The Government wants to end rough sleeping, is it going about it the right way?

    Last week the Government released new figures on the number of people sleeping rough in England. Our Head of Policy, Campaigns and Research, Bea Orchard, takes a deeper look at the figures.

    It’s not unusual for election promises to be greeted with scepticism, and perhaps many took this view of the Conservative Party manifesto commitment to end rough sleeping. It’s still very early days, but since the election in December there have been some positive signs the Government is determined to achieve its target of ending rough sleeping by 2024.

    The Prime Minister has made two visits to homelessness services in London to talk about the commitment, the Rough Sleeping Initiative (RSI) Fund has been extended and expanded beyond 2019/20, and last week a further £236m was announced for ‘housing first style’ accommodation to support up to 6,000 people away from sleeping on the street.

    The annual rough sleeping statistics for England were also published last week, providing an opportunity to scrutinise progress so far, and the distance still to travel.

    What do the latest rough sleeping statistics tell us?

    The statistics show the number of people estimated to be sleeping rough on a single night in England in autumn 2019. They show a 9% decrease taking the total number from 4,677 in 2018 to 4,266 in 2019. This is the second year in a row the number has fallen, which is something of a relief, given the truly shocking rate at which rough sleeping had been rising since 2010.

    However, the number of people sleeping rough on a single night in 2019 is still 141% higher than in 2010 when the current method for recording rough sleeping was introduced.

    A more detailed look at the statistics suggests some of the measures taken by government as part of the Rough Sleeping Strategy are having a positive impact. 244 local authority areas have now received some funding from the RSI Fund since it was introduced in March 2018 and overall these areas reported a 12% decrease in rough sleeping in 2019, compared to the previous year. While rough sleeping in the 73 areas without any funding has continued to rise.

    Not all areas in receipt of RSI funding reported a fall in the number sleeping rough locally. And only 50% of areas in receipt of funding for the first time in 2019 reported a decrease. This should be a reminder that services supporting people to find and keep a home take time to set up, and that new and expanded services are likely to find people who weren’t getting any help before.

    However, it should also be a reminder to government that funding for outreach services and short-term accommodation can only do so much when wider factors such as cuts to council budgets, housing benefit and a shortage of social housing mean more people are pushed into homelessness in the first place and struggle to get the long-term support they need to recover.

    How helpful are the statistics?

    The statistics are widely criticised for not offering a more accurate account of the total number of people sleeping rough over the entire year, rather than on one night. What they do offer is a useful indicator of the relative size of the problem and particular trends which can be monitored over many years. This is essential for holding the Government to account and keeping ministers focused on ensuring a significant, sustained reduction in the number of people exposed to the dangers of sleeping rough.

    Can government action end rough sleeping?

    St Mungo’s is calling on government action to end rough sleeping because we know it can be done. By 2010, 20 years of government action meant the end of rough sleeping was in sight.

    We also know that since 2008, nearly £1bn has been cut from vital homelessness services. Services that provide specialist one-to-one support to help people cope with complex problems like poor mental health, substance use and domestic abuse, and prevent people from sleeping rough in the first place by helping them before they become homeless.

    If the Government is going to end rough sleeping in a sustainable way, then it needs to restore funding to the levels invested before the financial crash and ensure that this funding is maintained long-term. This is why we are calling on government to invest an extra £1bn every year in services that prevent homelessness and end rough sleeping and ring-fence the money so it can’t be spent on anything else.

    726 people died while sleeping rough or in emergency accommodation in 2018. The consequences of not taking further action to prevent homelessness and end rough sleeping should be unthinkable.

    We’re certainly not planning to let the Government lose sight of its commitment on this crucial issue.

    Knocked Back: A tragic loss of human potential

    Our Knocked Back report revealed that at least 12,000 people who are homeless are missing out on potentially life-saving drug and alcohol treatment. Oliver Standing, Director of Collective Voice, reflects on the report’s findings.

    Collective Voice is the national alliance of drug and alcohol treatment charities, whose members collectively support 200,000 people every year. A substantial proportion of these people will not only be dealing with a substance misuse problem but with other areas of severe and multiple disadvantage, including homelessness.

    For this reason, we welcome the publication of St Mungo’s latest report, Knocked Back, highlighting the growing prevalence of drug and alcohol use by people sleeping rough, and its increasingly tragic consequences.

