Health access and homelessness

Healthwatch Salford undertook a follow up to their May 2018 report on health care access and homelessness.  This research focuses on rough sleepers and their access to mental health and drug and alcohol services. A survey was designed, and 25 rough sleepers were engaged over a 3-month period, starting at the very end of October 2018. The survey was designed to capture experiences across specific services and allowed for more expansive answers for some of the questions.

Key findings

• Family was important to homeless people where they had kept in contact with or had young children. Location of temporary accommodation would have an impact on wider family life if too far away and the ability to parent for those with children.
• Some would contribute to the cost of accommodation if they were working and could afford it.
• There were some reservations and concerns about sharing living spaces
• Clear and professional boundaries were seen as important but with a fair approach if mistakes are made
• Those that could cook preferred to prepare their own meals if there was a kitchen
• People talked freely about good and bad staff attitudes, having experienced both when accessing services
• Most people were negative about their experience of using night shelters
• People were positive about drug and alcohol services but more negative about mental health services
• Many people walked to services but if they had money or a pass would use public transport
• 14 out of 25 people spoken to were accessing mental health, drug or alcohol services
• 24 out of 25 were male
• 10 out of 25 said they had a long-term medical condition or disability
• The participants were aged between 18 and 60+.

Rough sleepers are often high users of services and so it is not surprising that they have had both good and bad experiences. It is however concerning that night shelters and mental health services had the most negative comments. This is especially concerning because rough sleepers often access these services when they are at their most destitute and vulnerable. It was noted that two people with an urgent mental health need that turned up at Salford Royal A&E left feeling unsupported, with one of them swearing to never go back there again. Whilst this was a small sample of rough sleepers there was significant reporting of negative experiences and comments about staff and service approaches. There is clearly both a need for more staff training and support and service user involvement in the review and design of services.

Recommendations

• Commissioners of these services should consider reviewing the services with the most negative comments. They should also recommend they look at the good practices demonstrated by other services, as commented on in this report.
• Commissioners should consider reviewing the quality of night shelter services. It is important to engage staff and services users in this process and in any proposed changes to improve the service and ensure staff and service users are getting the support they need