Blog: Health & Homelessness II

The true benefit of a conference such as that organised by Arch and Frontline Network yesterday, aside from the opportunity to network and meet contacts, is the opportunity to reflect, take stock and renew perspective. “Familiarity breeds contempt” as they say and even the most experienced and compassionate in frontline work, can lose perspective, forget…

So many are quick to judge the homeless.

So many are quick to distrust them.

So many forget that they are people.  

Metropolitan Jerome of Selsey

People often blame the homeless for their predicament, assuming in some way they must be culpable for their becoming homeless. For some of course, that may be true. For the majority however, it is not. Dr Tim Worthley’s session on Mental Health yesterday served to remind some of us and inform others not just about the varying degrees, conditions and presentations of mental health, but also some of the causes. Psychosis, neurosis, personality disorders, we’re all at once familiar with these terms and yet so unfamiliar with or confused about their symptoms but most importantly, often ignorant of their causes?

Most of us can relate to depression. Most of us have experienced depression. For sure, clinical depression is “a thing” and may have biological as well as emotional causes and physical symptoms, and it can develop into other mental health conditions. But the main causes of mental health are generally best appreciated as trauma, or even more accurately PTSD i.e. Post Traumatic Stress Disorder. This amazing suggestion by Tim certainly caught everyone’s attention, but quickly I could see and appreciate the logic behind his assertion, especially when recalling the life experiences of many homeless people I’ve known.

While we often think of PTSD with regards to veterans or refugees through warfare or violent conflict, we forget that other violent events can also be extremely traumatic, sexual assault, vehicle collision, physical attack etc. The awful truth about the lives of many homeless people is that they have often experienced severe trauma in their life, whether as children, as adolescents, as young adults or later in life. Relationship breakdown, redundancy, poor mental health, alcohol/substance addiction, domestic abuse some or all of these things our homeless people have experienced before becoming homeless and even while sleeping rough.

Homeless people are 17 times more likely to be a victim of violent crime than the general public, and 47 times more likely to be a victim of theft.

The charity CRISIS conducted a survey in 2016 which discovered that people who sleep rough are 17 times more prone to facing physical attacks than the rest of the UK public and are 15 times more likely to have suffered verbal abuse. Nine per cent of the 458 homeless people who took part in the study reported being urinated on as they slept on the street, and more than a third have been deliberately hit, kicked, or had things thrown at them. Nearly one in 10 homeless people have been victims of sexual assault while more than half have had their belongings stolen. Three in ten female rough sleepers experience sexual violence at some point while homeless. Is it any wonder that one in 9 homeless people are more likely to commit suicide than the general population and that 70% suffer with mental health issues?

Often the reason why so many homeless people present with complex medical conditions is because of trauma built upon trauma, through compiling situations that compact their predicament. A person going through trauma will often seek relief, escape from the reality of the situation either mentally creating defense mechanisms or ways of protecting themselves, or they may do that and/or turn to alcohol or drugs, initially just as a “coping” mechanism, but of course these things can spiral into over reliance, dependence and addiction. The side effects of these coping mechanisms can themselves compound their problems, so that the person who started trying to protect, defend or cope finds themselves hard-wired into certain behaviours or ways of thinking or overwhelmed, and thus actually undermined by the very things they sought help and relief from.  

The correlation between drugs, crime and psychosis is well known, similarly between alcoholism and health problems, and all of them contributory to perpetuating or exposing individuals to violence, anti-social behaviour, petty crime, infringements, poor judgement, hallucinations, delusions, insomnia, formal thought disorder and a whole host of mental health issues…! All of that is technically possible without homelessness… but all of them can be combined with or affected by or contribute to further traumatic experiences, putting as they do an individual into often further dangerous and unsought situations.

The average age of a rough sleeper at death was 43, nearly half the UK life expectancy. Eight out of 10 of the rough sleepers who died on the streets and in temporary accommodation over the past five years were men.

Source: Guardian FOIs 2017

For example, someone might have experienced severe trauma as a child and so developed a dissociative coping mechanism, but become hardwired to it or so reliant upon it that they can’t properly address the issue it obfuscates later in life. They turn to alcohol or drugs to help suppress the memories, emotions and/or anxiety attacks, gradually becoming disengaged or disassociated from their life. Being unable to judge properly or have disordered concepts they may enter into an unhealthy relationship, fall in with the wrong crowd and/or likely experience further abuse. Through the drug and/or alcoholic abuse, they may develop psychosis, become unable to hold down employment, relationship or home and find themselves on the street vulnerable to further abuse such as that described above etc, etc! 

How can frontline workers and volunteers affect change in the lives of the homeless? Now despite all this “doom and gloom” there is a way in which those with a heart to, can and are inspiring many people to find hope in their predicament. By remembering and treating them as people. By not presuming to judge their character, their personality, their situation, their actions, their behaviour. It is all too easy to objectify others consigning them to an umbrella term that takes away and ignores their individuality. It’s one thing to refer to “the homeless” its quite another to think of or refer to a person as simply “homeless”… they are so much more than that!

Everyone has a name. They are a person who has fallen on hard times, who doesn’t for a myriad of reasons have the usual support structures of family, friends, a home nor employment to assist them in their predicament. Yes, it may well be that they have perhaps deliberately or inadvertently brought themselves to their present plight… or it may not be down to any fault of their own at all. We all know life is hard. We all know that for many of us, family, friends, house, job… have perhaps spared us from becoming homeless ourselves. All they need is someone to care. Someone to listen to them. Someone to be there for them. Someone to treat and relate to them as John, Mary, Tom, Sarah or whatever their name is... a person

This was why when Cherubs got involved with The Hub we introduced table service rather than queueing at the hatch for food and volunteers to sit with guests and chat to them and serve them… to treat them as people.

TBC/…

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