THE FORGOTTEN

ONE’STHE MARGINALIZATION

OF THE

DISENFRACHISED

Mental Health and Homelessness:

Could this be a possible

place to sleep ?

Mr Johnson admitted he is going

to struggle to hit a target of

ending rough sleeping by 31

December.

forgotten street SW1

.

homelessness can contribute to a person developing a

mental health problem. The stress related to trying to

manage these issues can also make people with

existing mental health problems more vulnerable to

relapse were their mental health deteriorates requiring

more support.

Generally it is

considered that

having a safe,

affordable

home is a basic

Human need

Some homeless people

with chronic psychosis

may appear well

. In the substance misuse treatment population

alone, 670 people are thought to have a

personality disorder, with 1,274 from the

homeless population

Identifying the needs of this population proves a challenge due to

the lack of an evidence for interventions and consensus around

the proportion of people who need specialist care.

Mental health problems can

both cause and be a

consequence of

homelessness.

professionals are

reluctant to

undertake

compulsory

admission, even

when there is

clear

evidence of self

neglect and

vulnerability.

A good night’s sleep ?

To admit or not to admit?

An inpatient ward does not

seem appropriate.

This creates the apparent dilemma

around admission for ‘social’ rather than ‘medical’ reasons.

Homeless people are among the most

vulnerable in our society, often suffering from

significant and multiple health inequalities.

professionals who support them report that

they are often marginalised and left without

sufficient and effective support to deliver their

service.

There are fewer than

five specialist

clinical psychology

posts in England

specifically serving

homeless populations.

Admit or not to admit continued Assessing the severity of illness may also be difficult, in that hostel / shelter

staff and residents may be very tolerant of challenging or unusual behaviour

and this can lead to health and social care staff being inappropriately

reassured. Some homeless people with chronic psychosis may appear so well

adapted to their condition, albeit to living on the streets, that professionals are

reluctant to undertake compulsory admission, even when there is clear

evidence of self neglect and vulnerability. This reluctance can result in delays

in the obtaining of key information which might, for instance, trigger the

restarting of previously prescribed medication which may enable the person to

accept and retain accommodation. Admission for assessment and

investigation should be considered seriously in these cases.

The evidence is clear, whilst

progress has been made, too many

homeless

people still experience mental ill

health, and we have not yet got right

the

frameworks and services to respond

to their needs. We also need to

recognise

the full spectrum of mental health

problems from common mental

health issues

to psychosis; the differing needs of

particular groups of homeless

people; and to

ensure services and approaches are

tailored accordingly.

HAVE THINGS

REALLY

IMPROVED ?