Rough sleepers in homeless hotspots to benefit from NHS mental health outreach

Towns with high rates of homelessness are set for investment in specialist mental health care, as part of NHS services for rough sleepers across the country.

The NHS-funded services in seven parts of the country will bring in new psychiatrists, psychologists and other experts to offer homeless people advice and treatment to tackle underlying mental ill health.

More than half of everyone sleeping on the streets lives with a mental health problem, while those affected by homelessness die, on average, around 30 years earlier than the general population.

Nearly four in five people living without a roof over their head experiencing childhood trauma, but vulnerable rough sleepers can often face a ‘revolving door’ where they receive treatment and support, only to end up back on the streets.

The new NHS-led teams will bring together doctors, nurses and other clinicians to co-ordinate treatment and support with other local organisations including councils.

The new services, are part of co-ordinated efforts to ensure that rough sleepers have better access to NHS mental health support – joining up care with existing outreach, accommodation, drug and alcohol and physical healthcare services.

In each area, outreach teams – comprising NHS and local authority staff – will identify rough sleepers in need of help, support them to access a GP and then on to the new expert psychiatric help.

Claire Murdoch, NHS national director for mental health said: “While the NHS cannot solve homelessness on its own, it is working hard to make sure rough sleepers have easy access to services that are built and designed around their needs – putting an end to the revolving door of trauma care.

“Many rough sleepers have been through incredibly traumatic experiences which can cause mental ill health or exacerbate problems – often impacting on the type of support they need and this is about stopping people slipping through the net.”

The mental health care will sit alongside existing support for rough sleepers, including for example,  one to one support from a specified caseworker who can help with everything from housing advice to attending NHS appointments – and will keep in contact with the patient for as long as is required

The first wave of funding is worth almost £12 million over the next five years and will be used to build and scale up comprehensive services across:

  • Birmingham
  • Brighton
  • Hull
  • Lincoln
  • Lambeth
  • Luton
  • Haringey

At least 20 areas with high levels of rough sleeping will be expected to have set up new teams by 2023/24 as part of a wider national roll-out – backed by £30 million as part of the NHS Long Term Plan.

The new money will be directed at towns, cities as well more rural areas most impacted by rough sleeping.

Areas must already be working in partnership to address rough sleeping and ensure mental health services are accessible for rough sleepers.

Dominic Williamson, St Mungo’s Executive Director of Policy and Strategy at St Mungo’s, said: “In 2018, 726 people died while sleeping rough or in emergency accommodation, with many affected by a range of physical, mental health and substance use problems. This is a public health crisis and the NHS has a key role to play in tackling these issues and supporting people’s recovery from homelessness.

“As a result we are pleased to see investment in these specialist services for people who are homeless. We particularly welcome the promises to join-up provision between mental health, substance use and housing – to ensure no one is denied the treatment and support they need. We hope these services will save lives and ensure more people recover from homelessness and rebuild their lives.

“We hope that services seize this opportunity to do things differently, and that this is just the start of a renewed effort to truly join up health and housing, to ensure everyone sleeping rough gets the support they need.”

The programme will in part be based on a scheme in London which also included a crisis café for homeless people to visit and receive mental health support when needed. The service in Camberwell has been running since 1991 and includes rehab services, substances abuses services and mental health provision.