This month the NHS Confederation’s Mental Health Network published a new briefing paper on mental health and homelessness. As this briefing paper highlights, poor mental health is widely recognised as both a cause and a consequence of homelessness: housing conditions can lead to mental health problems not previously present, or those with existing mental health problems can drift more easily into poor housing. Homeless Link has estimated that around 7 out of 10 people accessing homeless services have one or more mental health problems. Yet many homeless people still find it hard to access mental health services and support. The briefing paper identifies a number of factors which can make it difficult for homeless people to access appropriate services. For example, homeless people are 40 times more likely not to be registered with a GP than the general population. And although many homelessness service providers now provide access to specialist mental health services, 64% of 500 such providers have reported that their clients had problems accessing these services.
The briefing paper rightly emphasises the particular difficulties facing those homeless people with a dual diagnosis of mental ill health and substance misuse, who too often are still excluded from mental health services because of a lack of a joined-up approach which tackles both their mental health needs and substance misuse issues. Moreover, it is crucial to remember that homelessness is usually part of a broader picture of multiple exclusion and disadvantage – alongside mental health and/or substance misuse problems, homeless people often have histories of trauma and family breakdown as well as unemployment, low educational attainment and contact with the criminal justice system.
Building on the Government’s mental health strategy, No health without mental health, which recognised the importance of improving access to mental health treatment for homeless people, and the development of the new health and wellbeing boards, this briefing paper is a timely reminder that providing mental health services to homeless people requires a clear recognition of the complex and overlapping needs of this group and the development of models that offer a recovery-orientated, person-centred and holistic approach to addressing those needs.