Homelessness and mental health: adding clinical mental health interventions to existing social ones can greatly enhance positive outcomes

Abstract

Purpose

This paper seeks to discuss the association between homelessness and poor health, both physical and mental. A pilot project run by St Mungo's suggests that adding clinical mental health interventions, notably psychotherapy, makes existing social care interventions several times more effective, enables deeper recovery, and frees people to move on across all the domains of their lives.

Design/methodology/approach

St Mungo's was awarded a grant by the Cabinet Office as one of the national pilots working with “adults facing chronic exclusion” (jointly funded by the Department of Work & Pensions, Ministry of Justice, Department of Health, Department of Communities, and Department of Families and Children – because these clients impact on the remits of all these departments). The aim of the project was essentially simple: to test the hypothesis that, if chronically excluded adults were excluded because of their psychological disorders, then could a psychotherapeutic intervention reduce their exclusion?

Findings

Recently, 274 people have attended for therapy; 30 per cent of these are women, 70 per cent men, with 68 per cent white and 32 per cent black. In total, 30 per cent did not come to the initial assessment session, and there are many reasons for this, for example, people abandoning or being evicted from their accommodation, death, imprisonment and resettlement. Some were also referred without proper consultation, so that when they were contacted it turned out they did not want psychotherapy or, in a few cases were already accessing it elsewhere. Of those who did attend assessment, 80 per cent went on to attend four or more sessions; most clients attended either two to four sessions, or more than 12. Attendance overall was 76 per cent, and non‐attendances were noted on 11 per cent of occasions.

Originality/value

Many homeless people become caught in the “revolving door” of hostels, prison, hospitals and the streets, often for many years. This paper argues that this form of homelessness affects people because of their mental health, and that social solutions alone are not sufficient, which is why the door continues to revolve. Offering appropriate clinical interventions alongside existing social ones could begin to transform this situation.

Citation

Cockersell, P. (2011), "Homelessness and mental health: adding clinical mental health interventions to existing social ones can greatly enhance positive outcomes", Journal of Public Mental Health, Vol. 10 No. 2, pp. 88-98. https://doi.org/10.1108/17465721111154284