    It will be sadly unsurprising to many in our sector to read that drugs and alcohol caused the deaths of 380 people sleeping rough in 2018 (over half the total number of people who died). But we must remain shocked and appalled at this growing public health crisis, and stay resolute in our ambition to reach the huge numbers sleeping rough who desperately need treatment but at present are not getting it – 12,000 people according to the St Mungo’s report.

    Every year people in the substance misuse treatment sector anticipate with sickening dread the latest drug death statistics. And with every year in recent times bringing more bad news, the dread only increases. In 2018, we know that hundreds of people sleeping rough died as a result of drugs or alcohol. The total number of drug related deaths are even higher, at 4,359. That’s the largest amount since we started counting in 1993 and a 16% leap from 2017’s figures. Those statistics alone make for disturbing reading.

    But what’s really disturbing are the human stories behind the statistics. Our communities have lost fathers, mothers, brothers, sisters, sons and daughters, who will no longer fulfil the promise their parents saw in their bright eyes as children, will no longer laugh or love. These are not just numbers, but a tragic loss of human potential.

    It can sometimes seem hard to determine the real-world impact of public policy making. But surely the seemingly unstoppable increase of this particular type of death marks a clear and significant failure of the public policy and political leadership necessary to protect a very vulnerable group of people.

    When it comes to people who use drugs and sleep rough we can’t ignore stigma as a factor. When people are dying on our streets from conditions we know how to treat we must ask ourselves the question — what is different about this group of people that allows this to happen well into 21st century Britain?

    The most frustrating aspect of this? That the evidence on what works is so very clear. We have a world class compendium of evidence in our “Orange Book” and multiple NICE guidelines. We have a substance use workforce not short of ambition, compassion and expertise.

    It’s welcome to see St Mungo’s Knocked Back report make clear the link between homelessness and drug related deaths. It demonstrates how some substance use outreach services, so vital in reaching people sleeping rough, have been lost in the blizzard of local authority cuts.

    While in 2013, local government was handed the responsibility for commissioning life-saving substance misuse treatment services, but it was asked to do so with one hand tied behind its back. In the eight years to 2020 local government has lost 60 pence in every pound it received from national government.

    It’s welcome to see the report stress the importance of close partnership work across the domains of severe and multiple disadvantage. People’s challenges simply do not resolve into the neat concepts such as ‘substance use’ or ‘mental ill health’ we use to think about the delivery of public services.

    On the frontline, practitioners have of course always known that partnership working across those boundaries is essential. The same can be said for service-managers, commissioners and Chief Executives. National programmes such as Fulfilling Lives and MEAM are making robust coordinated attempts to bring together these services at the local level. These are all to be welcomed.

    In the sector, we have the compassion, ambition and expertise to meet the needs of a great proportion of the people we support — we just lack the resource.

    The government’s new addictions strategy and monitoring unit should both be unveiled this year and will provide important opportunities to drive much needed change.

    I implore the government to set out an ambitious plan for preventing further deaths through the delivery of adequately funded evidence-based services — and I know that effective partnership between the substance use and homeless sectors will be essential in supporting the delivery of such a plan.

    Read our Knocked Back research.

    Find out more about Collective Voice.

    What must be done to prevent homeless deaths

    Photo of origami flowers made to commemorate those who died while sleeping rough

    Following the news of an increase in deaths among people who are sleeping rough or in emergency accommodation, Rory Weal, Senior Policy and Public Affairs Officer for St Mungo’s, discusses what must be done to combat this rising trend.

    Today we heard the news that 726 people died while sleeping rough or in emergency accommodation last year. This is a 22% increase compared to 2017, the highest year to year increase since the Office for National Statistics (ONS) started publishing these figures six years ago.

    These figures should shock and shame all of us. The figure of 726 means that someone dies while homeless every 12 hours – that’s the equivalent of two people a day.

    Moreover, these deaths are overwhelmingly premature and entirely preventable – the mean age of death was 45 for men, and 43 for women. To have so many people die in this way, in such discomfort and distress, failed by so many is nothing short of a national tragedy.

    But this is not the sort of tragedy where we simply pause, pay our respects, then move on, bemoaning the wretched luck of a particularly unfortunate group of people. It is the product of collective choices and decisions, and should be regarded as a national emergency, one which needs urgent action.

    The context to these figures is that rough sleeping has risen by 165% since 2010, the result of years of funding cuts which have devastated crucial services and the unavailability of genuinely affordable housing. More people are sleeping rough, which exposes them to a greater range of harms – a premature death being the greatest.

