We’ve known for some time that people being discharged from institutions such as hospitals, mental health facilities, prison, social care or armed forces face high risks of homelessness for a number of reasons.

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Some people become homeless because they were homeless before entering an institutional setting or because previous accommodation arrangements have broken down or are now unsuitable.

This is review looks specifically at the effectiveness of discharge programmes for people who are homeless or at risk of becoming homeless - the first of its kind.

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Findings

• Overall, discharge programmes can be effective at reducing homelessness
• Discharge interventions were likely to improve housing stability and reduce the number of hospitalisations. Some evidence suggests they could reduce incarcerations
• Communication and coordination between all service providers, the need for a clear written discharge plan prepared in consultation with the person, and the need to make the right training and experience available to case-workers are all key in the implementation of discharge interventions

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Case study

John had been in and out of prison for over 30 years. Discharge was the same each time; a small amount of money and nowhere to stay.

'In 2016 I was released with £42. I didn’t get the sleeping bag they were supposed to give us because the prison had run out. You’d have thought there would be support around housing because if you go to prison for a long time you lose your home. You have to wait a month before you can claim benefits, you have no options. I was given no help whatsoever and told to report to a probation officer.'

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How we went about it

This systematic review explores the existing evidence of the effectiveness of discharge programmes for people living in institutional settings such as in-patient health facilities, the armed forces, and prison. Even if the number of studies included is small, of mixed methodological quality and exclusively from the USA, it underscores that discharge programmes can be effective at reducing homelessness.

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What's next?

The results are encouraging as they show that discharge programmes can be effective in reducing homelessness and hospitalisations and may be effective in reducing re-incarceration post-discharge. However, the evidence is of mixed methodological quality, exclusively from the USA and limited to only a few outcome domains. Thus, more, high quality research is needed to improve the evidence base for the effectiveness of discharge programmes.

Find out more about how we can ensure that people leaving prison have both safe accommodation and immediate access to services, and what role this plays in reducing reoffending in the panel discussion below.

Rosie Reynolds, Practice and Partnerships Lead at Centre for Homelessness Impact (Chair),Dalton Harrison, Trans and prisoner rights activist, poet with lived experience, Paula Harriott at Prison Reform Trust, Lorna Griffiths, Pre-Release Coordinator, The Nelson Trust, explore this topic at the 2022 Birmingham Impact Forum

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Team

Jennifer Hanratty, Queen's University Belfast
Sarah Miller, Queen's University Belfast
Jayne Hamilton,
Ciara Keenan,
Christopher Coughlan

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