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Mental Health: Focus

May 12 2016
Rowan Blanco © Sophia Platts-Palmer Rowan Blanco © Sophia Platts-Palmer
Homelessness and mental health: ask most people who have been homeless and they’re likely to have something to say about the link. Often it’s a chicken and egg question: which came first?

Homelessness and mental health: ask most people who have been homeless and they’re likely to have something to say about the link. Often it’s a chicken and egg question: which came first?

Research shows that eight out of 10 people who are homeless report some kind of mental health issue – 45 per cent have a diagnosed condition.

Only one in four – or 25 per cent – of the general population report the same thing.

Ironically if you’re homeless it’s also harder to access mental health services.

It may be that your problems – from depression to biopolar disorder – were one of the causes of your homelessness in the first place. It may be that being homeless has caused them or made them worse. And getting help can sometimes seem almost impossible.

The Pavement’s view is clear; we need better access funding of mental health service and better training to help all frontline workers understand the people’s needs. We’ll be following this up in months to come, so watch this space.

Here we look at the issues around mental health and homelessness ahead of Mental Health Awareness Week (16–22 May) and look at your rights.

Find a full guide to services in the List in the middle pages and online:

Mental health and your benefits

When Mark Wood, who had longstanding mental health problems, starved to death it was just four months since he had been found “fit to work”.

The 44-year-old, who had a range of conditions including Asperger syndrome and obsessive compulsive disorder, had been surviving on £40 a week after he was reassessed and his additional payments stopped.

In court, his GP testified that he could only assume this “fragile” man had been pushed over the edge by the pressure of having his benefits removed. An investigation by the Mirror last August found that he was far from being a unique case. It found 2,380 people died between December 2011 and February 2014 after being found fit to work. In total, nearly 10,000 people died after being denied sickness benefits.

Over the past year, welfare reforms have been a hot topic following each budget announced by the chancellor.

The cuts have been brutal; even Iain Duncan Smith, the Conservative Secretary for Work and Pensions, thought the disability benefits cuts announced last March were a step too far, and resigned as a result.

And it is often people with mental health issues – sometimes considered an “invisible disability” – who are suffering.

“Welfare reforms absolutely do disproportionately affect people with mental health problems,” said Tom Pollard, policy and campaigns manager at mental health charity Mind. “Almost half of people on Employment and Support Allowance (ESA) have a mental health condition, but also mental health is particularly hard to assess and understand. When the system gets it wrong and people are put through a stressful process, the impact is likely to be much greater on someone dealing with mental health issues.”

Jobcentre workers are not extensively trained in mental health, so may ask a person claiming ESA, for example, to attend job interview sessions in a group environment, without any understanding of how that would affect a person struggling with an anxiety disorder. When not turning up to the session is considered a sanctionable offence for which benefits can be withheld, it can cause debt, financial instability and ultimately lead to homelessness. It’s not pretty.

In many cases, someone who is struggling with their mental health may be assessed as fit for work by their local untrained Jobcentre worker, and be required to go through a difficult and stressful process which they may struggle to keep up with. As a result, with benefits cut and a lack of understanding, eviction is a very real possibility. It then becomes even harder to get support.

Adrian Garcia-Miller is a mental health advocate who has been volunteering with the organisation Sane and running their Black Dog campaign, promoting awareness and visibility.

He explained how recent reforms have made it much harder to find the necessary support for people struggling with mental health.

“The number of beds in hospitals for mentally ill patients is far lower than needed, and Care in the Community has also been decreased, so patients are turned away from hospital or prematurely discharged with little to no further care,” said Garcia-Miller. “The criteria for diagnosis seem to be at odds with individuals’ actual needs, with many having to go through long and stressful processes of appeals in the hope of seeing a medical professional, or indeed receiving any benefits.”

A recent campaign by Mind shows the effects that issues such as debt, housing and benefits can have on our mental health. It highlights how stress and helplessness can exacerbate existing conditions, which, coupled with a lack of access to relevant support, can lead to homelessness – which in turn makes it even harder to help people get back on their feet.

This is avoidable, according to Pollard: “We need training and we should employ people who understand mental health, but we need to start with the assumption that we want to support and help people who actually want to go back to work, rather than coming at it by threatening to sanction benefits and pressuring people into compliance. We need to deliver our support in a more flexible way, understanding the challenges that face people with mental health conditions.”

Mental health: some tips

If you’re struggling with mental health problems and are concerned about losing your benefits and housing, you’re not alone, and there are a number of places where you can seek help.

First stop contact your local Citizens Advice Bureau:

Pollard also advised you call the Mind helpline on 0300 123 3393, where you’ll be directed to the relevant local support service.

Sane also have a helpline which you can reach on 0300 304 7000.

You can also ask your GP to refer you to a mental health service, which may in the short term mean you don’t need to fill in forms or be assessed.

If you think you might be suffering from a mental health condition, visit your GP. Mental health problems are considered a disability, and patients are entitled not to be discriminated against. You are entitled to paid disability leave from a permanent job, or ESA if you are unemployed. If you struggle to fill in the forms, it’s important you make someone aware of this.

You can ask a mental health charity to help you find someone to speak out on your behalf:

Mental health: statistics

Common mental health problems are over twice as high in homeless populations as in the general population

Psychosis is 4-15 times higher amongst the homeless population than in the general population

Serious mental illness is often accompanied by alcohol and/or substance misuse problems

European Schizophrenia Cohort found that 32.8 per cent of British schizophrenia sufferers had experienced homelessness in their lifetime

Overall research shows that as the stability of housing increases then rates of serious mental illness decreases

Women experience some risk factors (such as physical and sexual violence as a child) for both mental illness and homelessness to a greater extent than men

The proportion of homeless people who are mentally ill from BME groups is disproportionate in relation to their proportion in the general population.

All stats from