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March 16, 2023

Homelessness and mental health: The need for tailored support services

We are pleased to share that we have published an updated version of our Evidence Note that looks at homelessness and mental health. This Evidence Note provides a summary of the latest research from across the globe in an easily digestible guide for people working in and around the housing, homelessness and health care sectors.

Homelessness is a complex issue that affects individuals, families and communities across the world. One of the most significant challenges that many people experiencing homelessness face is their mental health. In fact, mental health support is the most common need among households who approach local authorities for homelessness assistance, and those experiencing street homelessness have even greater levels of mental health support needs.

Through the Rough Sleeping Strategy for England published in 2022, the UK government has committed £30 million for health interventions, including dual diagnosis work and mental health support. The NHS Long-Term Plan for England also sets out the intention to reduce the number of people who are sleeping out because of, or with, mental ill-health through the provision of specialist rough sleeping mental health services. 

Despite these commitments, further research is necessary to thoroughly understand the links between poor mental health and homelessness to make sure that it is handled more effectively. Some robust evidence from North America and the UK suggests that integrated support models can be effective at improving both housing stability and mental health outcomes. Such models bring together professionals from several disciplines such as drug and alcohol support, mental health, and homelessness outreach services to provide tailored support to assist an individual. Examples of effective integrated support models include Assertive Community Treatment (ACT), Community Engagement and Planning (CEP), and Family Critical Time Intervention.

While there are other mental health treatments with positive evidence of impact, most of the evidence is not specific to people experiencing or at risk of homelessness, and doesn’t measure housing outcomes. However, interventions for people who have experienced trauma, such as individual trauma-focused cognitive behavioural (TF-CBT) and eye movement desensitisation and reprocessing (EDMR), have shown to positively impact Post Traumatic Stress Disorder symptoms for people exposed to complex trauma.

Given the existing evidence on mental health and homelessness, we believe that more needs to be done to improve the current evidence base. However, identifying problems earlier amongst those who are experiencing or at risk of homelessness, including children, across a range of settings, and facilitating timely access to integrated models of support would be beneficial. 

Addressing mental health is crucial to tackling homelessness, and it is essential that governments and organisations prioritise and tailor mental health services to ensure that people experiencing homelessness can access the support they need to rebuild their lives.

Find out more about our updated Evidence Notes.

Stacey Kelly is Communications Lead at the Centre for Homelessness Impact

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