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The following is an extract regarding access to health services, mental health issues which compound and are compounded by homelessness and drug and alcohol services.  An Action Plan was recommended which can be seen from the reference below.

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There are very firm links between health and homelessness. The new duty placed on local authorities to review homelessness and develop homelessness strategies should begin to address how the health needs of homeless people are met at the local level. This consultation and the scrutiny process it proposes, presents a further opportunity to ensure that the health needs of homeless people are addressed at the local and national level.

Mental Health

There are services for people with severe and enduring mental illness, but little work is done with people with low level mental health problems. These are nonetheless very distressing to the person concerned and often leave them with vulnerable and chaotic lifestyles, for example Personality Disorders. The rate of mental health problems, for example depression and anxiety, are eight times higher in the homeless population and 11 times higher in those sleeping rough. [The Health of Single Homeless People, Wendy Bines, Centre for Housing Policy, University of York (1994)]

A commitment to funding preventative work, for example counselling, would help enormously and can help people resolve issues earlier.

Access criteria, such as a demand that a person be drug or alcohol free before accessing mental health services, further marginalises clients. Some of our members have reported that approximately 63 per cent of the clients to whom they are providing services have multiple needs or the very least are dually diagnosed.

Drug and Alcohol Services

Access to drug and alcohol support services need to be speeded up, in order to work effectively with a client who is motivated to change.

The different philosophies around the "motivation" of a client between the delivery of mental health and drug and alcohol services. For a dually diagnosed client, it does not matter to the mental health service whether he or she is motivated to change their lifestyle; they will always get support from the service. But when it comes to support for their drug or alcohol dependency, the delivery of the service is very much dependent on whether they are motivated to reduce the harmful effects. In order that dually diagnosed clients get equality of access to both mental health and substance dependency services, these differing philosophies should be harmonised allowing both should be supported regardless of the clientís motivation.

It is important that all health services working with homeless people address these barriers and ensure equal and targeted access to health care services for homeless people. With this in mind, the development of a health scrutiny process is a welcome change in the Governmentís approach to addressing the health needs of vulnerable people.




Health Action at Crisis

is helping to ensure that health related issues among homeless people is given priority in terms
of developing new strategies.  The Health Improvement and Modernisation Programmes now currently underway within the local authorities and the newly developed Primary Care Trusts are an essential way of ensuring that homeless personís needs are taken into account.

Anyone wishing to make any comments or suggestions in terms of good working practices, gaps in services and provisions for socially excluded groups or any other related concerns can contact Bolaji Bank-Anthony or Sarah Gorton at Health Action at Crisis, Warwick House, 25/27 Buckingham Palace Road, London SW1W 0PP.  e-mail:  bolaji.bank-anthony@crisis.org.uk.
or telephone Sarah on 020 7015 1815.