Homelessness and Health

Health is the foundation to move out of homelessness

Health first
Groundswell believes that everyone has the right to good health which is the essential prerequisite to living a full life. Homelessness is a significant factor in health inequality within our society, and homeless people’s health is extremely poor compared to the general population.

The benefits of health equality
Groundswell believes that when homeless people are supported to have good health, this benefits us all, as healthier people contribute more and use fewer resources. We know that access to healthcare is the biggest barrier to homeless people getting their health needs met and people need practical support to overcome these barriers.

The value of peer support
Groundswell believes peers are essential in delivering practical support to homeless people, as the shared experience and non-judgemental empathy can be key to making a connection with people some professionals deem “hard to reach”. Peers role model how to deal with the system, and can provide inspiration by demonstrating that you can make it out of homelessness.

We all have mental health
Groundswell believes that everyone needs support sometimes to achieve and maintain positive mental health, in the same way everyone needs support to maintain physical health. The experience of homelessness can make it particularly challenging to have positive mental health so creating proactive opportunities for homeless people to improve their mental health and build resilience is vital.

“I guess as well the longer you’re on the streets the more you feel separated from health professionals. You don’t want to go to them. They’re part of the system and you’re so far away from that.” – Peer Advocate

“You don’t know where you are from day to day, where you are from moment to moment, really.” – HHPA Client

“… the language and communication barriers, not understanding what the doctors are saying. People don’t have the confidence to even ask to see someone.” – Peer Advocate

“…you put a lot of it down to just being on the streets, the cold and the drinking and drugs, so you don’t think about it, and you don’t want to know.” – Peer Advocate

 

Why is health an issue?

Homeless people can have highly complex health needs, often demonstrating a multi-morbidity of physical illness, mental health problems and substance misuse whilst living chaotic lives on the streets or in temporary accommodation. Homeless people face many barriers to accessing services to address their health needs. Without support, individuals often fail to get treatment, seeing their health deteriorate and the eventual costs of unscheduled care soar.

  • Health is a serious unmet need for homeless people, of which 73% have a physical health need, with 35% attending A&E in the past six months, and 26% being admitted to hospital. (Homeless Link’s “The Unhealthy State of Homelessness”, 2014)
  • Rough sleepers’ life expectancy is 30 years shorter than average. (Homeless Link, 2014).
  • Homeless people are four times more likely to use A&E or be admitted to hospital than the general public, putting homeless people’s use of healthcare at least £85m per year. (Department of Health, 2010)

Groundswell’s health work

Since 2003 Groundswell has been involved with health work, working with Health Link, the Queen’s Nursing Institute, the Faculty of Homeless and Inclusion Health, NHS London, St Mungos and many CCGs across London to look at homeless people’s experiences of health care, what barriers they faced and how they felt services could be more accessible.

From this research we developed our Homeless Health Peer Advocacy (HHPA) service, and with funding from the NHS Regional Innovation Fund launched it in 2010. The intervention proved to be a huge success and has continued to develop and grow into a multi award-winning service working across several London Boroughs, along with additional projects all across London. We have now delivered over 10,000 engagements, supporting homeless people to access health care, won the 2016 Kings Fund GSK IMPACT Awards and First Prize at the London Homelessness Award 2014 (Andy Ludlow). Funding comes mainly from CCGs with support from the GLA.

“People feel empowered to look at their own health issues, you’re not nagging but checking in, it encourages them to give healthier behaviour a try.” – Peer Advocate