Causes and consequences
In recent Crisis research looking at people's turning points into homelessness those most often cited by UK male participants were relationship breakdown, substance misuse, and leaving an institution (prison, care, hospital etc.).
For UK women the most common were physical or mental health problems and escaping a violent relationship.
There are also problems in wider society that can contribute towards homelessness. These structural causes might include a lack of affordable housing; high levels of poverty, unemployment or worklessness; the way in which the benefits system operates; or the way social housing is rationed.
Whatever the causes of an individual's homeless, the consequences can be brutal. Homelessness damages people's capability through loss of skills, through an inability to think about employment whilst worrying about housing, and through their health becoming impaired whilst homeless. Homelessness also damages people's resilience, self-esteem and self-confidence.
One in four ex-homeless people also find themselves unable to sustain a tenancy - loneliness & isolation are the main causes, often compounded by lack of choice about where they can live. Therefore it is important to build people's skills, confidence and capability to empower them to feel in control of their lives again and so they are able to move on from homelessness for good.
- Housing
- Poverty and homelessness
- Work and skills
- Relationship breakdown and loneliness
- Transitions/leaving an institution
- Health and dependencies
Housing
There is a serious shortage of affordable housing in Britain and in particular social housing.
In England around 1.77 million households, 4.5 million people, are on the social housing waiting lists[1]. That number is predicted to rise to some 2 million households by 2010, that's 5 million people waiting for a social home.[2] As the demand for social housing in England has increased, so the supply has withered - there has been a drop of 1.8 million in the total number of social homes, from 5.5 million in 1981 to 3.7 million in 2007.[3]
Because of the strict rationing system, many people without dependent children cannot access social housing.
Owner occupation is also often out of reach for people on low incomes as it can be far from affordable.
Because of this, the private rented sector (PRS) can often be the only real housing option for many single homeless people. However, there are still barriers to finding suitable, long tem, affordable properties. One of the ways of overcoming some of these barriers has been the development of access schemes. These can provide bonds or guarantees for some of the up front costs of moving into the PRS, such as a deposit or a months rent in advance.
Crisis has 12 years experience of working to make the PRS a viable housing solution for single homeless people. In 1997 Crisis developed a best practice PRS access scheme model called SmartMove, which has helped house over 12,000 people.
Crisis is also the advisory service for the use of the private rented sector to house homeless and vulnerable people, and works with local authorities and PRS access schemes to share best practice and develop effective local services. As part of this advisory role Crisis manages the best practice website www.privaterentedsector.org.uk/ which includes a national database of PRS access schemes and good practice material.
Poverty and homelessness
Anyone can become homeless and many homeless people have previously had successful lives. Lack of monetary resources however do leave people more vulnerable to homelessness as they don't necessarily have the capacity to cope if, for example, they lose their job.
By 2007/08[4] almost 13.5 million people were living in poverty in the UK. Over the last decade, the number of both children and pensioners in poverty has fallen whilst the number of working-age adults in poverty has increased by over 400,000[5]. Link to poverty site http://www.poverty.org.uk/
On becoming homeless, poverty is a very real problem. Poverty and debt issues can prevent people who are homeless from being able to move on with their lives. One of the ways Crisis supports people is through our Changing Lives Awards which offer people grants to help them overcome the financial barriers they face to achieving their vocational goal.
The benefits system can also trap people in poverty. For instance, the way housing benefit (HB) operates can mean that work simply does not pay for its recipients. The current system creates huge barriers for those trying to move into work (unemployment trap) and also for those in low paid work trying to increase their earnings (poverty trap).
HB rules also hinder claimants' efforts to gain new skills and qualifications as anyone over the age of 18 cannot claim Housing Benefit if they are studying for more than 16 hours a week.
Work and Skills
Lack of work is a major cause and consequence of homelessness, eroding skills and self-esteem and acting as a practical obstacle to finding and keeping a home. Training and education can give homeless people the skills and confidence required to get them back on track and help them prepare for, find and keep jobs.
