‘knocked back’ from life-saving treatment

New research reveals at least 12,000 people experiencing homelessness missed out on vital drug and alcohol services last year.

St Mungo’s has declared a health crisis on the streets saying cuts to services have resulted in record numbers of people who are homeless living with, and dying of, preventable drug and alcohol problems.

The report – Knocked Back: failing to support people sleeping rough with drug and alcohol problems is costing lives – is one of the most comprehensive investigations into the links between rough sleeping and substance use for 20 years. It includes new data analysis, in-depth interviews and peer research from across the country looking at the issues behind people’s drug and alcohol problems and the challenges they face accessing life-saving support.

The charity is calling on government to deliver on its commitment to join up health and housing in a new cross-government strategy to end rough sleeping. This includes action to end deaths on the streets, investing in drug and alcohol services and quickly establishing a ‘rough sleeping and substance use personalised fund’ to meet immediate needs.

Last year the ONS found that of the 726 deaths in 2018 of people who were sleeping rough or in emergency accommodation, more than half were alcohol or drug related. Deaths by drug poisoning had risen by 55% in just one year. Our research looks into the issues behind this rise:

  • We estimate that at least 12,000 people sleeping rough, or at risk of doing so, went without vital drug and alcohol treatment in England last year.
  • Funding for drug and alcohol services has been cut by more than a quarter since 2015 -16.
  • 6 in 10 people sleeping rough in London have a drug or alcohol problem, up from 5 in 10 people in 2014-15.
  • In London there has been a 65% increase in women sleeping rough with drug and alcohol problems between 2014-15 and 2018-19, compared to a 16% rise in men.
  • Rough sleeping and drug and alcohol problems are closely associated with traumatic experiences and isolation which often precede someone’s first night sleeping rough.
  • Half of drug and alcohol services in the areas with the highest levels of rough sleeping say it will get harder to support people sleeping rough over the next two years.

Howard Sinclair, St Mungo’s Chief Executive, said:

“This is a neglected health crisis that requires rapid action. Our research shows that people who have already faced traumatic experiences throughout their lives are being turned away from life-saving treatment just when they need it most.

“Rough sleeping in England has increased by 165% in the last ten years. Not only are hundreds of people dying from drug poisoning but even more are living in terrible conditions on the streets whilst tackling very serious ill health.

“This needs urgent government action. Now is the moment for Ministers to show they are serious about the commitment to join up health and housing to end rough sleeping once and for all. This means a comprehensive review of every death, a personalised fund to help everyone access life-saving treatment services quickly, and funding increases for integrated treatment, support and accommodation services.”

Andrew Teale, Outreach Manager at St Mungo’s, said:

“I have seen first-hand the issues explored in this research. I’m a service manager working with people sleeping rough in Bournemouth and Poole. But I also know because I have lived it.

“I spent five years homeless, living for months on a makeshift bed in the woods, going down to the garage at the end of the road to get my alcohol. I was arrested, sectioned, ordered to get treatment many times – but nothing seemed to work.

“Eventually I spent 13 months in a local authority rehab and began to rebuild my life, volunteering with people who were homeless.

“I went on to work in drug and alcohol services, before taking on the role as service manager of the Bournemouth outreach team. I’ve been sober nearly 11 years. I drive home to my wife, my stepchildren and my dog – and I’ve never been happier.

“This is such a vital issue, yet often stigmatised and misunderstood. Having worked and lived both homelessness and drugs and alcohol, I know how closely related those experiences are, and how difficult it can be to navigate a stretched and under resourced system. When it works people’s lives are transformed, like mine.”

The report makes the following recommendations to the government

  • Ensure that funding for drug and alcohol treatment is protected and increased, while also establishing a ‘rough sleeping and substance use personalised fund’ to meet immediate needs regardless of local connection or immigration status.
  • Ensure services work better with the most vulnerable groups, by encouraging new trauma-informed approaches, shared ‘distance travelled’ outcome measures, and the provision of a greater number of specialist multi-disciplinary services providing integrated support.
  • A clear commitment to end deaths on the streets over the next five years, backed up by an independent national programme to review trends, make recommendations and hold agencies to account.
  • These efforts must be part of an updated cross-government strategy to meet the commitment to end rough sleeping by 2024. The strategy should recognise rough sleeping as a public health crisis, and set out a plan for providing the right integrated pathways of housing, treatment and support.

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