People experiencing homelessness are 50 times more likely to have hepatitis C, 34 times more likely to have tuberculosis, and eight times more likely to have epilepsy than people who have proper accommodation. They are also nine times more likely to die from suicide, and 20 times more likely to die from drug misuse/abuse, and people who die while they are homeless die on average around 30-40 years younger than the rest of the population.
Over the last eight years, The Queen’s Nursing Institute (QNI) has co-ordinated a national network of over 1500 community nurses and other health professionals focused on improving healthcare for people who have some of the poorest health outcomes in the country. This involves free learning and networking events about homeless healthcare, and a series of online resources for education and practice including health assessment guidance and condition-specific profiles such as Oral Health and Homelessness.
Prime Minister Theresa May wants to “fight against the burning injustice that, if you’re born poor, you will die on average 9 years earlier than others.” In the new English national nursing and care framework, Leading Change, Adding Value, NHS England’s Chief Nurse Jane Cummings calls for a “ need to investigate and correct unwarranted variations in health”. It is time for health inequalities to top the agenda.
We know what people experiencing homelessness have told us; that services rarely listen to them, rarely account for their views and often ignore them. One young homeless woman told us that she experienced discrimination and real fear when going to her hospital for emergency treatment on a severely injured eye:
“They didn’t keep me in the night even though I could barely see where I was going. I think I was treated the way I was because I was homeless… When that happened I thought I was going to die.”
Another formerly homeless man told us that once he was back in stable housing his care from health services improved:
“He didn’t want me around. The GP perceived me as to be a problem… Now I’ve got a stable address, he treats me with respect.”
The longer someone experiences homelessness the more likely they are to lose trust in themselves, and the world around them, including the medical profession. There is “a lot of broken trust between homeless people and doctors” according to a group of young people who had experienced homelessness, and that this was a two-way problem. They told us that when health professionals paid more attention to the art of caring for the person (using listening skills, connecting and empathy), it helped to create the trust needed for the right medical interventions. As one group member put it: “The doctors give you pills to solve a mental health issue rather than find out what’s wrong. You probably only need someone to talk to.”
The quality and stability of your housing has all kinds of benefits for your mental health and wellbeing that many of us take for granted. A diagnosis of a physical health condition can leave people out of work and at risk of homelessness. A mental health condition can leave people vulnerable and on the streets. Being homeless exposes people to numerous additional health risks and harms in terms of infection, injury, and exposes them to a culture of coping through health harming, and using unpredictable and highly addictive drugs such as alcohol and synthetic cannabinoids. We know how being ill can cause other major catastrophes in their lives. We know they are more likely to kill or harm themselves. We know they have suffered in their childhoods. Being homeless poses an enormous risk to mental health and homelessness and is a public mental health crisis.
The stories and statistics are frightening, but with collective effort we can make some big positive differences.
How can you help?
National Voices members have unique expertise in a wide range of health conditions and knowledge about supporting the most vulnerable. This information is highly valued by patients, carers and health professionals.
National Voices members can help the QNI to support homeless patients by doing one or more of the following:
- Joining the its QNI Homeless Health network for free news and events updates
- Learning from the QNI Homeless Health web pages
- Writing an article for The Queen’s Nursing Institute’s Homeless Health News
- Expressing interest in presenting about their condition at a QNI homeless health learning event for health professionals.
- Registering to attend the QNI Healthcare for Homeless Families Learning & Networking Event in Birmingham on 17 March
In 2017, let us learn from the warning signs, act quickly and together create world class healthcare for people who are homeless.
Contact: David Parker-Radford