1. Health and Homelessness

2. Numbers of homeless households accepted as in priority need

3. Multiple and Complex issues Low levels social support High levels of relationship breakdown Poor educational / employment records History of unsettled housing Domestic and neighbour violence Poor health

4. Homeless people Die young Poor physical health Lack social networks Insecure or no housing Mental health problems and mental illness

5. Mortality Average age at death – about 40 Violent assaults Suicide Drugs / Alcohol Accident

6. Health inequalities Significant mental illness - 30/50% Alcohol/drug use – a fifth have both Respiratory problems are 2/3 times higher Skin complaints are 3 times higher Musculo-skeletal are 2 times higher Gastrointestinal problems are 2 times higher

7. Health Inequalities Drug Misuse prevalence –single homeless - 80% –homeless families - 50%? Alcohol misuse prevalence –rough sleepers - 30-50% 1 in 5 also have mental illnesses

8. Children Developmental delay Domestic violence Parents with mental health problems Disrupted education Loss of social networks

9. Access to health care Average rate GP registration –Rough sleepers 40% –Hostel and B&B 80% –General population 98% High use of A & E departments

10. Barriers Referral Appointments Lack of recognition of time required Lack of knowledge of housing issues Multiple problems but not severe Small numbers – specialist services not viable Fear of large numbers – usual health services worry about being swamped

11. Practical solutions Specialist staff/teams Discharge from hospital planning Agreed referral points Consent to information exchange Influencing commissioners

12. Joint Work DH appointment of homelessness advisor DCLG appointment of health advisor Advice to LAs about health services DH guidance on joint commissioning Development of hospital discharge guidelines Guidance on mental health services Healthy hostels

13. Contacts DH Homelessness advisor Sue.Read@dh.gsi.gov.uk DCLG Health advisor Angela.Jones@communities.gsi.gov.uk