The changing face of rough sleepers

By Louise Tickle on June 12, 2008 in Adults

People who sleep rough are at the sharpest end of homelessness. In constant danger of physical attack, rough sleepers also commonly experience serious health problems associated with exposure and poor nutrition, as well as the effects of prolonged alcohol and drug abuse. Many experience mental illness that is either caused or exacerbated by their situation, and anyone who sells sex, typically to fund a drug habit, will regularly face even greater risks.

So the fact that there are still, even according to a much disputed counting methodology – which at best suggests trends over time, rather than an accurate headcount – an estimated 500 people sleeping rough across the UK, is not a happy result for a government that published the Coming in from the Cold strategy in 1999, subsequently set up the interventionist Rough Sleepers Unit and threw £50m at the problem of getting people off the streets.

It seems to be generally agreed that rough sleepers have been successfully reduced from about 1,800 nationwide in 1999 by about two-thirds. But the remaining 500 has remained stubbornly in place since then. Almost 10 years on, the Department for Communities and Local Government has decided to try to reduce the numbers sleeping rough to as close to zero as possible.

The DCLG invited agencies and local authorities to comment on ideas outlined in a discussion paper focused on helping this hardest-to-reach contingent and it turns out that interestingly, it’s not so much money that charities say is most urgently needed, but rather a decent dollop of intelligent co-operation between government departments and local authorities.

But first things first: what is it about this final cohort of rough sleepers that makes them so hard to shift? Partly, says Grant Everitt, who leads Shelter’s street homeless programme, it’s that some of them are, literally, hidden. Women and people from ethnic minorities who sleep rough have plenty of incentive to tuck themselves away from prying eyes and so won’t sleep in doorways or anywhere in the open. This means they feature in unrealistically low numbers in the official statistics – 90% of those counted on spot check nights between 10pm and 2am are white males – and therefore, services aren’t tailored to the former’s needs.

“We’d want to see the government’s strategy focused on these more hidden areas,” says Everitt. “And there also needs to be recognition that the established pathway from rough sleeping to hostel to supported housing and then to tenancy just doesn’t work for some people, such as older people with a history of drinking or drug problems. Most hostels ban drug use, and most long-term homeless people have drug problems.”

Revolving doors

Clearly, banning people from the accommodation and services they need is unlikely to work very well, so new ways of thinking about how to rehabilitate drug users who sleep rough will be required, otherwise no one with a drug problem can contemplate applying for a hostel place for more than the occasional night before shuffling back on to the street. And it’s this revolving door system that has to change, says Everitt.

Another reason numbers have stuck at 500 is a failure to stem the flow of rough sleepers on to the streets, says Mike McCall, operations director at homelessness charity St Mungo’s. Work on preventing people from getting into such dire straits must therefore be prioritised across government.

“It’s not actually the clients who are hard to reach, it’s the services,” he says. “Good, joined-up working across government never really happened. The DCLG is giving good leadership, but though this [long-term rough sleeping] is about housing, it’s also about health and work opportunities.”

Accessing primary care is almost impossible, he points out, for people sleeping rough, and it doesn’t improve once they arrive in a hostel.

McCall says: “We need a right to on-site health services, so that there’s a very low threshold into primary health care.”

On the training front, too, he’s sceptical about the provision that has been made.

“I don’t think the DWP (Department for Work and Pensions) or DIUS (Department for Innovation, Universities and Skills) have really signed up to homeless people and their training needs,” McCall says. “If government is serious about tackling rough sleeping, the last thing they need is for people to start the process of getting off the streets but ending up back there because they’ve not got the skills to move towards work. That means clear [training] pathways being developed in the hostels and then out into the community.”

At the charity for London homeless, Thames Reach, chief executive Jeremy Swain rails against the bureaucracy faced by his outreach teams to secure someone a hostel place. He says that, for London at least, there needs to be a small central team who are given the power to remove the red tape that impedes the rehabilitation process.

“This needs a small capital programme for those who are stuck in hostels. But this isn’t a problem that needs lots of money thrown at it,” he says. “Yes, there are not enough hostel spaces, but it’s really about more efficient use of spaces. Frankly, in 25 years’ time, we should be in a situation where there should be no hostels.”

Securing access to a hostel place, healthcare, training and rehab is all very well if it’s on offer, but not everyone is entitled to it. The DCLG’s own discussion paper acknowledges that 15% of rough sleepers in London are migrants from EU accession states, as well as asylum seekers whose applications have been refused. Neither group has any right to public funding, and so those in charge of local authority provision for homeless people, such as Janet Headington at the London Borough of Westminster, which has the highest rough sleeper count in the country, are left powerless to help.

“It’s a soul-destroying issue,” she says. “With economic migration we’ve been witnessing the creation of a new kind of rough sleeper. A sizeable number of the people who arrive at Victoria come completely unprepared, and have no recourse to public funds. As we can’t accommodate them, they have to resort to illegal activity.”

These people don’t even figure in the official count, she points out, and though Westminster has been lobbying for resources to work with them, so far the funding rules have remained unchanged. Clearly this does not spell good news for government hopes stated in the DCLG discussion paper of reducing the numbers of rough sleepers down to zero.

Crisis chief executive Leslie Morphy warns that if a better relationship between different pots of government money – and better co-operation between government departments – cannot be achieved, even getting our own, most vulnerable, fellow citizens off the streets won’t happen.

“It’s never a nice upward sloped journey that people make. It’s often quite a jagged journey, that’s why they need so much more than just a roof,” she says. “There has to be work on building their confidence, investment in their learning and skills, support as they go into accommodation, and then support over the long term.”

Will they get it? Well, £50m didn’t solve the problem in 1999, so it may be that a bit of joined-up thinking will turn out to be the more effective, cheaper option.

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