    To stop people dying on the streets we have to stop them living on the streets. We need to build homes, to make the welfare system truly work for the most vulnerable and to fund homelessness services to help people find a way off the streets, and out of danger, for good.

    And we must also tackle the direct causes of death – the figures show the majority of deaths are so-called ‘deaths of despair’, the result of drugs, alcohol or suicide. Drug related deaths in particular have soared in recent years, and account almost entirely for the increase we’ve seen last year.

    Just as housing and homelessness services have become harder to access, so too have drug and alcohol services, leaving many people languishing with serious drug and alcohol problems and going without the support they desperately need. We still have a situation where most of these deaths will never result in a Safeguarding Adults Review, the legal review process for deaths which have occurred due to  abuse or neglect. As a result vital lessons are going unlearned. We now need a new national system to review each and every death.

    As we consider what we need to do to tackle this emergency, we must remember each and every life that has been prematurely lost in recent years.

    At St Mungo’s, to commemorate those people who died while homeless, our clients, alongside staff and supporters, have together hand made hundreds of origami flowers, in tribute to lives needlessly lost.

    The most fitting tribute of all, however, would be meaningful government action to prevent future tragedies.

     

    The new NHS plan for mental health services has a clear offer for people sleeping rough

    For organisations who have campaigned for many years on homeless health, the NHS Mental Health Implementation Plan is a cause for celebration. Beatrice Orchard, St Mungo’s Head of Policy, Campaigns and Research, explains why the plan must deliver on its ambition to make sure everyone sleeping rough can access the mental health support they need.

    When the Government’s Rough Sleeping Strategy was published exactly one year ago by MHCLG, there were some positive signs that other government departments would also be doing their bit to reverse the dramatic rise in the number of people sleeping rough in England.

    One of the most solid commitments was in relation to improving mental health support for people who are sleeping on the streets. Last month, the details of this commitment became clearer when the NHS Mental Health Implementation Plan was published.

    The plan is clear that by 2023-24, 20 areas with high levels of rough sleeping will have established new specialist mental health provision for people sleeping rough, which will be made possible with £30m of central NHS funding invested for this specific purpose.

    This is a fantastic result for St Mungo’s Stop the Scandal campaign and our continued efforts to press the Government for investment in specialist mental health services to ensure people sleeping rough can access the support they need.

    Sleeping rough and mental health – the links

    It is fairly easy to understand that sleeping rough has a negative impact on a person’s mental health and wellbeing, as well as their physical health.

    Evidence shows people sleeping rough are 17 times more likely to be victims of violence compared to the general population. News reports describe horrifying attacks and abuse on people sleeping rough and our clients tell us about their experiences of feeling lonely, frightened and even suicidal.

    Furthermore, we mustn’t overlook the fact that some people sleeping rough have already been through many traumatic experiences in their lives, including violence and abuse from a young age.

    All of these experiences can cause mental health problems to develop or worsen, but also impact on the type of mental health support people need and how easy they find services to access.

    New avenues into support

    The new, NHS-funded, specialist services will make sure that people sleeping rough can access to clinical mental health support by integrating with existing homeless outreach, accommodation and physical healthcare services.

    They will be required to adopt a trauma-informed approach, known to help improve the psychological and emotional wellbeing of people with complex needs. We also expect the new services to help people who have drug and alcohol problems and are currently excluded from some mainstream mental health services as a result.

    This specialist support breaks down all of the barriers people sleeping rough often face when trying to get help to improve their mental health. Really effective specialist teams can also influence mainstream health services in their local area, encouraging them to become more knowledgeable and understanding of the needs of people who are sleeping rough.

    So far, so good. But what about people sleeping rough in other areas not in receipt of this new funding?

    A welcome step forward

    Research shows 4 in 10 people sleeping rough in England have an identified mental health problem. The latest data from the CHAIN reports on rough sleeping in London shows 50% of people sleeping rough in the capital in 2018-19 had a mental health support need.

    It is welcome, therefore, that the new plan for mental health requires all areas of the country to complete a mental health needs assessment for people sleeping rough and take action to increase access to mental health services for this group.

    This new approach to mental health for people sleeping rough is a real step forward.

    Specialist mental health services have been tried in the past. We know they can make a dramatic difference to individuals’ lives, and help to reduce rough sleeping by supporting people to move on from homelessness for good.

    Better still, it doesn’t stop with specialist services this time. Instead all NHS services will need to think about how people sleeping rough can access the healthcare they need in order to rebuild their lives.

