Wednesday 20 February 2019

Why Housing Encourages Stability, Security & Improves Mental Health

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By now, we know that there is a distinct link between mental health and homelessness: mental health is both a cause and consequence of homelessness. 26% of homeless people in the UK cite mental health problems as a reason for being homeless. 45% of the UK’s homeless population has been diagnosed with a mental health problem, compared to 25% of the general population — a clear indication that poor mental health is exacerbated by homelessness (and this figure doesn’t even include those who haven’t been officially diagnosed). 

While there is still a stigma attached to mental health, awareness and understanding are gradually improving. However, homeless people are at risk of being excluded from the conversation. It’s our duty to understand the impact homelessness and mental health have on each other and to keep an open dialogue about cause, consequence and solutions.  

Below, I’ll look at the two-way relationship between homelessness and mental health, and delve into why adequate housing is much, much more than just a dry, warm space. 

Negative effects of homelessness on mental health 

According to the charity Shelter, there are more than 300,000 people registered as homeless in the UK at the moment. And that isn’t even taking into consideration those who haven’t registered as needing housing assistance. These are the ‘hidden homeless’ – those who are sleeping on sofas, staying in unsafe places or inadequate housing. 

Here are some of the effects that homelessness has on mental health and those dealing with mental health and issues caused. 

Restricted or delayed access to mental healthcare 

Despite the fact that 45% of homeless people have been diagnosed with mental health issues, and 80% have reported poor mental health, there is still a huge disparity between the number of reported or diagnosed mental health problems among the homeless and the number of people who are treated.   

A lot of the time, mental ill-health just doesn’t get treated – homeless people often don’t get access to the support, services or health care that they need as many practices require identification and proof of address for registration, causing a further decline in mental wellbeing or mental illness symptoms to worsen.  

If accessed at all, the mental health care received by those sleeping rough is often restricted or delayed. Some of society’s most vulnerable people have the worst experiences of our mental healthcare services, receiving treatment that is inadequate, hard to access or just took too long to arrive. 

For those dealing with depression, anxiety, bipolar disorder, PTSD, psychosis and schizophrenia, this is dangerous and life-threatening.  

Lack of stability resulting in worsening conditions 

Homelessness can also negatively impact mental health due to poor living conditions, stressful situations and uncertainty. An Australian study from 2011 discovered the isolation and lack of stability that comes with sleeping rough can cause mental ill-health or aggravate an existing condition.  

Not only can mental health illnesses increase an individual’s chances of becoming homeless, but it also makes them more likely to remain homeless. St Mungo’s 2016 Stop the Scandal investigation found that homeless people with poor mental health are around 50% more likely to have spent over a year sleeping rough than those without mental health problems. This indicates that rough sleepers with poor mental health spend longer on the street. And the longer the time spent being homeless, the harder it is to get back on your feet.  

Positive effects of housing on mental health 

As you can see, the negative impacts of homelessness on mental health – and vice versa – are myriad. Aside from providing a roof over one’s head, how can housing encourage improvements in mental health? 

Encouraging stability and security  

If we have a home, we can often take this privilege for granted, or sometimes forget how important it is. A house is so much more than a roof over your head.  

Having a safe, secure home is a solid foundation upon which our lives are built. It allows us to settle, to feel warm, safe and comfortable, and to become part of a local and wider community. A sense of belonging enables us to forge connections and relationships in the communities that surround us more easily. Research suggests that housing contributes to a sense of self-worth and self-confidence, as housing is perceived as a symbol of status and identity. 

Increased access to the services and support you need 

Housing doesn’t just improve your physical and mental health; it helps you to gain access to services you need through life. Whether it’s getting an appointment with a GP, visiting the dentist, NHS services, or accessing mental health support, the chances of someone being seen when they have a home are much higher than someone who is homeless.  

Despite a survey listing 90% of homeless people as registered with a GP, many of those surveyed said that they did not receive the help they needed, and had even been refused access to a GP or dentist. Many practices request identification and proof of address when registering new patients, throwing another obstacle in the way for those without homes. 

Being housed therefore enables those needing access to a GP or medical care to seek the help they need. 

Improved mental and physical health 

The stability and safety that housing brings also encourages improvements to mood and poor mental health, making conditions more manageable, and improving confidence and self-worth. A report for Crisis (Mental Ill Health in the Adult Single Homeless Population (2009)) details various research showing that as the stability of housing increases, the rate of serious mental illness decreases. 

Having a comfortable, dry, warm home makes it easier to stay physically healthy and manage ongoing conditions. It also means that individuals are less at risk of physical or sexual violence and communicable diseases (such as colds, flu, TB or STDs) because of poor living conditions (shelters can be overcrowded, sleeping on the street can be cold and damp).  

As you can see, there is a clear two-way relationship between housing and mental health. Housing encourages stability, security and improves mental health. If we can act on our research and implement this learning, we could see a reduction in homeless numbers, as well as a decrease in mental-illness related deaths on the street. 

scott mcdougall profile picAbout the author: Scott McDougall (MPharm) is the co-founder and registered manager of The Independent Pharmacy, one of the UK’s leading independent online pharmacies. For more healthcare and treatment advice, visit their website. 

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