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Groundswell works with people with experience of homelessness, offering opportunities to contribute to society and create solutions to homelessness. Their vision is of an equal and inclusive society, where the solutions to homelessness come from the people with experience of homelessness. In this guest blog, Lucy Holmes shares the findings of their work on mental health and stigma, and signposts some invaluable resources for services:

Groundswell's research and lived experience tell us that people experiencing both homelessness and mental health issues are worried about being stigmatised in healthcare settings. ​ This can have serious impacts – the NICE Guideline ‘Integrated health and social care for people experiencing homelessness’ highlights that stigma and discrimination can create a barrier to accessing and engaging with preventive, primary care and social care services. (NICE guideline 214, p7)

With our new #HealthNow campaign we are bringing together resources to help healthcare and other professionals to:​

  • Recognise and understand people’s fear of being stigmatised and how it may present​.
  • Identify actions you can take to ensure your service is welcoming​.
  • Help the people around you to recognise and avoid stigmatising behaviours​.

The challenge

We gather insight from our peers with experience of homelessness in several ways; through research interviews, through reports written by our Listen Up! Reporters and by listening to the people our Homeless Health Peer Advocates support. Our work on mental health has shown that:

  • People experiencing homelessness face stigma in relation to homelessness, that this is even greater when they also have mental health issues, and that it’s even more complex if someone is using drugs or alcohol.

I have never been on the crisis team. I rang the crisis team, and they are exactly the same. They just think I am screaming for drugs” – a research participant

  • Mental and physical health services can be hard to access. When people experiencing homelessness are stigmatised, or fear being stigmatised, this can be even harder.
  • Stigma, or fear of being stigmatised, can lead to worsening mental health, which not only impacts health but also someone’s ability to move from homelessness.

I spent four and a half years sleeping on the floor, and I think this is because I was quiet. My mental health wasn’t good, so it was very difficult to put my point across.– a Listen Up! Reporter

  • Many people don’t get the support they need and end up at crisis point before they get help. Stigma plays a huge role in this cycle – both through the stigma imposed by others and the self-stigma/shame people experience.

It's a stigma, isn’t it? As soon as you say ‘oh, I have got mental health issues’, people just like look away” – a research participant

The solution

We need to dismantle the compound stigma people face when they’re experiencing both homelessness and mental health challenges. If you work in a service that supports clients or patients, you can help by understanding how stigma affects people experiencing both homelessness and mental health issues and taking steps to tackle it. We have produced some resources to help you ensure your service is welcoming:

Groundswell & Mind leaflet ‘You have the right to feel OK’

You can give this leaflet directly to your clients or patients to help them understand their rights to mental health support if they’re experiencing homelessness and having thoughts, feelings or experiences that are upsetting or overwhelming.​

Click here

​​‘Clarissa’, the film

Clarissa’s story is one of trauma, the importance of trust, and how this impacts someone’s experiences of healthcare. It has been woven together from real experiences of people trying to access the healthcare system while facing homelessness in the UK. Watch the film and download the resource pack at: https://groundswell.org.uk/resources/clarissa/ This film is used by many healthcare providers in team meetings, training or inductions.​ (23 mins)

Top tips for GPs to support people facing multiple disadvantage, a short film

Producing in partnership by Groundswell, #HealthNow and Westminster Changing Futures, this new film features advice from a GP people with lived experience of homelessness. Click here to view. (9mins)

How to help

  1. Share our resources with your team, and tell us how it went: research@groundswell.org.uk
  2. Sign up to our #HealthNow newsletter at https://groundswell.org.uk/get-involved/sign-up-for-our-newsletter/ to hear more and get involved with our campaign.
  3. Read, watch, comment and share our Listen Up! reports and short films at https://groundswell-listenup-hub.org/

Further reading

#HealthNow peer research report ‘Knowing where to turn: access to mental health support whilst experiencing homelessness’

Accessing mental health support while experiencing homelessness is challenging and complex. This qualitative, peer research is based on interviews with 73 people experiencing homelessness and 7 stakeholders. The findings highlight the key difficulties people who are homeless face when experiencing poor mental health.​

Listen Up! Insight 1: Mental health and homelessness

This Insight draws on nationwide research interviews with 44 people experiencing homelessness and a selection of stories from our 14 community reporters, who all have lived experience of homelessness.