    St Mungo’s will be watching closely and encouraging all areas to ensure the plan delivers.

    Tackling homelessness in Lisbon

    In summer 2018 Ed Addison, Case Coordinator for St Mungo’s project Street Impact London, took part in a two week long cultural exchange programme in the USA. Since then he has also been to Portugal to see how they approach street homelessness. Ed explains more about what he learned from Crescer, an organisation which has homeless and substance use outreach services in Lisbon.

    In my work in London, I see on a daily basis how the cycle of homelessness and drug use can be very hard for people to break out of. Using drugs can make people very sick and hard for them to address some basic needs, including housing. I wanted to see if I could learn a different way to support people who are using drugs and facing homelessness, and was fortunate to be able to spend three days with Crescer, which has staff offering substance misuse and homeless outreach services in Portugal’s capital, Lisbon.

    Minimising harm

    Throughout the 1990s Portugal had high rates of HIV and opiate related death, affecting all levels of society. Many people in Portugal knew a close friend or family member who was affected.

    In 2001 the government decriminalised the use of drugs and gave organisations like Crescer a platform to use a harm minimisation approach to address the issue. This kind of approach recognises that sometimes people will not be ready to make changes such as stopping their drinking or drug use completely, and helps people to minimise the risks to themselves and others.

    On my first day at Crescer I went out with the ‘E Uma Rua’ service in the east of the city. The team was made up of three psychologists, a nurse, a social worker and a psychiatrist. I watched as they talked to people on the streets, offering harm reduction advice, distributing kits meaning people could use drugs more safely and collecting used needles in a needle disposal bin. I was moved to see how the outreach workers offered support to individuals where they were, regardless of their situation. Those they spoke to seemed to hold them in high esteem and were willing to talk about their issues.

    Crescer work in cooperation with other services including a methadone van. Once people are registered, they are able to access a mobile service to receive their methadone prescriptions from a van. This serves the city seven days a week distributing methadone to 1,200 people at four locations throughout the day and is thought to be behind a reduction seen in drug related antisocial behaviour.

    The harm reduction approach means in Portugal, whilst there hasn’t necessarily been a decrease in the number of drug users, there has been a massive drop in cases of HIV, other blood born viruses and opiate related death.

    Housing First

    Crescer also offers a Housing First service – ‘E Uma Casa’ – which provides people who have slept rough for long periods, and also have mental and physical health needs, with a home. Their approach is multi-disciplinary, meaning lots of different agencies work together to provide support. The team currently supports 36 people and is made up of psychologists, a social worker, a nurse, a psychiatrist and a peer advocate.

    The team establishes a relationship with a person living on the street over a number of months and offers them a house. Once they have a home, the team put support plans in place, conducting home visits and offering psychological support, to help manage their drug use, mental health needs and encourage development of independent living skills.

    The team also works to empower the local community to offer support to those housed in the project. For example, I saw people from a local convenience store looking after a person with mental health needs and dispensing their daily medication.

    The challenge of ending rough sleeping

    I would like to say a big thank you to Crescer for hosting me for three days and giving me a fantastic insight in to the amazing work they are doing in Lisbon.

    In London I cycle up to 100 miles a week as part of my job, finding and working with people who are sleeping rough. That equates to a lot of thinking time!

    I’ve been inspired by some of the innovations I saw, particularly those which take specialists to the streets to meet people where they are. In Portugal, working together in an interdisciplinary way is reducing harm, and linking people who are using drugs on the street with other services that could help them leave homelessness behind such as sorting out benefit claims and mental health support.

    What I have seen in Portugal convinced me that treating the issue of drug use as a matter of public health is effective. I believe it is time for the UK to follow suit and recognise the severe health crisis that is occurring on our streets, in our communities and in our prisons, often due to drug dependency and other complex interrelated factors such as trauma, and mental health issues.

    We are starting to see more funding for multi-disciplinary approaches to supporting people who are homeless. I believe introducing innovative ideas could improve health outcomes for people who are sleeping rough and using drugs, helping to reduce drug related antisocial behaviour, the number of people needing ambulance services and the number of drug related deaths.

    Find out more about our service models, including Housing First and Social Impact Bonds.

    A Home for Good: what it will take to end rough sleeping

    This week we launched a new report at a reception in Parliament as part of our Home for Good campaign. St Mungo’s Chief Executive Howard Sinclair outlined to MPs, peers, partners and clients attending what we believe it will take to end rough sleeping. This is his speech.

