Committee calls for more to be done to help rough sleepers with mental health and substance misuse problems

​The National Assembly’s Equality, Local Government and Communities Committee has today called for more to be done to help rough sleepers suffering a mental health and substance misuse problem.

The Welsh Government’s Homelessness Action Group has described the situation in Wales as a “rough sleeping emergency” because of the 45% increase in the number of people sleeping rough between 2015 and 2018.

The Committee heard distressing evidence from people with experience of rough sleeping and from those who work with homeless people, prompting it to call for an urgent solution to the increasing problem.

Working in silos

The Committee was disappointed to hear from a panel of people working with rough sleepers that a significant barrier to delivering effective services were due to cultural issues within organisations and lack of leadership. Repeatedly, the Committee was told of silos and of an “us and them” attitude between different professional groups.

Those working with homeless people recognise that services to help individuals with housing, mental health issues and substance misuse must work together to tackle the issues they face. The Committee heard that the Welsh Government ‘s Housing First pilot scheme has shown that this can be done. Members of the Committee were told that the very nature of the model, bringing together a wide range of services, has led to more integrated working. However, the Committee is clear that Housing First is not a “silver bullet” and other problems needed to be addressed

The Committee is recommending that the Welsh Government takes the lead role in working with organisations across different areas, such as mental health services, substance misuse and housing to change the culture to bring organisations together to deliver properly integrated services. It also recommends that the government identifies best practice to encourage sharing across different sectors.

Training

Those dealing with substance misuse and addiction are often the hardest to reach and the Committee heard how there are different reasons why housing was not the only thing needed to prevent rough sleeping.

In evidence, the Wallich said:  “The real thing that’s stopping people coming in is that the offer that we have in services is less than what the streets offer. So, if you’re in the throes of addiction, you’ve got all these complex mental health issues… you can turn that pain off with spice or heroin quite easily. We can’t offer people that. You can be nobody in a flat, or you can be somebody on the streets. There are cultural implications for people who’ve been out there for a long time.”

The Committee was told that there aren’t enough staff with the right training and expertise to deal with the complexities of someone with mental health and addiction issues while providing more general support to rough sleepers. It believes this needs to be addressed to ensure that there are both enough specialists and also more general support staff with the  appropriate levels of training to support those trying to come off the streets.  As part of this, the Welsh Government should consider the effectiveness of specialist psychiatry training.

Bob (not his real name) is a tenant on The Salvation Army’s Housing First Cardiff programme which is funded by the Welsh Government. He says it helped him get off the streets where he’d become dependent on drugs to cope.

“Being homeless is horrible and I’ve been through some very dark times. You can’t see a light at the end of the tunnel. When I was on the streets I was abused and humiliated. You feel people are looking down their noses at you and I’ve been spat on; had beer bottles broken over my head; been kicked in my head; been insulted and had people make fun of me – it’s a very degrading and humiliating experience and taking drugs helped to blot it all out.

“When I got into The Salvation Army and Cardiff Council’s Housing First programme, I’d been ‘through the system’ for nine years – from being street homeless; in jail; staying in hostels to living in a shared house and my benefits were messed up and I was at a complete loss and had no hope.

“Life is looking a lot better now since working with professional support from my Housing First key worker, I’ve been able to address my addiction problems and I’m in recovery, because of this progress my daughter’s back in my life. I haven’t had contact for almost 20 years, but things are much different now. Housing First has been the only programme that’s worked to get me out of homelessness and to stop taking drugs and the reason it’s worked is because of the staff and the tailored support they’ve given me.”

John Griffiths AM, Chair of the Equality, Local Government and Communities Committee said:

“There is no question that we are facing a rough sleeping crisis and there is not currently enough money in the system to deliver the significant shift needed to tackle the problem. However, it’s also clear that there are many structural problems across Wales preventing us from eradicating rough sleeping. Homelessness cannot be prevented through housing alone, there is a role for all public services in tackling the issue.

“Organisations are often working in silos and when you have someone without a home, with a mental health problem, who is dealing with substance misuse, there are a number of different agencies that need to be involved. It is clear from our inquiry that these organisations must work better together and someone needs to take the lead – the Welsh Government should show leadership and bring people together.

“It is obvious to me that there is some brilliant work happening, such as the Housing First projects and the Community Care Collaborative in Wrexham, these people leading the way – but this must be replicated across Wales as a matter of urgency.

“We spoke to people in seriously difficult circumstances, we heard that many rough sleepers also face additional barriers as a result of conditions such as autism or ADHD. If they are also dealing with mental health problems and addiction, they have a mountain to climb to get the right support.

“We know that many people will spend Christmas alone this year due to a range of reasons. Although there have been some positive steps taken by the Welsh Government, today we’re calling on it to show leadership and act urgently to tackle rough sleeping and the complex reasons for it.”