World Homeless Day: The Intersection of Mental Health and Homelessness

There is a strong link between homelessness and poor mental health, so to mark World Homeless Day 2024, we’re exploring the cyclical nature of homelessness and mental health issues, and how the system could be improved. 

10 October 2024

People experiencing homelessness face significant barriers when trying to access mental health services, and this can add more stress to already challenging circumstances. 

But what are these barriers, and what are some systemic changes we’d like to see that could help break this vicious cycle? For this blog, we spoke to some of our Glass Door caseworkers for insights from the frontline. 

It’s World Homeless Day and World Mental Health Day 

World Homeless Day was founded on 10 October 2010, emerging from online discussions all over the world about how to respond to homelessness. It exists to raise awareness about homelessness, advocate for improved policies and funding, and promote the work of local communities who fight to end homelessness. 

World Mental Health Day was created almost two decades earlier in 1992, to educate the public and decrease stigma surrounding mental health issues. Although these two days aren’t officially linked, it’s apt that they fall on the same day, considering the close link between mental health and homelessness. 

The relationship between homelessness and mental health in the UK 

The hugely detrimental impact of homelessness on mental health is often overlooked. While you may be aware of some of the physical impacts of homelessness, including sleeping on a cold pavement or friend’s sofa, going without nutritious meals, and having no permanent place to keep personal belongings, the negative effects it has on mental health are some of the most profound. 

Imagine wondering where you’re going to sleep every night, feeling anxious for your own safety, and being treated like you’re invisible. All these things add up, creating extreme levels of stress and anxiety, and this mental toll can make it even more difficult to go through the taxing process of finding a route out of homelessness. 

Furthermore, the existence of a mental illness, whether diagnosed or undiagnosed, can act as a trigger, pushing someone facing difficulties into homelessness or greatly exacerbating their circumstances once they become homeless. 

To put things into perspective, Homeless Link’s The Unhealthy State of Homelessness 2022 Report states that the number of people experiencing homelessness with a mental health diagnosis increased from 45% in 2014 to 82% in the period 2018-21. This is a significant and worrying increase. 

Being homeless is inherently traumatic, but also exposes people to a range of traumatic experiences, including violence and exploitation. If you compound these experiences with any previous traumas – for example, research by Northumbria University and Homeless Link found that 94% of people facing homelessness have experienced trauma, often at multiple stages in life – then you can understand why statistics around mental health issues and homelessness are so high. 

Barriers our homeless guests face when trying to access mental health services 

So, what are some of the main barriers to accessing support? Three of our caseworkers – Zara, Alice and Karolina – suggest the following three barriers are some of the most significant. 

Underfunded mental health services 

Mental health services are struggling to offer adequate support to people in need due to a lack of funding and resources, and this includes those experiencing homelessness. In 2023, the NHS said that more than 1.8 million people were on the waiting list for mental health services. 

Due to the limited resources of mental health services in London, services are often reluctant to work with a guest until they have reached crisis point. This presents challenges for frontline services like Glass Door, as we are left to support guests with complex mental health issues.

– Alice, Senior Caseworker, Multiple Disadvantage at Glass Door 

As you might imagine, supporting people who are both homeless and experiencing mental health difficulties requires a specialist response, and many support services do not currently have the resources for this. 

Borough boundaries impacting rough sleepers 

Another challenge we often run into is that London boroughs usually require rough sleepers to have a local connection in order to receive support. This is particularly an issue when it comes to women – many women experience what we call “hidden homelessness” because they move around a lot for their own safety, often sleeping in different places every night and sofa surfing when they can. 

Getting mental health support when you’re rough sleeping is difficult; it’s often the borough’s responsibility but rough sleepers don’t always live in one particular borough.

– Zara, Glass Door Caseworker 

Moving around regularly can affect the support available to people experiencing homelessness, as it can be a challenge to find a borough that will accept responsibility for someone who can’t prove/demonstrate a consistent local connection to that area. That’s why it’s vital for London boroughs to be able to link up more easily. 

Communicating with different services 

It can be challenging to get different support services to work together. This can include healthcare providers like A&E, mental health services and GP surgeries, housing and social care providers, legal services and more, depending on a person’s situation and support needs. 

It's a very frustrating cycle where different services don't have the means to communicate with each other properly, so they can't come together to find a solution.

– Alice 

This difficulty often arises because services are overstretched and trying to function as well as they can under pressure, but supporting people experiencing homelessness often requires a coordinated response between different services.  

If there was an agency that joined up services in each London borough, including housing, social care and the NHS, this would help make sure that people experiencing multiple disadvantages don’t fall through cracks in the system. 

It doesn’t help that contacting services in the first place can be a challenge, especially if you’re experiencing homelessness and don’t have full access to a phone or computer. This can lead to digital exclusion. 

You can't go in person or to the building if you need to contact many of these services. You have to call, and if you need to call, you need to have a phone and you need to have money on the phone.

– Karolina, Glass Door Caseworker 

How Glass Door supports those experiencing homelessness and mental health issues 

At Glass Door, our Casework service exists to help people access support that they would struggle to find themselves, and this includes trying to connect them with mental health services. 

We have a Multiple Disadvantage Caseworker, Alice, who specifically works with more complex cases, where people experiencing homelessness also face other difficulties at the same time, i.e. multiple disadvantages. 

As the Multiple Disadvantage Caseworker, I work with guests who may be experiencing complex issues and have a number of different support needs. These could include mental health issues, drug and alcohol dependence, fleeing domestic abuse or having a long history of entrenched homelessness.

 – Alice 

Our caseworkers help guests access mental health assessments and refer them to talking therapies (like CBT) and specialist drug and alcohol support. In the past year alone, our caseworkers referred 86 guests to health services, including a wide range of mental health services. 

We hope to continue connecting people experiencing mental health issues alongside homelessness with the appropriate services, offering support and hope where it’s needed. 

How could the system be improved? 

While there’s no easy fix when it comes to the intersection of homelessness and mental health, there are some things that would help break down some of the barriers that our guests experience.  

We need better funding and more resources for homeless mental health services.

– Alice 

The new Labour government has pledged to modernise the Mental Health Act, including promising to invest in mental health services, expand the mental health workforce, increase the number of mental health workers in schools, and create a national network of early support hubs for young people.  

Additionally, the government recently confirmed that housing secretary Angela Rayner will lead a new cross-government taskforce to reduce “shameful record levels” of homelessness, working with mayors, councils and health services. Together, if they are implemented, these pledges show promising signs for the future of mental health and homelessness services. 

With these changes in place, we hope to see an increased capacity of mental health services in London and improved access to support for people who are experiencing homelessness.