    Thank you to everyone for coming, especially to our speakers and our host Bob Blackman MP. And a special thanks to Kevin who has already done so much to support our Home for Good campaign. Your story and enthusiasm has truly inspired us to be ambitious about the changes we want to see.

    And our Home for Good campaign is ambitious. It’s a campaign for more social housing, a more secure and affordable private rented sector and a new programme of long-term, guaranteed funding for homelessness services.

    These are the changes needed to put an end to rough sleeping. An end to people sleeping outside, exposed not just to the elements, but to violence and abuse, falling quickly into a state of despair and desperation that comes from not having a safe place to call home.

    St Mungo’s services work to end rough sleeping for these very individuals every day by:

    • Getting a roof over people’s heads
    • Supporting them to address the issues that led to homelessness
    • Helping them to make a journey of recovery from the damage rough sleeping causes
    • And ultimately helping them to rebuild their lives.

    Kevin’s story, and the stories of many others, encourage us to be ambitious for individuals knowing that with the right help, rough sleeping is not inevitable.

    The tragic return of mass rough sleeping in recent years is something no one should take lightly. Today more people than ever are not only stuck on the streets, but are dying on the streets. Since our reception last year, at least 449 people are known to have died while sleeping rough or in emergency accommodation.

    The Government has been clear about its ambition of halving rough sleeping by 2022 and eliminating it altogether by 2027, and it is encouraging to see the efforts made since our last Parliamentary reception to start work on achieving that ambition. For the opposition parties, as well, rough sleeping and homelessness is high on their agenda.

    The publication of the Government’s Rough Sleeping Strategy, including the funding for the Rough Sleeping Initiative, are very welcome steps. We know the Rough Sleeping Initiative money is making a difference in this respect. But as Kevin’s story shows, the right accommodation and support also need to be in place to help people stay off the streets.

    The report we’re launching today highlights the long term value of floating support, which is not always visible like a hostel in the local community, but does a vital job of helping people hang onto their homes.

    Our report also presents new evidence that funding for services which prevent and reduce homelessness is slipping away at a much faster rate than the Government is topping it up. The report includes new research showing an 18% reduction in funding for floating support services over the past five years in the areas with the highest numbers of people sleeping rough, in London the funding has reduced by 41%.

    And it’s an ever greater challenge in many towns and cities to help people find the secure, safe and affordable housing they need in order to rebuild their lives away from the street for good.

    Ten years of steady dis-investment in services, in housing and in support has lead us to this position, we know how to sort it but we cannot do it overnight.

    The short term Rough Sleeping Initiative is welcome – but it is ‘short term’. Next year’s Spending Review presents a real opportunity to inject some certainty into the Government’s plan to end rough sleeping. It is an opportunity to tackle the structural factors driving more people onto the street.

    I am clear that the number of people sleeping rough tonight across the country is a national disaster. 4,751 people on any one night, 4,751 people without any roof over their head. And in a disaster situation we would expect an emergency relief response, as well as a coming together of public authorities and civil society to provide the long-term solution. We would also expect, that as a society, we would strive to ensure it never happened again.

    The Government has rightly focused on the emergency response, but we also need the focus on long-term housing and support, and on preventing people sleeping rough in the first place.

    That’s why our Home for Good campaign makes three asks; more social housing, including specialist housing specifically for people moving on from rough sleeping; a more secure and affordable private rented sector; and a new programme of long-term, guaranteed funding for homelessness services.

    That’s what it will take to end rough sleeping and that’s what we look forward to seeing as the next steps to achieve the Government’s ambition to end rough sleeping for good.

    Support our Home for Good campaign to end rough sleeping for good.



    Steve Douglas, CBE

    • Role: Chief Executive
    • Email:

    Whilst numbers of people rough sleeping rise, essential services are being cut

    This week at the Houses of Parliament St Mungo’s released a research report highlighting the role of essential support services in ending rough sleeping. Robyn Casey, Senior Policy and Public Affairs Officer, reflects on the findings and how the Government can take action to ensure everyone can have a Home for Good.

    Last month, homelessness outreach teams and volunteers went out across England to count the number of people who were sleeping rough for official Government figures. Over recent years, these counts have revealed shocking trends as between 2010 and 2017 the number of people sleeping rough had more than doubled.

