A systematic review just published by the Centre for Homelessness Impact shows that accommodation interventions which include high-levels of support are more successful in terms of both housing stability and health outcomes. It also shows that the most basic types of accommodation could be worse for individuals than providing no intervention at all.
This spoke to me, because for five months last year I stayed in a ‘high risk homeless hostel’ for 16-25 year olds.
I’m not quite sure what made it ‘high risk’, but I’m guessing it was because we were all classed as having ‘complex needs’. Everyone has pretty complex needs in one way or another, so phrases such as this and ‘high risk’ only marginalised those of us that the service was supposed to be helping. In this context, it meant we were all experiencing homelessness, alongside one or more of; physical or mental health problems, problematic substance use, offending behaviour or had previous experiences of trauma.
If I was designing a homelessness service, my first thought would be to not call it ‘high risk’, what message does that send to both the young people living there and the general public – that we were a risk to them? My second thought would not be to house 18 young people under the same roof, most of whom had experienced trauma. Imagine the potential problems if you housed that many people, of any age in the same building. Then add in the problematic substance use, the experiences of trauma, the physical and mental health problems, and then the hormones; you get the gist.
The hardest part was the drugs. Although there was supposedly a strict ‘no drugs’ policy in the building, it didn’t make a difference. Unless the staff caught you smoking weed in your room (and the whole hostel smelt of it) or dealing on camera, there was nothing they could do, because most drugs don’t smell and are easily concealable.
Obviously the drugs made everything else worse; the arguments due to the comedowns, the fights about money and the antisocial behaviour.
Although there were staff or security guards at the hostel 24/7, once the staff finished at 9pm and the security guard started it was pretty much party time. It was easy to get sucked into; to begin with it was the peer pressure, but then it was the awareness that even though it was only a temporary fix, drugs made everything slightly easier to deal with. It also meant acceptance from the people I had to live with.
After a while I became aware that whilst the drugs were a quick fix, they were only making things worse in the long run. The come downs, the elevated anxiety and the increased irritability.
It got to the point where I learnt to say no to the drugs, but standing up for myself created a whole host of other problems; more arguments, violence and hostility. There was a pack mentality, so if you upset one person everyone else jumped on the bandwagon and it was suddenly you against the rest of the hostel.
I was pushed, spat at and threatened – but while I was in that environment none of it seemed like such a big deal, it’s only looking back that I realise how toxic it was. I’m not sure how they expected any of us to make progress whilst living in such an unhealthy situation.
One of the other challenges was the temperature; it was freezing as the building wasn’t originally designed to be accommodation and was repurposed. Each of the huge rooms had two tiny electric heaters that were ridiculously expensive to run, with one heater costing around £1 for 20 minutes. When you’re surviving on the basic rate of Universal Credit at £240 a month, you have more important things to pay for and so the room stays cold.
Whilst when I lived in the hostel I was not mentally well enough to hold down a job, none of us were given any incentives to work. Unless it was cash in hand, once we were working for more than a few hours a week we had to pay rent, which was extortionate. The council paid £240 per week in housing benefit to the hostel, which we had to start picking up once we were working. Opportunistic drug dealers would exploit one or two of the young people living in the hostel, getting them to sell drugs to the others, on the premise of earning a few extra pounds cash in hand, which wouldn’t affect their benefits.
Temporary accommodation is far more expensive than settled accommodation, with Local Authorities spending roughly £4 from every £10 they spend on homelessness, and experiences like mine show that it is delivering very poor outcomes. Whilst my stay in the hostel was costing £240 per week in housing benefit, ONS data shows that within the Borough of Scarborough there were one bedroomed flats available from upwards of £400 a month, which tells us that there can be far cheaper options which should be considered.
It wasn’t without positives; the regular activities, the support from staff and a level of independence which I hadn’t had previously in my supported lodgings placement.
It opened my eyes to the reasons why people, including myself, can sometimes behave the way they do. When you experience toxic stress or severe trauma at a young age it alters your sense of self, because survival takes precedence over normal development. Many of the young people staying in the hostel had been through various forms of trauma, and as many of them weren’t able to access treatment it was left unresolved, meaning many of them (and me when I first moved in) remained in survival mode. The main focus was maintaining a sense of safety in relation to other people and the environment, for many that included taking drugs to numb the emotional pain. Research from the Early Intervention Foundation backs this up and demonstrates the damaging, life-long impact of adverse childhood experiences on a wide array of outcomes.
There was always a waiting list for the hostel and whenever someone moved on the room was filled the same day. Official Statistics show that around 17,980 young people were owed a homelessness duty in England in 2019-20, however this is an underestimate. The numbers tell us that the demand is there, but some things clearly need to change.
The systematic review also found that Involving people in decisions about their housing options and placement is considered essential to the success of any intervention. When I was staying in the hostel, I was aware that I could be told I was moving on at any point with only a few days notice, with no choice in where I would be going. That creates another level of fear and uncertainty, especially when you don’t have a choice in where you are moving to. If young people who are experiencing homelessness are provided with settled accommodation from the beginning, we remove that element of fear.
In my opinion, young people experiencing homelessness should have access to mental health and trauma therapy, so that there is a focus on the often deep-rooted reasons they behave the way they do. Similarly with access to drug and alcohol treatment, a focus on why they may turn to drugs and alcohol to cope instead of just trying to treat the behaviours. CHI’s systematic review points out the importance of a person-centred and holistic approach including flexibility in support work, a non-judgemental approach and clear communication.
When I was living in the hostel it was hard to recognise the unhealthy coping mechanisms and behaviours that I picked up and was involved in, making it more difficult to distance myself from them. It was only when I met a new group of people and one of them truly had some faith in me that I was able to remove myself from that crowd and start to turn things around.
I recognise that I was able to get out of it because I had people who truly believed in me, which I know a lot of young people might not have. So whilst housing conditions are incredibly important, positive relationships can also make all the difference.
There is still a huge gap in terms of understanding what happens in other, related domains and therefore more research is needed in areas such as employment, income and wellbeing and how they are affected by accommodation types.
You can read the accommodation review here.
If you would like to discuss the findings of the review, or how they might influence the design of your service, you can contact us at firstname.lastname@example.org.
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