Earlier this week (8th September 2018), The Bureau of Investigative Journalism reported that there were at least 449 deaths of homeless people last year. This is significant, not just because of the shocking number that was revealed, but because the BIJ investigation drew attention to the fact that there was no centralised recording of homeless deaths taking place. It has already prompted the Office for National Statistics to start producing its own figure on homeless deaths. Such a move is welcome as it will help to measure not just the number of people who are becoming or remaining as homeless, but the scale of the impact that it is having upon them.
This matters because it is my experience that the problem of homelessness is getting worse – not just quantitatively (there are more homeless people), but also qualitatively (the impact on people of not having a home is greater now that it was ten years ago). Let me explain: Prior to the swingeing cuts in Supporting People funding which began to hit in 2009, organisations working with the homeless were funded to take the most difficult and vulnerable clients. So it genuinely was the case that, whilst people could not always be guaranteed secure housing immediately, there were very few people who couldn’t be accommodated somewhere in the homeless system.
But once the cuts started, the first group to feel the impact were those whose needs made them most challenging. At schemes like those which YMCA runs, the ratio of staff to clients began to rise dramatically. That meant there were simply no longer the resources available to deal with the kind of entrenched problems that the most vulnerable people often present with. It was no longer safe therefore, to have people with higher needs in a lot of schemes either for their own safety or those of the other clients. At the same time other cuts have meant that the integrated approach to dealing with rough sleepers, whereby homeless outreach workers worked alongside relevant professionals to secure urgent access to physical and mental health treatment and substance misuse services, has also fallen apart. The consequence has been that many of the most vulnerable people have not only had to revert to rough sleeping, they have also been unable to access the medical and other support they need.
What the BIJ’s figure’s reveal is the human cost of that policy. It is certainly the case that some of those who have died have done so as a result of drug overdoses and suicide, rather than freezing to death on a park bench. But that does not mean that the deaths were inevitable. Having access to secure accommodation with the appropriate support means that people can start to stabilise. They can gain access to a drug treatment programme, for instance, and be supported on it by a designated support worker. That same worker can also help make sure people attend doctor’s appointments, training courses, even job or college interviews. In short, the chances of them engaging in high-risk drug-taking and sustained problem drinking, or having a mental health crisis without anyone being aware are greatly reduced. Conversely, without access to secure accommodation and support the chances of someone ending up dead increases.
One of those people was Paul Williams whose tragic death on the streets of Birmingham was investigated by The Guardian. His story shows how the complexities of his situation allowed Paul to fall through all of the available safety nets. It also demonstrates that accommodation on its own is not enough – Paul had accommodation thanks to the heroic efforts of Birmingham Homeless Outreach. Without prompt access to intense, consistent support and the necessary treatment though, it was not enough to keep him alive. Hence my scepticism about the government’s fondness for the Housing First initiative (whereby access to housing is prioritised over everything else).
It is impossible to prove at the moment whether my hunch is correct and the number of people who are dying whilst homeless has increased, but the BIJ’s ground-breaking report should help us to establish whether that is indeed the case. But regardless of that, the deaths 449 highly vulnerable people should be unacceptable in any civilised society. The fact that the vast majority of these deaths were easily preventable using techniques that can have and have prevented such deaths in the recent past should shock us out of any complacency we may have about the impact that homelessness is now having on people.
Homelessness kills. And it doesn’t have to.
Alan Fraser is chief executive of YMCA Birmingham and YMCA Coventry & Warwickshire