    At St Mungo’s we’re working towards a time when there is no one sleeping rough, but know that there is much more work to be done to end rough sleeping for good.

    Everyone deserves a home for good

    The Government has promised to end rough sleeping by 2027, and our Home for Good campaign outlines the steps they need to take to achieve this.

    For starters, it is crucial that more housing is available to people with a history of sleeping rough, and that these homes are affordable, long term options.

    That’s why we’re calling on the Government to embark on an ambitious programme to build more social housing, with some of these new homes reserved for people who have slept rough. Reform of the private rented sector – including making tenancies more stable and limiting rent increases – will also mean that fewer people will face eviction from their home.

    However, we know that it takes more than a roof over someone’s head to end homelessness. Some people need additional support to keep their home for good. At St Mungo’s, we work with people who have a range of support needs. For example, in 2017-18, 50% of people seen sleeping rough in London had a mental health problem, 43% had a problem with alcohol use and 40% had a problem with drug use.

    Many others who have a history of sleeping rough struggle to manage a tenancy without support to pay their bills, speak to their landlord, or manage a welfare claim. Floating support services can help them to do this.

    Floating support provides the help that people need

    Floating support workers help stop people returning to the streets by providing support to people in their own home. This support is tailored to the person but can involve helping people to keep on top of their bills and control their finances; manage mental health or substance use problems; navigate the benefits system; or get into training or employment.

    Evidence shows these types of services both reduce the amount of rent arrears that people with a history of homelessness can build up and the number of people who are taken to court over rent arrears. They can also help people with a long history of rough sleeping to get, and keep, their homes.

    But unfortunately, funding for these services has declined dramatically over the past five years. At the same time, rough sleeping has hugely increased.

    Funding cuts have put these services at risk of closure

    We asked local authorities for details about their floating support contracts between 2013 and 2018. Shockingly, we found that funding for these services had decreased by an average of 18% across England. The funding cuts were even starker at a regional level, with a 41% reducation across London and 26% across the South East. Tellingly, these are the areas with the highest proportion of people sleeping rough in England.

    We also looked at funding for specialist services. Whilst funding for generic services, which anyone can access, increased by 5% over the five year period, specialist services for people with mental health needs declined by 44% and for ex-offenders declined by an astonishing 88%.

    These specialist services are important because floating support workers are experts in helping people to access the right healthcare for them and in advising them of their rights. Without this expertise, some people will fall through the cracks.

    Homelessness services, including floating support, need long term guaranteed funding to ensure they are available to everyone who needs them. But for too long these services have faced funding cuts and insecurity.

    Getting everyone the support they need

    Our Home for Good campaign is calling on the government to put an end to rough sleeping by ensuring that everyone gets the long term housing and support they need to rebuild their lives.

    The Government can make this happen by urgently reviewing the decline in funding for housing related support services, including floating support, and committing to guaranteeing funding for local authorities to plan and commission homelessness services. They should also ensure that local homelessness and rough sleeping strategies include a focus on ongoing support, including floating support services.

    Help us end rough sleeping for good by signing Kevin’s open letter to the Secretary of State for Housing, Communities and Local Government.

    Our #16Days of Action against domestic abuse

    This Sunday 25 November 2018 is the International Day for the Elimination of Violence against Women and marks the start of 16 Days of Action against domestic abuse. Cat Glew, Women’s Strategy Manager, explains how homelessness and domestic abuse are linked and how St Mungo’s is taking action.

    Women experience homelessness differently to men. In particular, gender based violence can be both a cause and a consequence of homelessness. Shockingly, half the women in St Mungo’s accommodation that have slept rough tell us that they have experienced violence or abuse from a partner or family member.

    As Women’s Strategy Manager, my role is to improve the situations of the women we work with who are homeless or at risk of homelessness.

    We’re making a stand for women

    A safe and secure home is the first step to recovery, so we must do all we can to keep women safe from abuse. That’s why St Mungo’s is proud to sign the Make a Stand pledge from the Chartered Institute of Housing. Developed in partnership with Women’s Aid and the Domestic Abuse Housing Alliance, the pledge is a commitment to support all our staff and clients experiencing domestic abuse.

    You may have read our recently published report from the University of York about the hidden harm of women sleeping rough. Women on the streets are exposed to frightening risks of sexual harassment, abuse and violence, but hiding from harm can also mean that they are hidden from help.

    The 16 Days give us the chance to us to bring hidden issues to light. Across the organisation, we’ll be having honest conversations about abuse and relationships and connecting people with specialist support.

