Homelessness & mental health

Dear Matt

Thank you for your offer to help when it comes to bringing together mental health services and those front line staff and volunteers who engage with homeless folk that have mental health issues, who do so on a daily basis. As I have more than intimated, I have frequently felt that in trying to relate to those services that purport to help those with mental health problems, or rather the people who are responsible for running those services, who one would expect to be able to and want to help, to be like banging my head against a brick wall, given their elusiveness and unpreparedness to take ownership of the issue of bringing these services to this particular client group, even if other groups happen to be well served by the organisation.

I don’t wish to be difficult on this matter but life is too short and sometimes given the plethora of things that need to be done it is necessary to leave things we can’t do much about and concentrate on where we can make the most difference, hoping that others will pick up on the things one is unable to do much about oneself. Mental health is a strange subject – we all have it or don’t to varying extents but, as you can appreciate, our homeless friends are more likely to have more mental health issues than those who aren’t homeless, and that has been my experience. The problem may be compounded because of alcohol addiction and our homeless friends being less likely to engage with services that might help!

For me, this is the crux of the issue. It is true that vulnerable people often don’t tell you the things you need to know in order to help, but I am pretty sure these folk do not engage with mental health services and such is the nature of the beast that in this regard those that most need the help don’t always recognise or seek it, besides which, living on the streets makes if difficult anyway. When we work with homeless folk, not only do we sometimes feel out of our depth as we try to help, but the mental health “professionals” are noticeable by their absence. The wisdom these days, which I endorse, is if we are to make serious inroads around tackling issues to do with homelessness then all “interested” parties need to be involved. Often when there is such a coming together and progress is made as a result, statutory mental health services are absent.

Some may say: “so what”? I am not in the position to say to what extent having a mental health presence will have improved matters but my feeling is that it would have. Firstly there is the matter of access to mental health related services e.g. biomedical and therapeutic – often not happening. Secondly, there is the matter of benefits – how many people with mental health problems are on the wrong benefit, typically Job Seekers Allowance, where the chances of getting sanctioned are high and getting a job low or non-existent? Thirdly, there is the matter of accommodation, hard enough anyway in the current climate, but if something mildly suitable is found there is the issue of support! These are three points from the top of my head, and there are more, regarding which, having mental health services on board, even if only taking a small part when it comes to doing what is needed, might make an important difference.

People like me who work at the coal face often do not fully realise that in the statutory world and, while voluntary organisations can help we do need statutory mental health on board too, there are those that provide services and those who commission them. At the point meaningful dialog is embarked upon between those working with homeless folk with mental health issues and statutory mental health service providers, and right now I don’t think I am even at that point, the comment may well come back – I am talking to the wrong people and I really need to be dealing with those that commission services. Be that as it may, it is wrong, it is very wrong that homeless people don’t get the help they need, particularly if, as I am told, help is out there. But what is the point of help being out there for those who need it, when those who need that help do not get to access it?

You ask me about practical solutions. Firstly, please get your statutory service provider act together and someone needs to take responsibility. Secondly, talk to those of us who work with homeless folk with mental health issues. Thirdly, assign a mental health professional, a community psychiatric nurse (CPN) or equivalent, to one of the services working with the homeless. In Southend, I suggest work with HARP, as they are the biggest and main service provider, who have a shrewd idea of which clients would benefit from such help. The “worker” can then work with projects like the Church Winter Night Shelters and Street Spirit. That person needs to have lots of wisdom and empathy and may well need to use subtle subterfuge in order to gain the trust of those who need help.

I don’t have too many answers but I do know that in my own town of Southend there is a sizable need, and I have no doubt this is repeated elsewhere in the country. Anything you can do to help, or bring your influence to bear, will be much appreciated.

Kind regards


Matt is not the real name of my friend but Matt is a real person who has an interest in the subject of homelessness and mental health and a position of influence. The letter is real and the issues current.


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