Homelessness and mental ill health in Scotland - New report

The Mental Welfare Commission published a new report today on homelessness and mental ill health, and found a picture of significant needs that were only partially being met.

For this small-scale study, Commission staff spoke to 43 homeless people in two local authority areas - one urban and one rural. The Commission sought to understand how interviewees accessed, and how they experienced, services for homelessness and for mental ill health.

The report includes anonymised comments from interviewees, giving their own views and experiences.

The Commission also spoke to staff working in homelessness services.

Kate Fearnley, executive director, engagement and participation, Mental Welfare Commission, said:

"This is a small scale study, through which we wanted to hear the views of just some of this particularly vulnerable group of people.

"We found that some people were receiving the care and treatment they needed, but others were not, or had difficulty accessing it.

"We saw engaged and committed staff in homelessness services supporting people with significant mental health needs, but lacking direct referral routes to psychiatric and psychological services. We heard that the only way of accessing those services was via a GP, but there could be barriers to registering.

"We also heard that there is a disconnect between mental health services and substance misuse services, and some people who need both may get neither. This issue has been recognised by government as an area in need of improvement in its new mental health strategy."

Key findings include:

• Thirty seven people were registered with a GP, but the Commission heard about significant difficulties getting registered.
• People who were diagnosed with both mental ill health and addiction issues sometimes had difficulty in getting help.
• Homelessness services told the Commission that access to psychiatric services was very difficult to arrange, particularly out of hours.
• On release from prison there is often a delay in accessing medication due to difficulties registering with a GP, and GPs' reluctance to prescribe without input from a hospital consultant.
• The Commission was told that the benefits system is not set up well for homeless people, and in particular for people with mental health problems.
• Seventeen of the 43 people spoken to felt they faced discrimination, particularly from private landlords.

Over half of the 43 individuals spoken to said they experienced depression. Twelve reported other diagnoses including bipolar disorder and schizophrenia.

Almost half had spent some time in prison.

Twenty had experienced sexual or physical abuse.

Fourteen of the 43 had been looked-after children in the care of a local authority, and three of the interviewees were in the 16 to 17 year old age group.

The Commission makes a number of recommendations in the report, including calls for NHS boards and social care partnerships to improve access to GPs and to consider the needs of homeless people in the local psychiatric emergency plan.

The Commission also recommends that local authorities review how they provide appropriate aftercare for former looked after young people under the age of 26.

There is a recommendation for the Scottish Government to ensure that the new Scottish agency set up to administer social security payments is fully accessible to people who are homeless.

Kate Fearnley added:

"This was an exploratory project in which we learned a lot about how best to reach this group.

"We had to take a different, more flexible, approach to the interviews and to information gathering, and we will now look for ways we can build this into our work in the future. We are grateful to all of the interviewees for sharing their experiences with us."

Notes to editors

The interviews were arranged through direct contact with services for homeless people. The Commission spoke to people who were available and willing to talk on the day of the visits, which took place between July and October 2016.

Due to the small scale nature of the report, individuals and local authority areas have been anonymised.