    The United Nations’ theme for this year’s campaign is #HearMeToo. We must make sure that the global movement against harassment and abuse also reaches women who are homeless and hidden. We need action in government and in homelessness services to #MakeHerSeen.

    The women we work with are blooming strong

    It’s important that we take domestic abuse seriously, and understand the harms and risks. But as Women’s Strategy Manager, that’s just one part of my role.

    The best part of my job is celebrating our women. Women face added stigma and shame while they are homeless. But that’s not how we see our female clients. We see women who have survived, who are strong and determined.

    That’s why we’re taking part in the Blooming Strong campaign in our services this year, presenting a variety of women with a single flower, and celebrating in other ways such as planting flowers, creating sculptures and making time to chat over a cup of tea. The campaign is a celebration of the strength of women, including those who have survived gender based violence and abuse.

    I can’t wait to see how our creative staff and clients will celebrate. Look out for more updates on our social media channels during the #16Days of Action.

    Survivors of domestic abuse need a home for good

    Everybody deserves a home where they can be safe from harm. Our Home for Good campaign report highlights that being forced to flee violence or abuse is one of a number of reasons why people struggle to move on from homelessness.

    It’s vital that specialist support is in place so that women can leave the streets behind and we can end rough sleeping for good. During this 16 days of activism, why not sign our #HomeForGood open letter and call on the government to give homelessness services the funding they need.

    If you or someone you know is experiencing domestic abuse, you can contact a specialist organisation for support:

    National Domestic Violence Helpline: 0808 2000 247
    National LGBT+ Helpline: 0800 999 5428
    Men’s Advice Line: 0808 801 0327

    Why it’s time for the NHS to step up and play its part in ending rough sleeping

    Rory Weal, Senior Policy and Public Affairs Officer, explains why St Mungo’s, together with more than 20 homelessness and health organisations, have joined forces to urge NHS England to spend more on specialist health interventions for people experiencing homelessness.

    Rough sleeping has more than doubled since 2010. Spiralling housing costs, increasing insecurity for private renters and cuts to services that prevent homelessness have all played their part. But rough sleeping is not just a housing problem, it’s a health problem too.

    One person dies every day while sleeping rough

    We face a situation where on average one person dies every day while sleeping rough or in emergency accommodation and many more have to cope every day with serious health conditions. Of the people seen sleeping rough in London in 2017-18, 50% had mental health problems, 43% were alcohol users and 40% were drug users. An estimated 46% had physical health conditions.

    Complex needs like these are mutually reinforcing. Without targeted interventions and support, many people end up stuck in a cycle of homelessness, poor heath, and – sadly too often – premature death.

    People can get stuck in a vicious cycle

    The issue of homeless health has gained increased attention in recent months. Over the summer the Government’s Rough Sleeping Strategy contained expectations for the NHS to be spending £30 million on health services for people who sleep rough. The Chief Executive of the NHS, Simon Stevens, also made similar promises that the needs of people sleeping rough would be addressed in the upcoming Long Term Plan for the NHS.

    This attention is welcome and long overdue. Health problems, particularly mental health problems, are often the reason why people are stuck sleeping rough. Poor mental health is an obstacle to engaging with services that can help move people off the street, while at the same time being homeless prevents people getting the mental health support they desperately need. This increases their exposure to the dangers of life on the street, and as a consequence, also increases their risk of early death.

    Urgent and emergency care costs are high

    The human costs of neglecting to address these issues are severe, but so are the financial costs. Estimates suggest the costs of treating homelessness for hospital inpatient and A&E admissions alone run to £2,100 per person per year, compared to £525 among the general population. In 2010 the total cost of urgent or emergency care for people sleeping rough was estimated to be £85 million per year, but this represents only a small fraction of the total costs to health services. The current figure is likely to be significantly higher.

    Without a conscious, proactive effort by the NHS and wider social services these barriers, and the resulting poor and costly health outcomes, will continue to persist, in turn costing core and acute services more in the process.

    The Long Term Plan is an opportunity for change

    The Long Term Plan is being developed by the NHS to cover the next decade of service delivery, and will be published later this year. It presents a vital opportunity to reduce the appalling health inequalities which exist for some of the most vulnerable and unwell people in our society.

    The £30 million promised by the Government’s Rough Sleeping Strategy is an insignificant amount in the context of the wider costs associated with homelessness. That’s why St Mungo’s, together with 20 other organisations across the homelessness and health sectors, want to see at least this amount pledged every year to develop specialist services for people who sleep rough, delivered in partnership with local authorities.

