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Health and Homeless - The power of working together
Healthcare sessions provide opportunities to recognise the signs that someone is struggling to keep their home or that the condition of their housing is causing ill-health.
Bart was 34 and working as a security guard when he was admitted to hospital with acute myeloid leukaemia.
"I had no savings and was on the minimum wage. I had been staying with a friend, but was not able to return there because my friend was afraid that he might ‘catch’ the cancer."
- Bart, one-time homeless person
Bart had to undergo chemotherapy, which meant repeated visits to the hospital. However, he had nowhere to live. The London borough where he had previously lived was reluctant to house him, despite his medical reports.
There are many cases such as Bart’s. Bad housing conditions, homelessness and poor health are intrinsically linked and it is well known that poor health is both a cause and a result of homelessness.
The complexity of providing quality healthcare to the homeless is the reason why the fields of homelessness and health need to find ways to work together. As it is, the healthcare system and homeless organisations are set up to work separately from each other. This hampers the possibility of reaching the most vulnerable. Medical professionals do not know the housing status of their patients, which limits the scope for intervention. In addition, it is difficult to provide ongoing healthcare to the homeless or those in danger of losing their homes.
A lack of joined-up working across sectors has often been cited by politicians and policy-makers as a fundamental barrier to resolving social problems. In 2013 the Minister of State for Care and Support, Norman Lamb, said, “People don’t want healthcare or social care, they just want the best care.”
“Working together produces better outcomes for people,” said Amanda Beswick, Director of Oak’s Housing and Homelessness Programme. “Yet there are some clear barriers to achieving this common-sense logic, both structural and cultural.”
Oak funds initiatives that work to strengthen the links between the homelessness sector and health providers. These include Pathway, which helped Bart, mentioned above, find a home.
Integrated working across government agencies or between not-for-profit organisations is a common theme running through HHP grant-making. Oak sees firsthand the challenges and the benefits when services work together. We asked our grantees some important questions about their work. Read on to find out what they are doing to link the two sectors of housing and healthcare.
Can health providers detect early signs of housing distress?
People at risk of losing their home are not always that easy to reach. Medical appointments are one way to make contact with people who do not use other services – they provide a window of opportunity to talk through issues that contribute to people’s ill health, such as poor housing. Healthcare sessions can provide ways to recognise the signs that someone is struggling to keep his or her home, or that the condition of a person’s housing is contributing to their ill-health.
The Govan Law Centre (GLC), based in Scotland, provides free legal services to people on low incomes for housing, debt, discrimination, education, employment and welfare.
GLC has established weekly Rights Hubs in the four main psychiatric hospitals in Glasgow. These Hubs help the most vulnerable and marginalised people in the city find out about their rights in regard to welfare benefits, debt and housing. In this way, GLC strengthens referral routes between mental health services and homelessness prevention services across the city.
“Our work is clearly having a positive impact on patients. This is in terms of resolving housing and related issues, but also in terms of health, wellbeing, recovery and discharge.”
- Alistair Sharp, Govan Law Centre
“A key factor to our success was having someone champion our cause,” said Alistair. “In this case, it was one of the National Health Services’ mental health service operational managers – he certainly opened doors for us. He saw the immediate benefit and impact of our work with patients. We developed a shared vision of how benefits could be expanded across other psychiatric hospitals in the Glasgow area.”
The Boston Medical Center has always had a progressive view on homelessness. It is one of Boston’s largest hospitals and has, for many years, helped homeless people with medical problems.
Its Elders Living at Home programme identifies housing problems that may put older patients at risk of becoming homeless. It then partners with the Medical Legal Partnership to help resolve these problems so that clients can overcome barriers to securing and maintaining suitable, permanent housing.
“The key to success has been educating medical providers about all of the challenges that their patients, particularly their low-income patients, face in their daily lives,” said Eileen O’Brien from the Boston Medical Center. “We help them understand how a lack of housing or very unstable housing impacts on their patients, and can undermine their health no matter how many health interventions the providers attempt. They appreciate the programme because it makes them better, more effective practitioners, and they see that their patients have better results. They are now starting to embrace the approach on a policy level as well.”
Find out more in our Annual Report 2015.
The photos in the HHP section of the report illustrate the work of Oak's partners. They are working to help people who have experienced homelessness improve their health, find work and keep their homes.
Photo 1 © Providence Row (Bart)
Photo 2 © Janian Medical Center for Urban Community Services
Photo 3 © Reach the Charity
Source: Oak Foundation Annual Report
Year of publication: 2015
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Grantee Perception Reports
Oak Foundation commits its resources to address issues of global, social and environmental concern, particularly those that have a major impact on the lives of the disadvantaged. With offices in Europe, Africa, India and North America, we make grants to organisations in approximately 40 countries worldwide.