Low levels of skills and high levels of worklessness persist amongst the homeless population and despite investment in mainstream welfare to work programmes and interventions for low skilled adults, they do not work for the majority of homeless people who need more tailored support.
Work
Not having a job can lead to you losing your home and not having a home can seriously harm your chances of finding a job. Most homeless people have multiple labour market disadvantages and almost all have extremely low employability.
- Only 2% of homeless people are in full-time employment. 12% work part-time. 13% do voluntary work.
- 57% of homeless people have been unemployed for three years or more.
With an employment rate of 15%, homeless people are five times less likely than the wider population to be in employment. However, the vast majority of homeless people want to work either now (77%) or in the future (97%)[6].
Homeless people or those at risk of homelessness, ex-offenders, those with mental health needs, people who have alcohol/substance misuse issues and those with a past history of long or frequent benefit claims are amongst those likely to have additional support needs and to require extra support on their journey back to work.
Skills
Many homeless people have low or no qualifications and lack the necessary skills for sustained employment. Many have had bad experiences of formal education and find that mainstream adult learning doesn't cater for their needs. As a result they lose essential self-confidence and lack purpose for improving their prospects.
- 60% of homeless people have low or no qualifications, putting over 80% of job vacancies beyond reach.
- And 37% of homeless people have no qualifications whatsoever
Even for those homeless people who have previously achieved qualifications and/or had successful jobs, the experience of homelessness itself deskills and isolates, destroying confidence, self-esteem and social ties. Many are caught in a destructive cycle of unemployment, mental health problems, addiction or reoffending which prevents them taking control of their lives and moving on. Engaging in activity and learning and developing new skills is a way of breaking this cycle and many homeless people prefer learning in the more relaxed environments of voluntary settings such as the services Crisis provides.
Gaining new skills is not just a means of getting homeless people into employment. It builds confidence, gives structure to the day and a sense of purpose and achievement, improves mental health and well being and gives people the tools to sustain a tenancy. Attending classes and training courses also provides the opportunity for social interaction, a chance to meet new people and make new friends. Investing in learning and skills projects for homeless people can therefore have multiple benefits for individuals, Government policy and public spending.
Relationship breakdown and loneliness
Crisis research[7] has found that, for many homeless people, social isolation preceded homelessness and the experience of homelessness then exacerbates that isolation.
Informal support, such as that provided by family members and friends, can be extremely valuable for all of us, but they can be especially key to a better future for someone with experiences of homelessness.
However, the main cause of homelessness is widely accepted as being relationship breakdown (such as disputes with parents, domestic abuse, marital breakdown or bereavement) and many homeless people do not have any contact with their families.
Alongside the lack of informal support networks, isolation and loneliness are common among people who are homeless. Less than a third of homeless people spend time with non-homeless people, and almost 38% of homeless people said they spent their entire day alone. A third of homeless men reported that their only daily contact was with service providers, and more than half of homeless people said they had no ‘family ties'[8].
Isolation of this kind erodes people's capability (e.g. employability, skills, knowledge, etc) as well as their resilience or ability to cope with life's adverse events, including having the ability to overcome life's difficulties[9].
It is important to emphasise that isolation and loneliness are also commonly experienced after people have been re-housed into permanent housing and are often linked to tenancy breakdown and repeated episodes of homelessness. One in four ex-homeless people find themselves unable to sustain a tenancy, with loneliness and isolation the main causes of this[10].
Building people's skills and confidence, engaging them with society, offering opportunities for volunteering and linking them to others, for example through mentoring, all help break isolation.
Transitions/leaving an institution
Time spent in an institution such as care or prison can increase the risk of someone becoming homeless and, there large numbers of care leavers and ex-offenders in the homeless population and lower numbers who have spent time in the Armed Forces.
Recent data from homelessness day centres and accommodation projects across England shows that, on average:[11]
- 18% of clients were prison leavers
- 14% of clients were care leavers
- 6% of clients were ex-Service personnel
The experiences that people have in an institution such as care, prison or the Armed Forces can trigger homelessness once they leave those surroundings. Likewise, an inability to cope with the adult, outside or civilian world can also lead to homelessness.
