Homeless left with 'no choice' but to access mental health support through A&E
Also Episodic Research An Homelessness File Mental Shows Forms A And Have Health Experiencing Of Picture Issue, Of 60% Chronic Estimated People
Frontline staff working with those who are homeless have criticised the "reactive" level of mental health services open to their clients, claiming many people have "no choice" but to access supports through overcrowded Emergency Departments in hospitals.
It is one of a number of findings from a new study exploring the experiences of frontline workers assisting those who are homeless and the interaction with mental health services.
The research was carried out by Gerry Devine of Waterford HSE Mental Health Services, and Michael Bergin of the School of Humanities, Waterford Institute of Technology and the 20 participants who were interviewed — all based in the South East — identified five key service gaps.
Those included inter-agency communication and collaboration, assertive community recovery-orientated care, shortcomings in training, information sharing and up-skilling, and discharge planning and resource constraints.
An estimated 60% of people experiencing chronic and episodic forms of homelessness also have a mental health issue, and according to the research: "Many workers expressed concerns relating to insufficient information regarding the homeless person’s mental health not being provided from the relevant treating teams. Concerns were reported that standards of communication between relevant departments within mental health services and the frontline staff supporting the homeless person were inadequate."
One of the people interviewed said: "Mental health services don’t really tell me anything because of confidentiality, so I just try to handle the lads [service users] myself the best I can."
The report said: "This leads to frontline workers feeling ‘abandoned’ in terms of shared care planning and worry about the potential risk posed to service users.
"They suggest that, frequently, homeless people have no choice but to access mental health service through very often overcrowded Emergency Departments particularly during out-of-hours time frames."
Those interviewed work across a range of local homeless services, Department of Justice, youth and addiction services, community health and hospitality sectors, and according to the report: "There is a need for mental health professionals to have stronger links with hostels for homeless people", including community clinics.
"Women’s refuge centres are unable to accept homeless women engaged in active addictions, highlighting the need for separate homeless women’s emergency accommodation," it said.
It also said: "Frontline workers report that homeless service users often feel ‘abandoned’ by their mental health teams and are ‘scared’ to approach services."
According to the report, the absence of a discharge policy for homeless people has a significant impact for planning and managing after-care and recovery. "Frontline workers receive little or no notice of discharges, resulting in poor follow-up in the community. The practice of discharge for non-attendance following two missed outpatient appointments is also challenging as quite often appointments are sent to incorrect addresses."
It makes a range of recommendations, including the provision of better outreach mental health services.
The study, entitled'Experiences of Frontline Workers’ Engagement with Mental Health Services for Homeless Adults in Ireland', is included in the latest edition of , the European Journal on Homelessness.
The same journal also features an article by Paula Mayock and Sarah Sheridan School of Social Work and Social Policy, Trinity College Dublin, in which the experiences of 60 homeless women were tracked between 2010 and 2012. It too found issues with accessing mental health services and adequate supports, alongside additional problems in trying to raise children through "enduring and extreme instability" due to a lack of secure housing.