Dominic Williamson

Ten ways to better homeless health

December 8, 2016 :: 3.16pm
Health (2)

Executive Director of Strategy and Policy Dominic Williamson spoke recently at the Westminster Social Policy Forum about homelessness, health and inequality. Here he gives us ten examples of work to improve homeless health.

The average age of death of people sleeping rough or in homelessness hostels is 47. That figure underlines just how closely linked health and homelessness are.

Unfortunately, homelessness has been increasing in England in recent years. Rough sleeping has more than doubled since 2010.

The government has accepted that there needs to be action to tackle heath inequalities for people who are homeless,  But translating good intentions into better healthcare remains an enormous challenge.

We know that many people sleeping rough have a mental health problem – and that this group tend to spend longer living on the streets. But just this month we published research that shows that in two thirds of areas with high levels of rough sleeping there are no mental health services commissioned to work with people sleeping rough.

We have a long way to go to make to make good health care and health promotion the norm for homeless people.

Fortunately, we are not starting from scratch. In my recent speech to policy makers at the Westminster Social Policy Forum, I gave ten great examples of work to improve homeless health:

  • For local health leaders, I talked about our Charter for Homeless Health. We are pleased that 44 Health and Wellbeing Boards have already signedup and pledged to measure, understand and meet the health needs of homeless people.
  • For commissioners, the first step should be conducting a Health Needs Audit. Homelessness and levels of need will vary from area to area, and this toolkit from Homeless Link helps every area look closely at their local situation.
  • For health leaders thinking big on homelessness, the London Homeless Health Programmeis one example of regional work aiming to improve health responses across the capital. Their report called More than a Statistic commissioned peer researchers to explore homeless people’s experiences of using health services.
  • For health professionals working with people who are homeless, I recommended the Faculty for Homeless Health for support and guidance.
  • For hospitals, the fantastic multi-disciplinary Pathway service is now operating in Manchester, Brighton, Leeds, Bradford, London and other places, providing support for people admitted to hospital while homeless.
  • For mental health services, the ACE service from St Mungo’s in Bristol reaches out to people and groups who are currently underrepresented in mental health services.
  • For housing projects, an example of good practice is the St Mungo’s Hammersmith and Fulham Health and Homelessness Project. A co-ordinator and a team of volunteers regularly gather data across supported housing projects, recording missed appointment and ambulance call outs to find out where extra work is needed to help people access treatment.
  • For better wellbeing and prevention, I thought about the St Mungo’s Putting Down Roots gardening project. Projects that engage people in what they love doing promote better health and wellbeing and are crucial to prevent illness before it happens.
  • For real people power, I always look to our clients for the best examples. Last week I received a flyer for a new Fitness Walking Group.A group of students at our recovery college are planning to climb Snowdon next summer, and set up the group aspart of their training.For me, better wellbeing goes hand in hand with empowering people.

Sir Michael Marmot, Director of UCL Institute of Health Equity said: “My argument is that tackling disempowerment is crucial for improving health and improving health equity. I think of disempowerment in three ways: material, psychosocial and political.”

The golden strand running through many of these approaches is that people with experience of homelessness can help reduce inequality and create a better health service.

In that spirit please do watch the film ‘My Health My Story – the challenges for Hackney’s Homeless’, made by and for some of St Mungo’s clients in Hackney about their experiences of health  services with the help of  Spice Time Credits and funded through City and Hackney CGG.

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