A long way from home: mental distress and long-term homelessness - a Good Practice Briefing

By: Marcus McPhillips  Published: December 2008


The prevalence of mental health needs among those experiencing homelessness and the difficulties they face when attempting to access mainstream mental health services are well documented. Shelter’s research shows that people with mental health problems are at a greater risk of experiencing long-term, damaging homelessness. This continues to occur despite recent changes in policy and the introduction of high-profile reports and practice guidelines.

Summary

From April to October 2007, Shelter conducted in-depth, semi-structured interviews with 22 people at low-threshold homelessness services in Westminster, Doncaster, Liverpool and Manchester. All service users had experienced long-term homelessness and suffered from mental health problems, from chronic or severe to the more ‘common’ mental health problems, such as depression, anxiety, and stress. Key findings included the following:

Despite positive changes within service provision, many of the barriers to accessing mental health support remain, and are a continuing challenge to the development of good practice.

Emergency, temporary, and supported accommodation schemes tend to be generic services, housing a mix of individuals with differing needs. Hostel workers can lack the relevant knowledge and skills necessary to support fully those suffering from mental distress. This can lead to exclusion from hostels and create additional problems for the service user.

Drug and alcohol problems were common among interviewees, who reported that primary-care practitioners were often reluctant to refer them to psychiatric services. This can hinder recovery and exacerbate current mental distress.

This briefing collates the key issues raised during the interviews. It identifies good practice for those working with people who have been homeless for a long time and have mental health support needs. The briefing also examines how to prevent long-term homelessness by working effectively with people experiencing mental distress.

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