Access to Health Services
What is this intervention?
Access to health services for people who are homeless is complex and sometimes requires delivery through unconventional means. Interventions may provide access through mobile street outreach or through health professionals attending a non-traditional setting such as a hostel or shelter. Individuals may have multiple and complex needs relating to their mental and physical health requiring enhanced care.
People who are homeless have comparably poorer mental and physical health than the general population. This means that they have a greater need for access to health services, but many people experiencing homelessness do not regularly see a doctor.
The reasons for this lack of engagement with health services are multifaceted. Firstly, in countries without a free healthcare system, people who are homeless may not be able to afford to visit a doctor. They may prioritise food and shelter over their health needs. Secondly, correspondence with health services can be difficult without a phone or permanent address. Thirdly, the individual may experience prejudice and discrimination when trying to access health services, or fear these attitudes and therefore avoid health services.
What is its goal?
Access to basic health care services is as a fundamental human right. Through regular and appropriate contact with health care professionals, morbidity and other outcomes related to ill health are reduced. Access to health services is more complicated for people who are homeless and therefore interventions are needed to reduce the barriers to healthcare faced by homeless people. Individuals who are homeless are also more likely to have multiple and complex health needs, such as mental ill health and substance misuse, which will require a specialist approach.
Access to appropriate healthcare represents much more than improved health outcomes. The empowerment and self-esteem associated with health autonomy is a central aspect of quality of life. Interventions provide access to healthcare that is appropriate to the specific needs and circumstances of homeless people.