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There are an estimated 320,000 homeless people in Britain. The routes in and out of homelessness are numerous, and so too are the health implications. The mix of structural causes, such as poverty and access to housing, and individual causes, such as relationship breakdown and addiction, highlights the interconnectivity between public policy and individual circumstances in creating homelessness. Critical to understanding homelessness is the cyclical relationship between homelessness, mental health and addiction.

There is a disproportionate link between mental health issues within the homeless population compared with the general population. An estimated 41% of rough sleepers are diagnosed with a mental health condition, compared to 25% of the general population. Reports indicate that an inability to cope with, and stress and anxiety around, the overwhelming prospect of homelessness is an exacerbating factor in mental health.

The stress and anxieties of homelessness are also closely linked with first-time cases of drug abuse. Substance misuse frequently creates an opportunity cost between substances and adequate or stable housing. Reports suggest abuse often goes hand-in-hand with self-medication for mental illnesses. Addiction and mental health issues decrease the chance of those affected finding suitable housing and a job which can facilitate the initial steps to a more stable lifestyle. Consequently, there is an increased likelihood of turning to other ways of earning an income, such as prostitution, to maintain their access to drugs. This, in turn, threatens to further worsen existing mental health conditions, creating a dangerous cycle of worsening mental health and increased dependence on substances.

Just under a third of homeless people suffer from addiction and there is a strong correlation between homelessness, substance abuse and experience of the criminal justice system. In a considerable number of cases, an individual’s substance abuse intensified relative to the strains of the increasing instability of their personal relationships, financial health and housing security. But poor and deteriorating mental health as a contributing cause of homelessness is by no means monopolised by substance abuse.

Access to long-term public services is therefore key to challenging the cycle between homelessness, mental health issues and addiction. Health services and local authorities are required, under the Homeless Reduction Act 2017, to provide tailored services to those affected by homelessness. Issues, however, remain around the local authorities’ resources, cohesion between local services and an inconsistency between programmes. Homelessness represents a failure to break the cycle through the consistent access of integral public services such as stable housing and mental health provisions. Furthermore, with homelessness on the rise, it is argued that more preventative measures are necessary. New government initiatives to solve the issue must target key factors which initiate and maintain the cyclical nature of homelessness, mental health being a prominent example.

Homelessness is an exclusionary condition; often denying individuals access to those services we often see as a civic right and isolating these especially vulnerable members of the population from economic and social participation in society. Providing local authorities with access to key resources to support homeless people with mental health conditions and addiction is a vital part of preventing individuals from entering the cycle, as well as lifting people out of it.

Tom Davis is a student at King’s College London studying for an MA in Early Modern History. He is currently undertaking a week’s work experience at Bright Blue. The views expressed in this article are those of the author, not necessarily those of Bright Blue.