A third of all those evicted in Britain suffer with mental illness

By Julie Hyland
30 August 1999

Local Authorities in Britain are continuing to evict mentally ill people onto the streets, according to a new report by the national homelessness charity Crisis.

The “Pressure Points” report estimates that in a third of all cases, those who lose their accommodation are suffering with mental illness. This perpetuates a vicious cycle in which the stress of homelessness often exacerbates the illness and makes it difficult for those suffering to gain access to housing and healthcare in the future. Once homeless, many mentally ill people can remain without permanent housing for several years. Many local doctors' practices are reluctant to accept the homeless onto their lists.

The report's publication is aimed at beginning an awareness campaign to promote long-term solutions for the homeless mentally ill. It estimates that:

* Six out of ten homeless people experience some form of mental distress. The homeless are 11 times more likely to suffer from illnesses such as depression, than the general population.

* One person in five sleeping rough has a severe mental health problem, such as schizophrenia. More than one in six rough sleepers have stayed in a psychiatric hospital as an inpatient.

* People who sleep rough are 35 times more likely to kill themselves than the general population. The average age of death by suicide for rough sleepers is 37 years old.

“Pressure Points” praises examples of good practices—such as floating housing support teams, which combine health, housing and social services staff. But such practices are few and far between. A more accurate indicator of Local Authorities' attitudes is revealed in the comments of one London borough housing official that is contained in the report: "You can't help people like that. We evict and they come back round through the homelessness resettlement route. We can put them in temporary housing but they often disappear after a couple of months."

Many homeless mentally ill are placed in hostels and bed-and-breakfast accommodation. More than a third of such individuals have high levels of mental health problems including anxiety, depression and obsessive-compulsive disorder. Two percent of those in hostels and eight percent in private sector accommodation are diagnosed as psychotic.

Releasing the report, Shaks Ghosh, chief executive of Crisis, said: "The mentally ill are ending up on our streets when there is no need for them to be there in the first place. Mental health problems often start before homelessness and can directly cause a loss of accommodation, but they can also be the reason people remain homeless for many years as simply re-housing these people is not always the answer."

The National Housing Federation, an umbrella body representing housing associations, said the support needs of mentally ill people were often not identified at an early stage when action could be taken to avoid eviction. Good practice was patchy, the federation admitted, and housing officers were under pressure to ensure rents were collected on time. Due to high-profile media scares about the dangers of "psychopaths on the streets", money for mental healthcare had been targeted at acute services, whilst investment in preventive measures had been sidelined.

A spokeswoman for the Local Government Association—which is currently compiling information focussing particularly on evictions of vulnerable people—said the issue was not a housing problem. It is "a result of a breakdown in mental healthcare", she said.

The previous Conservative government introduced a programme of “Care in the Community” that provided neither adequate care for the mentally ill nor community support. Between 1988 and 1995 the average daily number of long-stay beds available in hospitals for the mentally ill was cut by half to 18,644. During the same period the proportion of the average hospital budget spent on mental health fell from 14.4 percent to 12 percent.

Labour has continued the Conservatives' approach, with the result that having lost access to residential mental healthcare many are now also losing their homes. Over the last year the government has empowered Local Authorities to evict tenants for "anti-social behaviour". Local Authorities have also stepped up their crackdown on non-payment of rent. With mental health and social service resources already overburdened, those in need of help are increasingly likely to be overlooked, or even turned away. Labour's proposal to indefinitely detain those deemed to be suffering from "Severe Personality Disorder", even if they have committed no crime, can only have heightened the anxiety facing mentally ill people. Faced with such a threat, many will be extremely reluctant to seek help with their problems for fear that they may be locked up for life.

The “Pressure Points” report can be downloaded from the Crisis web site in pdf format: http://www.crisis.org.uk/