence need to be away from drink and drugs, and we need more projects that house and support people in this situation.

Many street homeless people, however, are not able to commit to abstinence, and continued homelessness lowers their motivation to do so. Stable housing can reduce the harm caused by drugs and alcohol, and provide a platform upon which substance use can be reduced. So we need more projects that are willing to work with on-going drink and drug users. With alcohol this concept is quite well established through the use of 'wet' provision. But with drugs it is less well established.

We have also supported the development of a Drugs and housing website designed to provide help and support to people working in housing with current or former drug users.

Mental health

Lack of access to mental health services prevents many people from escaping homelessness. Many street homeless people have had traumatic backgrounds, such as abuse, a history of care, or bereavement, and psychotherapy can in some cases be of great benefit. Unfortunately this is not readily available to most street homeless people so at Shelter we have been working to promote projects that provide this type of help.

A big area of concern is that some people are diagnosed as having a personality disorder, which is not considered to be a treatable mental illness. Such people can therefore sometimes be left on the streets until they have a health crisis or break the law. This does not make social or economic sense. Shelter has supported the work of the Elmore team, who seek to work with people with personality disorders rather than ignore their needs until a crisis occurs.

Dual diagnosis

Sometimes street homeless people cannot access mental health services unless they stop using drink and/or drugs. For many this is an unrealistic expectation and they remain un-helped. There are too few projects working with people who have a dual diagnosis.

Offending

It is still the case that too many people go straight from prison to street homelessness and people on short sentences are particularly badly affected.

Leaving prison to street homelessness can lead to drug use, which in turn leads to offending and once again prison and then homelessness. Not enough is being done to break this vicious circle, which involves enormous social and financial costs. Our report 'Time to change' features projects that break the cycle of people on short sentences leaving prison and returning to street homelessness.

With hostel places sometimes not appropriate and often in short supply, more could be done to enable ex-prisoners to gain access to the private rented sector. The Coastal Homeless Action Group, in Suffolk, has a highly innovative way of enabling homeless ex-offenders with multiple needs to gain access to the private rented sector. We have supported their work.  Read more about this in New Directions in Street Homelessness.

Street based sex workers

Homelessness among street based sex workers is the norm rather than the exception. Most people involved are very vulnerable. Housing can reduce harm and in some cases support exit from prostitution. The social cost of this problem is huge, yet very few housing providers are willing to actively work with this group. Fortunately there are a few that do and some of these projects are detailed in our report called Off the Streets.