Homeless people with mental ill health overlooked by health services, report says

Homeless people are often left out of the planning and commissioning of healthcare services in England, despite 45% having been diagnosed with a mental health issue, a report has found.

The report by homeless charities St Mungo’s Broadway and Homeless link audited 50 Health and Wellbeing Boards found that 64% of Joint Strategic Needs Assessments (JSNAs) – where local authorities outline their health priorities – made no mention of single homeless people 14% made no mention of homeless people at all.

In local authorities with high levels of homelessness, 68% of JSNAs did not give single homeless people a high priority when assessing health needs, despite the often severe health issues faced by this group.

The ‘Needs to Know’ report also highlights specific barriers to accessing care that homeless people face. These include:

• Being required to provide a permanent address when registering with a GP

• A lack of flexibility in appointments systems, which can be challenging for people with chaotic lives

• Gaps in provision of support for homeless people with mental health problems, substance use needs or dual diagnosis (mental health and substance use needs) 

• Discrimination from staff at health and other services

• Difficulties dealing with staff, particularly for those with bad experiences in the past.

Howard Sinclair (pictured), chief executive of St Mungo’s Broadway, said: “JSNAs are fundamental as they inform the health strategies and priorities for local communities and how to reduce health inequalities for all local people in those communities, which includes those who are homeless.

“However, this report shows that homeless people, and lone homeless adults in particular, are being overlooked in England, and their needs sometimes ignored completely. We must change this, not only to make sure homeless people have access to better healthcare but also because it’s about the good use of ever-more scarce resources.”

But the report did find examples of local authorities that are addressing these issues and improving access to care for single homeless people.   

Rick Henderson, chief executive of Homeless Link, said: “The link between homelessness and ill health is well documented, and the cost of not tackling the two issues together is significant for both tax-payers and society. Homelessness must be recognised as a public health issue so we can begin to improve wellbeing, tackle homelessness and reap the financial benefits. 

“In all too many cases, homeless people are being let down by health services and not being considered in the planning of future provision. We know that significant improvements can be made when agencies work in partnership and are calling for the political and financial backing for this to continue, and for health and wellbeing boards to commit to a greater focus on homelessness."