The plight of the homeless.

Background

The issue of homelessness is wide-spread, at an international level, and worse so in times of economic crisis. The charity organization ‘Crisis’ (http://www.crisis.org.uk/data/files/document_library/factsheets/homlessdefs_2005.pdf (Accessed December 2014)), define homelessness as ‘…the problem faced by people who lack a place to live that is supportive, affordable, decent and secure…’ They further state that a permanent address is more than a physical space, and that it represents security and well-being in a very real sense. The term ‘homelessness’ may refer to not having a roof over ones head, but potentially the concept goes much further than this, and as Seager [1] reminds us ‘…homelessness is more than houselessnes and goes much deeper in terms of psychosocial issues and social exclusion..’.

For a homeless person, social and emotional support, a sense of belonging, trust, assistance with daily living, help to re-build their lives, and assistance with primary/secondary/mental health care access, may all represent important issues, in addition to the importance of shelter and longer term permanent housing.

Homeless people represent a vulnerable group in society, yet according to the Lancet [2], ‘…we still have a 14th century-long tradition of treating them as criminals. Yet this vulnerable group are more likely to be victims of crime, rather than perpetrators. Many homeless have experienced brutal childhoods, unstable families, or domestic violence. They are more than ten times as likely to be assaulted and 50 times more likely to be robbed than those who have a home. 40 % of young homeless women have been abused sexually and many are at risk from untreated sexually transmitted diseases…’.

It can be difficult to categorize a homeless person, and in addition to the above, the reasons that a person may become homeless vary considerably, and can also include, relationship breakdown, loss of job/income, eviction, inability to cope with everyday life due to either mental, physical or environmental trauma and so on. There does seem however, to be a relationship between homelessness, mental health problems, and drug or alcohol abuse, together with an overlap with social exclusion. These are crucial issues which require understanding, support and guidance, in order for a person to re-build their life, and re-establish their important role as an individual human-being in society.

The role of ‘Compassion’ in assisting the homeless

Recently, the concept of ‘Compassionate Care’ has received much attention globally, particularly within healthcare settings, and much work is in place at a multidisciplinary level to enhance and utilize this concept [34]. The role and importance of compassionate care was particularly brought to the forefront in the UK, following the release of the Francis Report which was based on an inquiry into devastating events at Mid-Staffordshire Hospital in the UK [5]. This report gained international attention by demonstrating that for many patients the most basic elements of care were neglected.

The concept of compassion is generally thought to include a number of other virtues, such as empathy, sympathy, kindness, respect, and perhaps most importantly, actually taking some kind of ‘action’. A well used definition of compassion is: that ‘… [compassion] reflects a deep awareness of the suffering of another, coupled with the wish to relieve it’ [6]. There is evidence to suggest that the components parts of compassion are also crucial in alleviating pain, prompting fast recovery, assisting in the management of chronic illness, and relieving anxiety. Physiological benefits of compassion have also been reported in studies which show that kindness and touch alter the heart rhythm and brain function in both the person providing compassion and the person receiving it [78] (http://www.sciencedaily.com/releases/2012/12/121203145952.htm (Accessed November 2014)).

As such, a compassionate approach applies not only to the health care setting, but also to the needs of vulnerable groups such as the homeless who may have specific health and social needs.

Due to the nature of the virtues of compassion, it might be assumed that during acts of compassion, these virtues must be explicitly demonstrated. But there is also room for implicit acts of compassion, which might also be termed ‘tough love’ (i.e. we may imply the virtues of compassion, but in a given situation we may not be explicit in demonstrating them). Under such circumstances, explicit demonstrations of the virtues of compassion might be less important, whilst the implicit might be the important factor – remembering of course, that compassion implies taking ‘Action’. This is particularly essential when helping homeless people. For example, compassion may be explicit in attending to, and offering services in relation to basic needs, but more implicit in terms of encouraging independence and choices. In this sense, it would seem appropriate to apply the term ‘tough love’, whereby we may refer to a sometimes stern approach where the intention is to help the individual in the longer term – thus reflecting genuine feelings of care and concern for the individual.

The notion of tough love within the context of dealing with homeless individuals can have a strong emotional and behavioural effect. This may be because at an individual level, people who are vulnerable need to feel safe and this is less likely to be the case in an environment which it too soft and where the rules may be simple, few, and vague. There is a need for homeless individuals to move away from a chaotic lifestyle, but assistance in helping them back into a world where rules apply such as payment of bills etc., might seem frightening and unsafe to them if too soft an approach is taken. An analogy to this might be if we were to imagine crossing a dangerous river by way of an unsafe bridge – we would want someone to help us to safely reach the other side, but we would need this person to be strong.

