What is the impact of rough sleeping?

The ongoing cost of living crisis and housing crisis are likely to lead to more people becoming homeless in the UK, with more and more people being unable to afford to pay their rent and bills. Here we explore the long-term impact homelessness has on people’s physical and mental health.

Last year, Between April and June, 66,040 households in England were assessed as homeless or threatened with homelessness – up 1% on the year before. Young people were hit particularly hard. Between July and September 2021, 280 young people were seen sleeping rough in London – up 12% from pre-pandemic levels.

The long-term impacts on physical and mental health for someone sleeping rough can be catastrophic. According to the Office of National Statistics, people who experience rough sleeping over a long period are, on average, more likely to die young than the general population. They also face a higher likelihood of dying from injury, poisoning and suicide. In 2017, the average age at death of people who experience homelessness was 44 years for men and 42 years for women – in comparison, in the general population the average age at death was 76 years for men and 81 years for women.

Ryan was supported by Depaul, and was experiencing many health problems, as he explains:

“My health was poor, to be honest. I had really bad kidneys, I had kidney failure. I had two massive stones and a cist on my kidney that had to be operated on. My feet were absolutely terrible. My eyesight got ten times worse because I didn’t have glasses for long periods of time.

I’m blind as a bat and my glasses would get broken from fighting and I was left for two months at a time without glasses and being able to see at all. My health did deteriorate quite a lot.”

Access to care is also a major issue. Many people who are sleeping rough report being unable to register with a GP practice. Not being able to access the support they need – whether physical care, mental health support, or access to employment or housing advice – only adds to the negative cycle someone rough sleeping is likely to experience.

Dan Dumoulin is Head of Rough Sleeping Services at Depaul UK. He explains the physical impact rough sleeping has on a person: “The wear and tear of sleeping outside in the cold really affects people’s physical health. It can directly cause extremely painful chronic foot and back problems; health issues get worse and worse. Sometimes people sleeping rough start using drugs or alcohol just to help them sleep.

Lots of people sleeping on the street feel very isolated, that no one cares for them.”

Beyond the increased risk of death, people who sleep rough experience some of the most severe health inequalities and have much poorer mental health than the general population. Many need support with substance use, and most have experienced significant trauma in their lives.

Common mental health conditions such as depression, anxiety and panic disorder are over twice as high among people who experienced homelessness compared to the general population, and psychosis is up to 15 time as high. Of the people seen sleeping rough in London in 2017 to 2018, 50% reported mental health needs.

At Depaul UK, we deliver a number of rough sleeping services in London, Greater Manchester and the North East. Our services provide a holistic support which is much needed to help break the cycle of rough sleeping.

Most of Depaul’s rough sleeping services were set up during 2020 as a response to the pandemic. We’ve now helped thousands of people off and away from the streets in the last three years.

Dan said: “There is a need for these specialist services because they fill gaps in the system that other services weren’t filling or it was very difficult for people to progress through.”

Ryan highlights the true impact rough sleeping can have, and the importance of getting the right support: “To be honest I’d probably be dead without the support from Depaul.”