Homelessness in Camden Dr Kristinn Tan Lead GP Camden Health Improvement Practice (CHIP)

Camden Health Improvement Practice (CHIP) Specialist General Practice Serving largely single homeless adults and other marginalised groups in Camden. Registered List size around 550 patients. 50-60% annual list turnover In 2013-2014 we saw 753 patients

Spectrum of Housing Needs People literally without a roof over their heads including those regularly sleeping rough, newly arrived migrants, victims of fire, flood, severe harassment or violence and others. People in accommodation specifically provided on a temporary basis to the homeless (hostels, B&B, short-life housing) People with insecure or impermanent tenures: this includes other (‘self-referred’) hotel or B&B residents, and those in holiday lets, those in tied accommodation who change job, tenants under notice to quit, squatters and licensed occupiers of short-life housing (e.g. short-hold secure tenancies) and owner-occupiers experiencing mortgage foreclosure People shortly to be released from institutional accommodation, e.g. prisons, detention centres, psychiatric hospitals, community or foster homes, and other hostels, who have no existing alternative suitable accommodation or suitable existing household to join. Households which are sharing accommodation involuntarily Persons of groups living within existing households where either (i) relationships with the rest of the household, or (ii) living conditions, are highly unsatisfactory and intolerable for any extended period Persons or groups living within existing households whose relationships and conditions are tolerable but where the individuals/ groups concerned have a clear preference to live separately, also cases where the ‘potential’ household is currently split but would like to live together. Source: Homelessness and the London housing market. School for advanced Urban Studies, 1988

Working definitions of housing need Group I Statutorily accepted homeless individuals and households placed in temporary accommodation by local authorities. These are mainly families and pregnant women. This group constitutes the “official” homeless. Group II Rough sleepers, night shelter and hostel users and self or agency (not local authority) referrals to B&B. This group is mainly NOT included in official statistics Group III Other groups with inadequate housing and refers to all the people in the UK with significant housing need. Source: Homelessness and the London housing market. School for advanced Urban Studies, 1988

Group I: Statutory homeless in Camden Households accepted by Camden Local Authority as being homeless July-Sept 2014 Total Of which: H/holds with dependent Children Number of children/ expected children 612 417 873 Source: UK Government Live tables on Homelessness. Department for Communities and Local Government. 2015

Group I: Statutory homeless in Camden Households accommodated by authority, by household and gender type. Couples with dependent children Lone parent household with dependent children One person household All other households Male applicant Female applicant Total Of which: minority ethnic 181 13 195 45 24 69 527 424 Source: UK Government Live tables on Homelessness. Department for Communities and Local Government. 2015

Group II: Combined Homelessness and Information Network (CHAIN) Data Volumes No. Rough Sleepers Change from last period Change on same period last year New Rough Sleepers 89 + 27 +13 Living on the Streets 46 +14 +1 Intermittent Rough Sleepers 64 -17 -4 Total 191 +18 +8 Source: CHAIN Quarterly Report Camden July-Sept 2014

Hostel information Hostel Beds 88 Arlington Road 38 Arlington House 220 Arlington Road 95 Birkenhead Street 31 Camden Road 25 Conway House 60 Dennis Handfield House 39 Endell Street 53 Endsleigh Gardens 57 Mount Pleasant 50 Single Homeless Project 165 16 Ollalo 33 Total 497 Source: Camden Safer Streets Team Feb 2015

Single Homeless Adults Gender 83% of single homeless people were male Source: Nations Apart: Experiences of single homeless people across Great Britain Peter Mackie, Ian Thomas Crisis December 2014

Single Homeless Adults Source: Nations Apart: Experiences of single homeless people across Great Britain Peter Mackie, Ian Thomas Crisis December 2014

Single Homeless Adults Nations Apart: Experiences of single homeless people across Great Britian Peter Mackie, Ian Thomas Crisis December 2014

Rough Sleepers CHAIN Quarterly Report Camden July-Sept 2014

Personal Causes of Homelessness individual factors including lack of qualifications, lack of social support, debts - especially mortgage or rent arrears, poor physical and mental health, relationship breakdown, and getting involved in crime at an early age family background including family breakdown and disputes, sexual and physical abuse in childhood or adolescence, having parents with drug or alcohol problems, and previous experience of family homelessness  an institutional background including having been in care, the armed forces, or in prison. Source: Making every contact count: A joint approach to preventing homelessness. Department for Communities and Local Government. 2012

Structural Causes of Homelessness Housing benefit Unemployment Poverty Others e.g. closure of long-stay psychiatric hospitals Lack of affordable housing Housing policies Source: Homelessness in England. Wendy Wilson. House of Commons Library. 14th Jan 2015

The Camden Context Unemployment: JSA claimants have decreased Housing benefit: Paid to claimant instead of landlord Reductions in amount led to reduction in ability to use private rented accommodation. Lack of affordable housing: More applicants for social housing Hostel closure and conversion into private dwellings Housing policies: Modernisation of some existing hostels has led to better but fewer rooms. Hostel Pathways Cuts in public investment in social housing Right to buy scheme Others: Camden No Street Drinking Zone Kings Cross Regeneration

Camden Hostels Pathway There are no open access hostels in Camden All people must be referred into the hostel pathway by recognised referral agents e.g. Safer Streets team, NSNO Aims to ensure that vulnerable and homeless people are actively supported to change behaviour, raise their aspirations, gain meaningful occupation and move from a state of homelessness and dependence to independent living and social inclusion.

Homelessness Kills Average age of death of those who die on the streets or while resident in homeless hostels = 47 years old (77years for general population). Average age of death of street or hostel homeless Women 43 years (80years for women). s4 . Homelessness kills: An analysis of the mortality of homeless people in early twenty-first centruy England. Bethan Thomas. Crisis 2012

Homelessness Kills Homelessness kills: An analysis of the mortality of homeless people in early twenty-first centruy England. Bethan Thomas. Crisis 2012

Causes of death Homelessness kills: An analysis of the mortality of homeless people in early twenty-first centruy England. Bethan Thomas. Crisis 2012

The unhealthy state of homelessness Widespread ill health 73% (28%) of homeless people reported physical health problems. 41% said this was a long term problem.  80% of respondents reported some form of mental health issue, 45% (25%) had been diagnosed with a mental health issue. 39% (5%) said they take drugs or are recovering from a drug problem, while 27% have or are recovering from an alcohol problem. 35% had been to A&E  and  26% had been admitted to hospital over the past six months.   Source: The Unhealthy State of Homelessness: Health Audit Results 2014. Homelessness Link

The unhealthy state of homelessness Unhealthy lifestyles 35% do not eat at least two meals a day. Two-thirds consume more than the recommended amount of alcohol each time they drink. 77% smoke (20%) and 41% (63%) want to quit Source: The Unhealthy State of Homelessness: Health Audit Results 2014. Homelessness Link

Illicit drug use by homeless people who reported a substance misuse problem

Alcohol

The Costs of Homelessness The MEAM manifesto published in 2009 contains sample costs of support for a man with multiple needs who had previously been sleeping rough in London. The total for one year since he had moved off the streets was £24,350 (broken down into hospital costs £150; drug treatment £3,000; medication £400; day centre services £1,800; and accommodation and support £19,000). These calculations include direct government expenditure only and not the full range of indirect costs to government, but give a sense of the costs associated with supporting somebody with multiple needs, which can be considerably higher (£407,500 in this extreme case) if they are homeless and not properly supported. Source: Evidence review of the costs of homelessness. Department for communities and Local Government. August 2012

Homeless Resources.

Kristinn Tan Camden Health Improvement Practice Kristinn.tan@nhs.net