Thus by referring to the notion of tough love within this paper, and within the context of compassion for homeless people, we may be referring to a set of creative rules intended to enable happiness and independence of the vulnerable person in the longer term. This may further include providing a sense of direction, showing the person the way and teaching them examples of being assertive but in a calm manner. We are referring to a behavior which in some ways might resemble that of a ‘fair, kind, but disciplined parent’, which is important as many homeless people have encountered a disturbed background,

In both cases (both implicit and explicit provision of care) the concept of compassion and taking action is highly relevant.

There are many worthy causes, charities, and organizations dedicated to supporting homeless people. However, in this short paper, we draw on experiences from a small but devoted centre for the homeless – ‘Catching Lives’ in Canterbury, UK (Additional file 1) (www.catchinglives.org (Last accessed February 2015)). We aim to draw attention to the important issue of homelessness, and to the importance of ‘compassion in action’, and how the concept both implicitly and explicitly can play a crucial role in assisting the homeless. We feel that it is important to share this experience, and to encourage others to publish work in this field.

With the above in mind, this paper will incorporate extracts and data (as boxed text), from a recent report compiled by Limebury [9] on behalf of ‘Catching Lives’.

Catching lives

‘Catching Lives’ is an independent local charity, which is dedicated to supporting the homeless and vulnerably housed in and around Canterbury, UK. The charity has operated in Canterbury and East Kent for over 20 years and represents a community effort to raise awareness and help people to get off from the streets and to change their lives. The charity seeks to change attitudes regarding the issue of homelessness, and works closely with the community by engaging in school talks, talks to church groups, study placements, training events, and training different types of volunteers.

The charity has a vision of ‘…a society where all are included and all, no matter how disadvantaged, can make a contribution… ‘. The charity also works with their clients ‘…to help them to tackle any issues that they may have, get access to suitable accommodation and find the motivation to take steps towards personal recovery and independent living…’ (www.catchinglives.org).

A number of services and attention to basic needs are offered by the charity, including: food; laundry facilities; toilets and showers; storage; telephone and postal address usage; IT access; mental health services; structured activities etc. In addition, the charity offers advocacy and advice, including specialist advice to encourage independence.

Finding shelter for the homeless

Becoming homeless is likely to be one of the most stressful and frightening events that can happen to a person, and finding shelter or knowing who to approach to assist with this, might be difficult. In assisting with finding shelter for the homeless in and around Canterbury, the Rolling Shelter model is utilized which was first piloted in London in 2000. Rolling Shelters offer overnight accommodation to the homeless which ‘roll’ between different locations. Rolling Shelters initially replaced Cold Weather Shelters and were open all year round for four monthly periods in different locations in inner London [10]. The concept of Rolling Shelters presents a good solution to the problem regarding provision of overnight accommodation. Because of the laws surrounding provision of accommodation, one location/church cannot be utilised as a full-time shelter. For this reason, the impact on the community is minimal, allowing the venues to still operate and offer the services that they would normally offer. Utilising the Rolling Shelter model, whereby each venue may offer accommodation for 24 hours once a week is also cost effective and minimizes the risk of mis-use. In Canterbury, this initiative is referred to as Canterbury Community Shelter, and is coordinated by ‘Catching Lives’:Our model uses 7 venues, one for each day of the week, with each venue having a set day of the week on which to be act as shelter and overnight accommodation for our clients.
Coordination of the shelter is taken care of by Catching Lives, based at Canterbury Open Centre; this was done alongside the normal provision of food, personal storage, showers, laundry and a project team who assess and assist our clients to change their situations for the better.
We work with the homeless and rough sleepers of the Canterbury area, an issue that has not reduced in the past year. The official estimate was that over 20 people were sleeping rough in the district last autumn. At Catching Lives’ Canterbury Open Centre had up to 25 individual rough sleepers accessing it’s services in October and November 2013, with an average of just over 20 individuals accessing over the two months.
Although recent political publicity has claimed that the economy is recovering, we continue to be in the midst of a housing crisis. Quality affordable housing and well funded, coordinated services to deal with the issues vulnerable people are lacking and local government and statutory agencies of all kinds have to find more savings and cuts to budget. The effects of this continued to show as our project progressed and will be discussed later in our Social Policy Summary.
We have, however, learned a lot from previous years; and in the operation of 2013/14 Canterbury Community Shelter we took on as many of the suggestions from last year as we were able, and the incorporation of these into our service model made a major difference.
(Limebury, 2014)

The shelters consist mainly of the rotated use of local Church Halls.

Other services that have assisted with the Canterbury Community Shelter initiative include:

  • Porchlight Rough Sleeper Service
  • CatchingLives’ Mental Health Outreach Team
  • Sanctuary Supported Living – Floating Support

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