Homeless people with mental health problems face a major struggle to get the help that they need, a new report has highlighted.
The research report, Homelessness and Mental Health: Voices of Experience, looks at the personal stories of people with mental health issues who are also homeless.
"This report explores homeless people's interactions with mental health services and takes a rare look at homeless people's own perspectives of the barriers they face in accessing mental health supports," explained Dr Shari McDaid, director of Mental Health Reform, which jointly launched the report with Dublin Simon Community.
The report highlights two particular issues facing homeless people with mental health problems:
-Inadequate access to appropriate crisis mental health support on a 24/7 basis
-Difficulties accessing mental health services if the person has both a mental health problem and an addiction.
"Homeless people usually have to go to an Emergency Department (ED) if they are in crisis. However we think that this is not a practical solution. Most homeless people won't go to an ED in the first place because they know how they're going to be treated.
"The solution is to develop and deliver a 24-hour seven day a week direct access community mental health service for homeless people already engaged in the mental health services," commented the Homeless Adults Speak Out on Mental Health group, which helped to advise on the research.
Meanwhile, Dr McDaid described being homeless and having mental health issues as a ‘double stigma'.
"The findings illustrate the struggle homeless people face in accessing mental health services including bureaucratic barriers, the double stigma of homelessness and mental health difficulties, and being denied mental health care due to having a substance misuse issue.
"We know that severe mental health difficulties are more prevalent among homeless people than the general population, therefore it's crucial that their pathways into services are easy and that the service they receive is respectful and compassionate. The Government needs to act to ensure that mental health services are fully accessible to everyone, including homeless people," she commented.
Claire McSweeney, head of emergency services in Dublin Simon Community, pointed out that many of the people that the charity works with have previously been exposed to some sort of trauma and they often have severe mental health issues and addiction problems.
"The experiences of people in this report emphasises the need for services for people with severe and enduring mental health and addiction issues, as well as for those experiencing less severe mental health difficulties, such as anxiety and depression, with problematic alcohol and/or drug use," she said.
Responding to the need for mental health care and support among their clients, Dublin Simon Community established the Sure Steps Counselling service. This offers one-to-one counselling, drop-in clinics, emotional wellbeing groups and an on-demand crisis intervention for people who are in distress or feeling suicidal.
Ms McSweeney noted that there has been a ‘significant uptake' in this service and as a result, it has been ‘greatly expanded over the past four years'.
"The main success of this service is that counselling and support goes to where our clients are staying, with flexible session times and lengths. However, this Sure Steps Counselling is but one service and is a drop in the ocean when you look at the needs of our clients and the barriers that they face in accessing support and care. As we see from this report, there remains significant gaps in mental health services for people who are homeless," she emphasised.
She added that once a person becomes homeless, the deterioration in their physical and mental health ‘can be both rapid and debilitating'.
"Rapid access to support and specialised care is vital to ensure that people can address what circumstances brought them to be where they are and provide the emotional supports for them to recover from the detrimental impact of homelessness."