    Specialist interventions – such as dedicated mental health teams working with people on the street, or tailored services to increase access to general practice – can prevent admissions to acute service like A&E further down the line. When delivered in partnership with local agencies and homelessness services, these initiatives can be an essential in helping people off the streets too.

    We hope the contents of the Long Term Plan will build on the real momentum we have seen on the issue of homeless health in recent months.

    St Mungo’s, together with more than 20 homelessness and health organisations – including Homeless Link and The Queen’s Nursing Institute – wrote earlier this week to the Chief Executive of NHS England, calling for more action to address the appalling health outcomes faced by people sleeping rough. You can read our joint policy briefing, developed with Homeless Link, here.

    We campaign for an end to homelessness, making sure the voices of our clients are heard by decision-makers at every level. To join us and speak out for people experiencing homelessness, become a campaigner today.

    Why the budget 2018 is a missed opportunity for ending rough sleeping

    Following the announcement of the autumn 2018 budget, Rory Weal, Senior Policy and Public Affairs Officer, analyses what the Government’s plans mean for those sleeping rough or at risk of homelessness.

    Amongst talk of an ‘end of austerity’ budget, the Chancellor yesterday delivered one that was really a missed opportunity from the perspective of homelessness.

    It had been a positive summer, with the Government listening to the homelessness sector and deciding to keep funding for supported housing in the welfare system, as well as publishing a rough sleeping strategy which contained a variety of interventions to stop the scandalous rise in the number of people sleeping rough across the country.

    However, the Budget failed to build on these developments, and did not contain measures which will deliver on the Government’s commitment to halve rough sleeping by 2022, and end it all together by 2027.

    There were bits of positive news to be found which – if delivered with homelessness in mind – could contribute to helping people off the streets.

    A new mental health crisis service

    On mental health, there was the news that a new mental health crisis service will be developed, as part of the NHS Long Term Plan. Given the scale of the mental health crisis on the streets and the difficulty many have accessing support, this is particularly welcome.

    The service will include comprehensive mental health support in every major A&E, more mental health specialist ambulances, and more crisis cafes. We want to see this service work with people sleeping rough who have mental health problems, providing support on the street if necessary.

    More money for the NHS

    However, we know that prevention is always better than cure. We want to see fewer people getting to crisis point and helped much earlier before conditions worsen.

    People sleeping rough have much higher rates not only of mental illness, but of physical health problems too, and shockingly high levels of mortality. So the cash injection for the NHS – £20bn over the next five years – is desperately needed and clearly welcome. But we know that without a clear plan, these kinds of funding injections often don’t make their way through to helping the most vulnerable. That is why we want the upcoming NHS Long Term Plan to earmark some of these funds for specialist services for people sleeping rough, to ensure their needs are not forgotten.

    Funding to address problems in Universal Credit roll-out

    Universal Credit roll-out has had a particularly damaging impact on people sleeping rough, which is why the £1bn announced in the budget to address problems with roll-out is welcome. These problems include large deductions being taken from Universal Credit awards to repay Advance Payments and other debts such as rent arrears. We are also seeing increases in arrears for service charge in supported housing, as Universal Credit no longer allows claimants living in supported housing to request direct payments to their landlord for the likes of gas and electricity.

    The complexity of the new system means that many struggle to navigate it and make a claim without support. The cumulative effect of this is to make it even harder for people to move on from homelessness.

    We want this new funding used to address these serious problems. However, in order to stop vulnerable claimants being pushed further into destitution, we still want to see a pause in the roll-out to give time for the process to be fixed.

    But not enough to end rough sleeping…

    Despite these positive notes, the overall feeling is that this was a missed opportunity. With no funding measures on rough sleeping specifically, and no plans to tackle the key drivers of homelessness, there is still much more to do to get close to the Government ambition to ending rough sleeping by 2027.

    We need to see further commitments to increase social housing, strengthen private renting and funding for homelessness services for people to find, and keep, a home for good. We will be working to build support for these changes in the months ahead. With the numbers sleeping rough continuing to rise, we cannot afford to delay.

    Our Home for Good campaign is calling on the government to put an end to rough sleeping by ensuring that everyone gets the long-term housing and support they need to rebuild their lives. Sign Kevin’s open letter to the Secretary of State for Housing, Communities and Local Government.

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