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Pathways into Multiple Exclusion Homelessness in the UK

Pathways into Multiple Exclusion Homelessness in the UK. Feedback Seminar. Dr Sarah Johnsen. Background. ‘Multiple Exclusion Homelessness’ Research Initiative – 4 projects Need for better understanding of ‘deep social exclusion’ and ‘multiple and complex needs’

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Pathways into Multiple Exclusion Homelessness in the UK

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  1. Pathways into Multiple Exclusion Homelessness in the UK Feedback Seminar Dr Sarah Johnsen

  2. Background • ‘Multiple Exclusion Homelessness’ Research Initiative – 4 projects • Need for better understanding of ‘deep social exclusion’ and ‘multiple and complex needs’ • Relatively small group but very vulnerable and costly • Role of homelessness 2

  3. Our Study • Nature and causes of MEH in UK • Multi-stage quantitative survey of people experiencing MEH in seven UK cities: Belfast, Birmingham, Bristol, Cardiff, Glasgow, Leeds and Westminster (London) • University team + TNS BMRB + a wide range of voluntary sector partners; crucial role played by 7 ‘local co-ordinators’ • Academic papers, feedback seminars, briefing papers, and national launch (12 September 2011) 3

  4. Definition of MEH People have experienced MEH if they have been ‘homeless’ (including experience of temporary/unsuitable accommodation as well as sleeping rough) andhave also experienced at least one of the following: • ‘institutional care’:prison, local authority care, mental health hospitals/wards • ‘substance misuse’: drug, alcohol, solvent or gas misuse • 'street culture activities’: begging, street drinking, 'survival' shoplifting or street-based sex work 4

  5. Methods Identified all relevant ‘low threshold services’ – randomly selected 6 services in each location (= 39 in total, including Leeds pilot) ‘Census questionnaire’ survey of all service users over a 2 week ‘time window’ = 1,286 short questionnaires returned ‘Extended interview’ survey with service users who had experienced MEH = 452 interviews completed 5

  6. Main Findings from Census Survey - 1

  7. Main Findings from Census Survey - 2 • Westminster (London) different from the other 6 cities - migrants; less complex needs • Other cities broadly similar (although Birmingham often at ‘lower end’ of frequency range amongst these) 7

  8. Extended Interview Survey: age and gender profile 8

  9. Clusters of Experiences 1. ‘Mainly homelessness’ (24%) = least complex; male + over 35; migrants; Westminster 2. ‘Homelessness + MH’ (28%) = moderate complexity; disproportionately female 3.‘Homelessness, MH + victimisation’ (9%) = much more complex; suicide attempts, self-harm; victim of violence; LA care and prison; younger than average 4. ‘Homelessness + street drinking’ (14%) = moderate complexity; high levels of rough sleeping + street culture; male + over 35; Glasgow 5. ‘Homelessness + hard drugs’ (25%) = most complex; very high across all domains, especially substance misuse and street culture; most in their 30s 9

  10. More Complex • Male • Middle years (esp. 30s) • Childhood physical abuse and neglect • Childhood hunger • Childhood homelessness • Parents with drug, alcohol, DV or MH problems • Poor school experiences (truancy, bullying, exclusion) • On benefits for most of adult life 10

  11. Less Complex • Female • Younger (under 20) and older (over 50) • Migrants (but not so true of A10) • Westminster • In steady work for most of adult life 11

  12. Individual Sequences Four broad phases in individual pathways: Solvents etc., leaving home/care, drugs/alcohol, leaving armed forces MH problems, survival shoplifting, survival prostitution, victim of violence, sofa-surfing, prison, redundancy Sleeping rough, begging, injecting drug use, admitted to hospital with MH issue, divorce, bankruptcy Hostels/TA etc., applying as homeless, eviction, repossession, death of a partner Generally consistent across all five clusters 12

  13. Implications • Services should be alert to a very high prevalence of childhood trauma and extreme forms of distress in adulthood • ‘Clusters’ of experience may be helpful in planning services – but not a substitute for individual needs assessments • Relative consistency of pathways – can be used to inform prevention • ‘Visible’ homelessness is generally a ‘late’ sign of MEH - schools, drugs/alcohol agencies, criminal justice system, etc. must be central to prevention efforts • Does not diminish importance of tackling homelessness – should not conflate ‘pathways in’ with ‘pathways out’ • Men in 30s/early 40s – specific needs associated with the most extreme forms of MEH • Migrants need bespoke services 13

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