Homelessness and mental ill health are inextricably linked. Today is both World Homelessness Day and World Mental Health Day – an opportune time to share how homelessness and mental health interact with each other.
Manager of Sacred Heart Central, Chris Middendorp says, “Mental ill health is endemic to the experience of homelessness, and a significant factor in the lives of our clients.”
When people are experiencing homelessness, they are at greater risk of trauma, which makes it harder to maintain good mental health. Broadly, people who have histories of frequent breakdowns of housing have often not received the treatment they need for complex mental illness.
A lack of mental health support, and the trauma of experiencing homelessness exacerbates their conditions. Owing to life experiences, people may find it difficult to connect with or trust others and face barriers to participation in community life. This in turn can contribute to a fear of health services, and a reluctance to seek further support – yet this leads to greater social isolation. It is a vicious cycle.
“Finding creative, sensitive, flexible approaches to mental health treatment is absolutely critical, and this is why the partnership with Alfred Health is so important,” says Chris.
To combat the barriers for people experiencing poor mental health and homelessness, Sacred Heart Mission partners with Alfred Health’s Homeless Outreach Psychiatric Service (HOPS).
HOPS primarily work with Sacred Heart Mission’s Engagement Hubs, Sacred Heart Central and Women’s House, and our women’s crisis accommodation service, Homefront. HOPS provides a pathway for people who are experiencing homelessness and who are highly vulnerable to access mental health treatment.
“HOPS check in with us every day, giving us a list of names of people known to them to look out for. For those who are itinerant, we are the one constant in their lives. Sacred Heart Mission acts as a conduit to help connect HOPS to this group who are hard to follow up with, and they use us as a way to send messages and engage with people they are treating, and we are a source of new referrals,” says Chris.
HOPS mainly conducts outreach work, meaning they meet with their clients in a public environment, such as Sacred Heart Mission to ensure they remain connected to the Alfred’s community mental health service and engage with their treatment, and monitor people who are reluctant to engage.
HOPS provides expert clinical advice to Sacred Heart Mission staff on working in a strengths-based way to support people in accessing treatment, to help staff understand the nature of mental illness, impacts of certain medications and how the Mental Health Act works.
“Since the HOPS and Sacred Heart Mission partnership was implemented, we are seeing less social isolation and psychosis overall,” says Larissa Berrell, Outreach Coordinator and Senior Nurse of the HOPS program.
“The most significant change comes from the grassroots level, role modelling, and where clients see others experiencing positive changes in their mental health directly, they are more likely to engage with us,” says Larissa. “Clients don’t always need our help forever, but when experiencing homelessness, they need additional support to get back on their feet.”
The importance of access to treatment, particularly for people with complex mental health needs, cannot be understated. When someone does not access appropriate treatment in a timely manner, the risks to that person, their loved ones and broader society can be severe. Without intervention, people are more likely to use substances to manage their pain, engage in self-harm or self-destructive behaviour, and have contact with the police and justice systems.
Essential to good mental health is access to housing. “Without housing, there is a greater risk of trauma, and it is much harder to maintain positivity and ability to look after yourself – physically and mentally,” says Larissa.
“We need more housing. We need more accommodation with support like Sacred Heart Mission’s Rooming House Plus Program (RHPP), says Larissa. “For people who have long histories of homelessness and complex mental illness, housing is essential – from there we can wrap support around people and help them address their goals.”
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