In Mental Health Awareness Week, and following Mayor of Greater Manchester Andy Burnham’s recent speech on homelessness it is worth reminding ourselves of the links between the two.

  • Up to 80 per cent of homeless people reported some form of mental health issue
  • Approximately 45 per cent of homeless people have been diagnosed with a mental health issue.

When we talk to people about what is causing those problems we find causes that are societal, related to adverse life experiences which in turn affects the emotional wellbeing of the individual.

Previous research suggests that homeless people are more likely to be affected by a prior brain injury.  Around 12 per cent of homeless people were assessed as having autism and many more have suffered traumatic experiences, often in childhood.  As a form of coping with complex trauma homeless individuals may turn to drug and alcohol use.

Homeless individuals can be affected by a sense of shame, guilt and alienation from society.   Along with lack of trust of others, due to being let down in the past, it can be harder for homeless people to engage with mainstream mental health services. When combined with drugs and alcohol use it can be difficult to know where to start.

The approach of the mental health homeless team is to build a rapport with the individual. When we get to know the person, we get to know their needs.

We receive referrals from organisations like Urban Village GP practice, which specialises in providing health services to homeless people, from day centres, hostels, from the council and from our own drop-in services.

Through the voluntary sector, rough sleeper outreach teams or hostels, the homeless person will often have access to a support worker who is there to provide practical guidance on linking people in to support regarding housing or benefits.  We support this and fulfil our core role to offer assessment of mental health needs and to refer or signpost accordingly. To do this we need to figure out the person’s needs and wants.

What are we looking to achieve when we start to support a homeless person?

Quite simply, we want to move someone on from where they are to somewhere safer and better. Getting them access to the most appropriate form of support for their emotional needs.  This may include therapy, social support or medication or a referral to a community mental health team which can provide longer term support.

Our goals, along with partner organisations may be getting someone off the street into temporary accommodation. It might be moving from temporary into permanent accommodation. Getting the individual registered with a GP or accessing drug/alcohol support. Those things can lead to less attendance at A&E, less begging or less of the “revolving door” in the criminal justice system.

Building that rapport with the individual should also help in providing appropriate services. We also think about what good mental health means. It’s about a person’s attachment to others, understanding the effects of childhood trauma and the capacity to form healthy relationships.  We recognise that the people we work with have the same values as we do; to form healthy connections with others, to understand and be understood, to trust, to have safety, to be accepted, to contribute and for equality.  This understanding forms the basis of our work.

We work in partnership with voluntary sector organisations and the local authority who support homeless people, helping them to understand how mental health affects people.  We need to base our interventions in relation the individual’s motivation to engage and motivation to change problematic behaviour while recognising the effects the environment has on that person’s motivation.  This understanding can form the basis for all of us to be psychologically aware and trauma-informed in our practice.

Our small team is made up of a clinical psychologist, mental health nurses, a social worker, an occupational therapist and a psychiatrist.  We are committed to being a psychologically informed team in line with the wishes of the peer-led mental health and homeless action group.

We strive for constant development to provide a clinical and cost effective service while adding to the evidence base for homeless individuals who experience mental health issues.  We recognise the limited capacity of our resources and work closely with other Greater Manchester Mental Health Trust (GMMH) services to reduce the barriers for mental health support for homeless individuals. GMMH has made homelessness a priority for all services, with both a housing and homeless strategy in development.   GMMH is also a partner in the Greater Manchester wide Housing First Project to provide diagnosis and support for mental health and substance misuse.

The work with homeless people can be difficult but it is also a great privilege gain trust and to bear witness to stories of survival, and to know we are helping people to get to a better place.

How can you access our services?

  • Speak with your GP
  • Speak to any other healthcare professional or anyone involved in your care
  • Attend our drop in service.
  • Self-refer via the GMMH gateway service – 0161 276 53 65

For further information

GMMH website

Support for homeless individuals in Manchester

Peer-led research by the Manchester Mental Health Action Group

Latest developments and best practice mental health homeless

Homeless autism toolkit

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