Why do people experiencing homelessness struggle to get support? One answer seems obvious. With no fixed address, how can councils, the NHS, and other public services keep in contact with them?

But there are far more reasons for this struggle. And far better and more scientific ways of figuring them out than speculation. You just have to ask people who have experienced homelessness themselves. So says Samantha Dorney-Smith, an academic and nurse who has worked with people experiencing homelessness for more than two decades. “It can be very difficult to empathise and put yourself in someone’s shoes,” Ms Dorney-Smith says. “All the evidence suggests that you need to really get alongside people and ask them directly what they want.”

Ms Dorney-Smith is also an independent adviser to the Outreach with Health Specialism project, part of the Test and Learn programme which is being co-ordinated by the Centre for Homelessness Impact and funded by the Ministry of Housing, Communities, and Local Government.

This programme is rigorously evaluating a number of interventions to help people experiencing homelessness and several are being shaped by a panel of lived experienced advisers. They are providing essential input and training to those running these projects. They’ve shared their often hard-hitting experiences of how they were treated when experiencing homelessness, ideas about how services might be improved, and share a hope that through their involvement they may even influence Government policy on the matter.

Ms Dorney-Smith says her work with panellists on the project has shown her once again the importance of asking people with lived experience of homelessness about what they think. “I’ve worked on projects where I thought access to care was about the struggle to get an appointment. But the service users said, no, no, no. It’s not just that,”  she adds. “They’d had appointments but had just felt they had been told off. They’d been told, for example, if you continue doing that, you're going to lose your leg. But this can feel very threatening and and can just push people away. They’d also often been given leaflets that they couldn't read or didn’t make any sense to them.”

One of the lived experience advisers on the Test and Learn programme has helped train nurses running the Outreach with Health Specialism project. “I was homeless on and off for a few years and the services I received were not great,” she says. “People would often look down on me. There are a lot of people who do judge. They can think that people experiencing homelessness are all on drugs and don’t realise their experience can differ from another homeless person. They don’t seem to realise that homeless people are human. They have just had bad experiences or their lives have not gone the way that they want.”

She says public services need a more “empathetic” approach to helping people experiencing homelessness. “After being through what I’ve been through this has given me a voice to change policy and create a different narrative about people experiencing homelessness, and help them get further in life” this panellist says.

Another panel member has helped shape the Support For Non-UK Nationals project by sharing her experience of homelessness as an asylum seeker and refugee.

“I was homeless for a couple of years because I really struggled after getting my refugee status,” she says. “I was told I had one month to leave my accommodation and that I had to go to the Job Centre. But it wasn’t that easy. I was without work and didn’t know how to get a job. Nobody helped. I ended up in a hostel and sleeping at my friends’ for years.”

She hopes her input will help reduce the number of asylum seekers who are experiencing street homelessness and have limited recourse to public funds due to their immigration status. “You can learn to speak English but you don’t know what your rights are. You might know the rules but not know how things work. People don’t know what we go through. The transition from asylum seeker to refugee was very hard. I hope more people can get support so you can lower the number who are homeless.”

Lived experience voices have played a critical role in informing the Test and Learn programme’s research and evaluation, as well as contributing to intervention design and delivery. By listening to these lived experiences, we hope to not just change the conversation around homelessness, but to change the outcomes of people’s lives.

Keith Cooper is a freelance journalist