The journey of street homeless people using Croydon's health services

Healthwatch Croydon undertook research on the journey of street homeless people using health services in Croydon. They spoke to 50 homeless people between April and December 2019 through organisations including Crisis, the Salvation Army, Nightwatch and Rainbow Health Centre. The research found that unemployment, poor physical and mental health, relationship breakdown, financial difficulties, domestic abuse and immigration issues were common reasons for becoming homeless. Around a quarter of respondents reported having a physical or mental disability, and 30% had been homeless for between two and five years. 

Most respondents said they found it easier to access health services than in a similar study conducted two years earlier. Many had used GP services, hospitals, pharmacies and A&E departments, although some still experienced barriers due to disability, language difficulties, lack of GP registration or immigration status. Dedicated homeless services, particularly the Salvation Army, Rainbow Health Centre and Crisis, were viewed very positively and were reported to have made a significant difference to people's health and wellbeing. 

The strongest message from participants was the need for stable accommodation. Many also wanted employment, financial support, help with benefits, mental health support, counselling and treatment for physical health conditions. Respondents described the impact of homelessness on their wellbeing, including trauma, depression, anxiety, addiction, poor physical health and social isolation. While many praised local support organisations, some felt mainstream services were not always designed to meet the needs of homeless people and that they often struggled to get the help they needed. 

Healthwatch Croydon recommended maintaining permanent accommodation options for homeless people, improving access to employment and training, providing dedicated therapy and rehabilitation services, strengthening support for people awaiting immigration decisions, enhancing access to health services and increasing support with benefits and income. The report concluded that while access to services had improved since 2018, street homeless people continue to face complex and interconnected challenges that require a coordinated response from housing, health and support services.