homelessnesS  is  a  symptom of structural dysfunction in society.

When the person have lost everything,  there is no more that the body for cry and the street to get lost !

Homeless people live in conditions of severe & chronic precariousness – social, physical and psychological. Their predicament calls our into question our democracy when so many citizens are denied their fundamental rights.   

Homelessness is a provocation and a challenge. Not only for those who work directly with homeless people but to all parts of the social system.

Two questions will underpin our reflections and exchanges of knowledge and experience:

A.  How to understand and engage with people who refuse help.
      Some homeless people - with mental health problems, who permanently
      sleep rough, use  emergency centres or liv in squats seem to refuse any 
      institutional offer of help.

B.  How can services for homeless people  promote dignity, rights and
      well-being? 

These questions arise against a background of:

1.  Increasing poverty in the EU:  financial, material and reduced
  employment (cf.  EUROSTAT  Statistics Explained)

    2. Increasing numbers of homeless people in the EU  - 700,000 
     homeless people in Europe. (2021) (CRISIS estimation UK)

    3. Persisting high levels of severe mental illness amongst homeless
     people - around 3 to 4 out of every 10 homeless people have a
     significant mental health problem.

4.  An under-estimation of the psychological impacts of homelessness
     on the development of children -

 

A contradiction has arisen. The greater the number of people in poverty in Europe, the more extreme and  complex their needs become, but the fewer services are available to them as budgets and personnel are cut and planning is neglected.   

The unspoken motive seems to be  that such people don't count . And, moreover, that they do not deserve to be able to again find their place in society and the social community. Austerity creates huge stresses for people, especially when they cannot plan a  future  for themselves and their families.

 

Barriers to health /mental health services  can be both individual and institutional:

• Workers in health services cannot offer more time because of the reduction of personnel and bureaucratisation of the time. This can  make it impossible to establish a therapeutic relationship

• A lack of outreach work with marginalised people.

• Reduction of hospital beds and social housin

1.  Poverty in EU increasing:  monetary poverty, material deprivation and low 
  work  intensity,  (cf.  EUROSTAT  Statistics Explained)

2.   Number of homeless in EU increasing :  (CRISIS estimation UK)

3.   Average of mentally illness  is between 3 and 4/10, minimum recognized in
   all  studies about the homeless living in permanent way in the streets are
   mentally  illness average of mentally ill among the homeless

 

We assist in Europe to this contradiction: more it increases the number of the people in situation of poverty, more their problems and needs are complex both social and sanitary, strictly tightly connected and more decreasing the services, the personnel, the budget, the investments and the strategies.

The motive, first of all, it is that these people don't count and they are not even held able to find again their place in the social context, to find or to find again their place in social community.

 

Austerity creates a real stressful on people, especially when people cannot make project for future  for himself and family .

The passage from daily worry to desperation and passage to an action of violence against himself or against others, damaging himself or others, this passage above all if in situation of preceding vulnerability, it is not so rare then.

Worsening of mental condition aggravates the way a person functions at family, at work etc. which ultimately may result in relations falling apart, loss of work, consequently loss of a home, loss a family, loss health and pleasure of life.

This in turn is an extreme stress in itself with all the consequences stress has on a person and his/her mental condition.

So we have in fact a vicious circle, a spiral where the original financial stress of austerity generates a psychical suffering, and those mental problems generating further material deprivation and further mental degradation

The  ‘life expectancy’  in homeless is reduced of the around 40/50%, living in permanence in a situation suicidal that at times it concludes also with acting out.

Barriers and discriminate access to health /mental health services :

    Access to the health and mental health services in the city and in hospital;
it’s very difficult for these people, because of the different barriers, both individual and institutional

    Impossible for workers in health services to offer more time because the reduction of personnel and bureaucratisation of the time, that make impossible to stablish a very relationship

    Unpreparedness to approach and to work with this people, outreaching where they are

• Reduction of beds and available of professional workers ;

    Difficult collaboration for integrated and sustainable care and cure ...

    Frequent burnout of the operators, working with these persons

   
PERSON  FIRST  and  DIGNITY - WELL-BEING projects was and are an opportunity to:

    1.   Engage with and so understand better, the voice of people who have
          become socially excluded and, effectively, silenced.
          Analyse and to mostly evaluate where the problem him finds

2.   Highlight non-observance of fundamental rights.

3.   Cultivate connections between health and social providers of services.

4.   To clarify the consequences of reduced funding for services for
       marginalised people –  both in the short and long-term.

5.   Reduce the  negative consequences because of discriminatory and
       stigmatising social policies.

6.   Lobby European Institutions, regarding priorities in social & health
      policy.

7.   Identify and disseminate information about innovative practices.

8.   Plan, prepare and pilot training, capacity building, exchanges
      experiences and personnel among European colleagues that work
      across health and social services
      with socially marginalised people.

9.   Facilitate networking between public and private, social and health/
      mental health services.

10. Reach practical operational arrangements, beyond institutional and
       official policies.

 

 

ETHOS classifies homeless people according to their living situation:

•   rooflessness (without a shelter of any kind, sleeping rough)

•   houselessness (with a place to sleep but temporary in institutions / shelters)

•   living in insecure housing (threatened with severe exclusion due to insecure
     tenancies,  eviction, domestic violence)

•   living in inadequate housing (in caravans on illegal campsites, in unfit housing,
     in extreme  overcrowding

-   700,000 homeless people in Europe. (2021)
 

-   “a home for all by 2030”   :   the  EU  has launched the European platform
      on  combating  homelessness !... 

 
-   “the most extreme form of  social exclusion”..... is homelessness
     declaration  of  Nicholas Schimdt  EU Commissioner

 

HOME sweet home : missing or is not sufficiently emphasized the affective dimension, because even in an unhealthy house you can live very strong and intense emotional relationships that allow will grow strong and  healthy.

 

 

mental health   as  an integral and essential component of health, indeed, there is no health without mental health.  Mental health is more than the absence of mental disorders.

The WHO constitution states: "Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity."

Mental health is a state of well-being in which an individual realizes his or her own abilities, cope with the normal stresses of life, can work productively and is able to make a  contribution to his or her community.

In this positive sense, mental health is the foundation for individual well-being and the effective functioning of a community.

 

More than 450 million people suffer from mental disorders. (WHO)

More than 970 million 1/8 people  suffer  from mental disorder (WHO)

Many more people have mental problems. 

Mental health is determined by socio-economic, biological and environmental factors.

 

The vulnerability  is not a characteristic of homeless but of person everyone  has his Achilles heel but not  all of them are injured.

 

Q U E S T I O N S  :   about  EMERGENCY  SERVICES  are the interventions

•  integrate social & health ? . . . ,

•  coherent with real request of person in need ? . . .,

•  respectful of the dignity ? . . . ,

•  accessible to marginalized and excluded people ?...,

•  are sufficient and adequate services in emergency center?