By Jack Dixon
Homelessness is on the rise in London with increasing numbers of people forced to spend a night on the streets.
Drugs and alcohol are often identified as key factors – but the link between sleeping rough and mental illness goes under the radar.
As part of the South London Press and London Weekly News Change Is Possible campaign, reporter Jack Dixon examines the mental health crisis on our city’s streets.
The spiralling homelessness crisis is London’s most shameful open secret. It is not the ‘silent killer’ of air pollution or the after-dark threat of knife crime. We are faced with its devastating effects in plain sight every day.
But while the statistics continue to shock and appal – the number of people sleeping rough across England more than doubled between 2010 and 2015 – one crucial headline goes unreported.
The streets of London are fast becoming a burn pit for mental illness as thousands battle complex health conditions while struggling to find shelter.
In the capital alone, the number of rough sleepers with an identified mental health problem has rocketed from just over 700 in 2009/10 to more than 2,500 last year.
It has led the London homelessness charity St Mungo’s to warn of a “mental health crisis” on our streets.
A landmark report produced recently by the charity – Stop the Scandal – revealed that failing support structures are blocking the pathways for rough sleepers who are experiencing mental illness to get the help they need.
At the same time, these complex problems are being exacerbated by poverty – and the cycle is locking the most vulnerable into long-term homelessness.
Shockingly, those who are sleeping rough with a mental health problem are around 50 per cent more likely to spend over a year living on the streets than those without.
Howard Sinclair, chief executive at St Mungo’s, said: “Our research indicates that four in 10 people sleeping rough have a mental health problem. By any measure these figures are unacceptable.
“It is a disgrace that in our developed country over 3,500 people sleep rough on any one night – and it is likely that number will be even higher this year.”
The charity points to problems in the commissioning of dedicated support services for the most in need.
Last year it probed local councils and clinical commissioning groups in parts of the country with the most severe homelessness problems.
Less than a third were able to identify local mental health services that actively targeted rough sleepers in their area.
St Mungo’s fears that people living on the streets with mental illness are, at best, falling through cracks in the system, and at worst, being ignored by it.
“Despite the mental health inequalities faced by people sleeping rough, most commissioners are not rising to the challenge with targeted mental health services,” Mr Sinclair added.
In-depth research has proven that sleeping rough deepens mental health problems for the most vulnerable.
And the daily pressures of basic survival on the streets can make it almost impossible for people to access support for their conditions.
All too often poor mental health becomes a barrier to engaging with vital services that can help people to move off the streets, and an obstacle to reaching dedicated healthcare.
When the charity approached homelessness professionals themselves, three quarters conceded that people sleeping rough in their area were unable to access appropriate mental health services.
The “crisis” is not only putting people’s mental health at risk but exposing rough sleepers with serious conditions to physical danger on the streets.
Fear and isolation, as well as the constant threat of crime and abuse, leaves them frightfully unprotected.
One former rough sleeper who experienced mental health problems said he began to think of himself as a “wild animal” while living on the streets.
Another laid bare the harsh reality: “I’ve had people piss on me, try to set me on fire. I’ve been kicked in the head, sexually assaulted and touched up.”
The sense of disconnect – even from the professionals that should be there to help – can lead to crippling isolation and a feeling of utter helplessness.
“My mental illness, being on the street and that, it didn’t help,” explained one rough sleeper who started self-harming when she became homeless.
“I have suicidal tendencies and it kind of heightened everything, you know? It was like me against the world.”
Many of those who develop serious conditions once they become homeless have faced mental health problems before.
In fact, in lots of cases, these issues play a role in the events that push people towards the streets – whether drink or drug addiction, relationship difficulties or stress brought on by pressure to make rent and pay bills.
One St Mungo’s client, who is no longer sleeping on the streets, recalled how a succession of traumatic experiences forced him into a corner.
“I felt like my life was actually going nowhere at that point. No aim, no job, Dad just passed away. Still feels like that now, but I’ve got somewhere to stay so it’s a step on the ladder as I see it. When I’m sleeping rough I don’t see no ladder to step on.”
The basic building blocks for survival – a safe place to stay, enough food and drink, good personal hygiene and someone to talk to – become unattainable targets for people with mental health problems who find themselves sleeping rough.
But St Mungo’s fears that our poor understanding of the problem at hand is creating “unhelpful attitudes” and a reluctance among commissioners to work with people who are challenging – even if they are seriously unwell.
The charity is lobbying policy-makers to change the way the mental health system works, so that it becomes better integrated with housing and support services.
“We know mental health services are extremely stretched,” says Mr Sinclair.
“But by focusing resources we can not only alleviate the human cost but potentially save money over the long term – if people receive the help they need at the time they need it.”
Our Change Is Possible campaign aims to promote and protect good mental health for all Londoners, helping to shape a community that makes sure people with experience of mental health problems are treated fairly, positively and with respect.
South London Press, London Weekly News and Lambeth and Southwark Mind are committed to raising awareness about the complex mental health problems that many people in our community face, and working together to expand and improve the range of support available.
We aim to put a stop to the stigma around mental health – at home, at work and at school – and to break down the barriers that prevent people from seeking help.
If you would like to support our Change Is Possible campaign, there are several ways to get involved.
– Share your story. Do you have personal experience of living with mental health problems? Has a friend or family member been affected? Your story could help inspire others to donate towards our campaign.
– Help us fundraise. Could you support our appeal by organising a fundraising event or setting yourself a sponsored challenge? Every penny could be crucial in helping us reach our campaign targets.
– Donate to our campaign. To make a donation to our appeal, you can visit www.givey.com/changeispossible. Alternatively, you can write to Lambeth and Southwark Mind, 4th floor, 336 Brixton Road, London, SW9 7AA.