Care leavers
The lack of stability associated with being in care can mean care leavers tend to have lower levels of educational participation and attainment and higher levels of mental health problems[12]. All of this can store up problems for the future, meaning those in care might not just face problems when they are leaving care but also in late life - care leavers might also tend to have unstable career patterns tend and higher than average levels of unemployment[13].
Added to this, around two thirds of young people in care have left by the age of 18, while the average age of leaving home for all young people is 22. This means that care leavers have to attempt the transition to independence at a much younger age than other people and so might lack independent living skills.
Prison leavers
About 34% of London's rough sleeper population have previously been in prison[14].
- Around a third of prisoners are not living in permanent accommodation prior to imprisonment.
- Up to a third of prisoners lose their housing while they are in custody.
- Around a third of prisoners about to leave prison said that they had nowhere to stay[15]
When compared to the general population, prisoners are more likely to have had disturbed childhoods, problems at school, literacy problems, a family history of criminality, mental health problems, unemployment, drug and alcohol problems and a history of homelessness[16]
Ex-Service personnel
Crisis research[17] in the mid 1990s suggested that around a quarter of the homeless population had spent timed in the Armed Forces. Since then, there has been a concerted effort from Government and other organisations to tackle the problem. Now only around 6% of both rough sleepers and the wider single homeless people are ex-service personnel[18].
There are generally four distinct "life history trajectories" or pathways into homelessness for ex-service personnel. Amongst homeless ex-service personnel there are these are those with vulnerabilities from childhood or adolescence; those who developed problems whilst in the armed forces; those who struggled to adjust to civilian life after discharge and those who only faced problems after an unrelated traumatic experience after discharge.[19]
Health and dependencies
The experience of homelessness can have seriously detrimental effects on your physical and mental well being. This is especially true for rough sleepers, who have an average life expectancy of just 42 years, compared with the national average of 74 for men and 79 for women[20].
However, poor physical or mental health, along with dependency issues, are problems for the entire homeless population, whether they are sleeping rough on the streets, in hostels, or in overcrowded or temporary accommodation.
Physical disabilities, mental ill health or dependency issues can also trigger, or be part of, a chain of events that lead to someone becoming homeless.
Problems such as these can make it more difficult for people to engage with services and get the help and support they need and too often services are not set up to respond to the needs of homeless people.
Poor physical health
Homelessness and poor physical health go hand in hand. It is perhaps to be expected that sleeping on the streets, in hostels, in squats or in substandard or overcrowded accommodation can have a damaging effect on your physical well being. Homeless people are also 13 times more likely to be a victim of violence - much of it perpetrated by the general public.
A survey of homeless people living in hostels[21] showed that more than two thirds were suffering from physical health problems which included conditions such as bronchitis, pneumonia, trench foot, frostbite and wound infections; respiratory (such as asthma, bronchitis and pneumonia) and cardiovascular (such as heart problems, blood pressure issues and diabetes) conditions; and cancer, epilepsy/seizures, renal damage, hernia and liver damage.
It is not just the physical experience of homelessness that leads to poor physical health. Homeless people lack adequate access to healthcare services. The same survey of hostel residents found that more than one third of those who required treatment did not receive any.
Crisis research has found that homeless people are 40 times more likely not to be registered with a GP than the general public and 55% have had no contact with a GP in the previous year[22]. Emergency services, such as A&E, are often used instead of a GP and homeless people who are not registered with a GP will often have untreated medical conditions that potentially escalate into a situation requiring urgent medical attention[23].
Mental health
Mental ill health is both a cause and a consequence of homelessness. It is widely acknowledged that there are higher rates of mental health problems in the homeless population than in the population as a whole. The onset of mental illness can trigger, or be part of, a series of events that can lead to homelessness. Mental health issues might well be exacerbated or caused by the stresses associated with being homeless.
- 32% of clients of homelessness services in England have mental health needs and 14% have a personality disorder[24].
- 35% of those sleeping rough in London have mental health support needs[25] and rough sleepers are 35 times more likely to commit suicide than the general population[26].
