Patient Stories
There is stigma in society surrounding homelessness which healthcare systems are not immune to. There is proof that homeless people face organisational and attitudinal barriers when trying to access healthcare (Jones & Pleace, 2010). Our survey showed that healthcare professionals may feel more able to engage with homeless patients if they are aware of real life stories from patients themselves. The stories below are real. For obvious reasons names, places and dates have been altered to protect the privacy of the people kind enough to share them.
David - 21
David had recently moved to the area. He had only registered with the surgery in the week before after having seriously self harmed. He told me how he had been brought up in care elsewhere and had not been registered with a GP for 6 years. He said he always had 'a lot going on is his mind' and thought he had been depressed. Being from a care background, David could be considered to be in priority need as a single homeless person because he would be classed as 'vulnerable'. This is why he could stay in the local night shelter. However, because he was not FROM the area he would have to stay in emergency accommodation for 6 months until he would be eligible for more permanent housing, such as a council flat. With no address and no job, he could not afford private rents.
David was referred to the community mental health team. He started taking anti-depressants from his new GP. David told me he had never spoken about his mental health problems to anyone before but felt comfortable talking to the new doctor as he saw the same one each time - that way he did not have to try and repeat something he clearly found difficult to talk about.
David was legally homeless and was eligible for emergency accommodation as he was in priority need (because he had been in care). He lacked a local connection, though, and could not be helped further until this had materialised over time. He had clear mental health problems and had trouble thinking beyond the immediate future, which is perhaps why he had not engaged in a meaningful way until that time. Regular follow up might be crucial to help keep him in treatment whilst his social situation can improve.
Linda - 55
I was shocked when Linda told me she was living in the homeless shelter as she did not 'look the part'. She had moved abroad many years ago and so had no contacts or property in this country. She needed to return but on arrival found her eligibility for council assisted accommodation was not clear. The council told her they could not legally help her (perhaps because she was classed as 'intentionally homeless) and she would need to seek the help of a homeless charity. She had never been homeless before.
She approached a charity who put her up in a hostel and from there she tried to register with a local surgery due to some ongoing health concerns. She was told by a member of staff there that she could not register as a patient because she did not have an address.
Without an address she cannot register for a bank account and has no references to get a job. Without savings she cannot rent. Her barrier is eligibility for assisstance. She managed to register with another practice and her health issues are, at least, under control.
Ryan - 23
Ryan presented because he was feeling depressed. On exploring things it transpired he was binge drinking to cope and that he had been sofa surfing for months after his step-dad and he had fallen out. Ryan had been in a stable job, which he loved, for years and was worried his mood and his drinking could threaten this. He had a steady wage but was struggling to save enough for the high rental deposits required by local landlords.
Ryan started working on his mood with some CBT techniques. He declined counselling groups for his alcohol problem and so we tried harm reduction measures at first. Through the GP Ryan got in touch with Citizen's Advice about his rights to any benefits as a single homeless person and for help with planning a budget so he could start saving for a rental property.
David - 21
David had recently moved to the area. He had only registered with the surgery in the week before after having seriously self harmed. He told me how he had been brought up in care elsewhere and had not been registered with a GP for 6 years. He said he always had 'a lot going on is his mind' and thought he had been depressed. Being from a care background, David could be considered to be in priority need as a single homeless person because he would be classed as 'vulnerable'. This is why he could stay in the local night shelter. However, because he was not FROM the area he would have to stay in emergency accommodation for 6 months until he would be eligible for more permanent housing, such as a council flat. With no address and no job, he could not afford private rents.
David was referred to the community mental health team. He started taking anti-depressants from his new GP. David told me he had never spoken about his mental health problems to anyone before but felt comfortable talking to the new doctor as he saw the same one each time - that way he did not have to try and repeat something he clearly found difficult to talk about.
David was legally homeless and was eligible for emergency accommodation as he was in priority need (because he had been in care). He lacked a local connection, though, and could not be helped further until this had materialised over time. He had clear mental health problems and had trouble thinking beyond the immediate future, which is perhaps why he had not engaged in a meaningful way until that time. Regular follow up might be crucial to help keep him in treatment whilst his social situation can improve.
Linda - 55
I was shocked when Linda told me she was living in the homeless shelter as she did not 'look the part'. She had moved abroad many years ago and so had no contacts or property in this country. She needed to return but on arrival found her eligibility for council assisted accommodation was not clear. The council told her they could not legally help her (perhaps because she was classed as 'intentionally homeless) and she would need to seek the help of a homeless charity. She had never been homeless before.
She approached a charity who put her up in a hostel and from there she tried to register with a local surgery due to some ongoing health concerns. She was told by a member of staff there that she could not register as a patient because she did not have an address.
Without an address she cannot register for a bank account and has no references to get a job. Without savings she cannot rent. Her barrier is eligibility for assisstance. She managed to register with another practice and her health issues are, at least, under control.
Ryan - 23
Ryan presented because he was feeling depressed. On exploring things it transpired he was binge drinking to cope and that he had been sofa surfing for months after his step-dad and he had fallen out. Ryan had been in a stable job, which he loved, for years and was worried his mood and his drinking could threaten this. He had a steady wage but was struggling to save enough for the high rental deposits required by local landlords.
Ryan started working on his mood with some CBT techniques. He declined counselling groups for his alcohol problem and so we tried harm reduction measures at first. Through the GP Ryan got in touch with Citizen's Advice about his rights to any benefits as a single homeless person and for help with planning a budget so he could start saving for a rental property.
For more real patient stories click HERE
References
Jones & Pleace. A Review of Single Homelessness in the UK. 200-2010. 2010 - http://www.crisis.org.uk/data/files/publications/ReviewOfSingleHomelessness_Final.pdf
Jones & Pleace. A Review of Single Homelessness in the UK. 200-2010. 2010 - http://www.crisis.org.uk/data/files/publications/ReviewOfSingleHomelessness_Final.pdf