Homelessness in Camden

Dr Kristinn Tan Lead GP

Camden Health Improvement Practice (CHIP)

Camden Health Improvement Practice (CHIP)

Specialist General PracticeServing largely single homeless adults and other marginalised groups in Camden.Registered List size around 550 patients.50-60% annual list turnoverIn 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

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)

DataVolumes No. Rough Sleepers Change from last

periodChange 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 informationHostel 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

CHAIN Quarterly Report Camden July-Sept 2014

Rough Sleepers

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

Unemployment

Poverty

Lack of affordable housing

Housing policies

Housing benefit

Others e.g. closure of long-stay psychiatric hospitals

Source: Homelessness in England. Wendy Wilson. House of Commons Library. 14th Jan 2015

The Camden ContextUnemployment:• JSA claimants have

decreasedLack 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

Housing benefit:• Paid to claimant

instead of landlord• Reductions in amount

led to reduction in ability to use private rented accommodation.

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).

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

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

Homelessness Kills

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 TanCamden Health Improvement PracticeKristinn.tan@nhs.net