- A recent report for Crisis[27], found that the homeless population has twice the levels of common mental health problems when compared to the general population. Psychosis is 4-15 times more prevalent in the homeless population.
Drugs and alcohol
Problems with drugs or alcohol can be part of a person's spiral downwards into homelessness. For example, a family bereavement may lead to depression or mental illness and drugs or alcohol might then be used as a coping mechanism, to numb the pain. Two thirds of homeless people cite drug or alcohol use as a reason for first becoming homeless[28] and those who use drugs are seven times more likely to be homeless than the general population[29]
There are high levels of stress and mental illness associated with being homeless and it is not uncommon for those traumatised by homelessness to seek solace in drug or alcohol abuse.
Of course, not everyone who has problems with alcohol or drugs becomes homeless and not every homeless person has problems with drugs or alcohol abuse. However, levels of drug and alcohol abuse are relatively high amongst the homeless population.
- 39% of clients of homelessness services in England had issues with alcohol and 42% had issues with drugs.[30]
- In London, 49% of rough sleepers have an alcohol problem and 40% have a drug problem[31].
Serious mental illness is often accompanied by substance misuse problems. Around 10-20% of the homeless population have both a mental health and substance misuse problem - so called dual diagnosis. Services for this group are particularly poor as dependency services find it difficult to cater for people with mental health issues and vice versa.
[1] CLG (2009) Table 600 Rents, lettings and tenancies: numbers of households on local authorities' housing waiting lists, by district: England 1997-2008 (accessed 29/6/09)
[2] LGA (2008) Councils and the Housing Crisis (accessed 29/6/09)
[3] CLG (2008) Housing in England 2006/07
[4] DWP (2009) Households Below Average Income (HBAI) (accessed 29/6/09)
[5] The Poverty Site (2009) Low income by age group (accessed 29/6/09)
[6] OSW (2005) No Home, No Job.
[7] Crisis (2008) Valuable Lives: capabilities and resilience amongst single homeless people
[8] Crisis (2003) Homelessness Factfile
[9] Smith, J. et al (2008) Valuable Lives: capabilities and resilience amongst single homeless people
[10] Crisis, (2000) Homelessness and Loneliness
[11] Homeless Link (2009) Survey of Needs and Provision (SNAP)
[12] Randall, G. & Brown S. (1999) Prevention is better than cure
[13] Randall, G. & Brown S. (1999) Prevention is better than cure
[14] Broadway (2009) Street to Home, Annual Report for London, 1st April 2008 to 31st March 2009
[15] Social Exclusion Unit (2002) Reducing Re-offending by Ex-prisoners
[16] Social Exclusion Unit (2002) Reducing Re-Offending by Ex-Prisoners
[17] Randall, G. & Brown, S. (1994) Falling Out: A Research Study of Homeless Ex-Service People
[18] Homeless Link (2009) Survey of Needs and Provision (SNAP) and Centre for Housing Policy, University of York (June 2008) The Experiences of Homeless Ex-Service Personnel in London
[19] Centre for Housing Policy, University of York (June 2008) The Experiences of Homeless Ex-Service Personnel in London
[20] Crisis (1996) Still Dying for a Home
[21] St Mungo's (2005) SOS Sick of suffering briefing
[22] Crisis (2002) Critical Condition
[23] St Mungo's (2008) Homelessness: It makes you sick
[24] Homeless Link (2009) Survey of Needs and Provision (SNAP)
[25] Broadway (2009) Street to Home, Annual Report for London, 1st April 2008 to 31st March 2009
[26] Crisis (1996) Still Dying for a Home
[27] Crisis (2009) Mental Ill Health in the Adult Single Homeless Population: a review of the literature
[28] Crisis (2002) Home and Dry
[29] Kemp P et al (2006) ‘Homelessness amongst problem drug users: prevalence, risk factors and trigger events' Health and Social Care in the Community 14 (4), 319-328
[30] Homeless Link (2009) Survey of Needs and Provision (SNAP)
[31] Broadway (2009) Street to Home, Annual Report for London, 1st April 2008 to 31st March 2009
