Big Issue Vendor

Homelessness and the mental health scandal

Four in five homeless people suffer from a mental health problem, and the lack of support is condemning them to a life on the streets. Paul English speaks to the people who are demanding a change

They are findings to make the blood run as cold as a winter’s night on the streets. A series of reports in recent years have highlighted stark failings in provision for homeless people suffering from mental ill-health.

Research by homeless charity St Mungo’s found that four in 10 people who sleep rough in the South East need mental health support, with the figure rising to more than 50 per cent across the UK as a whole.

Another study of 2,500 people from around the UK, carried out by Homeless Link, found that 45 per cent of homeless people had been diagnosed with a mental health issue, with 80 per cent reporting some form of mental health problem.

45 per cent of homeless people have been diagnosed with a mental health issue

Studies also found that rough sleepers with psychiatric issues spend longer on the streets, with little or no effective targeted provision from mental health services, and that 40 per cent of those surveyed had attempted suicide.

The figures make grim reading in themselves, but when coupled with reports of society’s most vulnerable being abused, assaulted or worse, they become unremittingly bleak.

Last week, the government’s latest figures on homelessness showed a 15 per cent increase in the number of people sleeping rough in the last year – over three years the increase has been 73 per cent. Charities are now scrutinising Westminster’s policy-makers for signs of delivering on pledges to improve strategy, especially where mental health provision for homeless people is concerned.

Dominic Williamson, executive director of strategy and policy at St Mungo’s, is one among those calling for action.

“We’ve been campaigning for the government to have a new rough sleeping strategy and they’ve now agreed that they’re going to do that,” he says.

Homeless man

“They’re setting up a cross-department task force to put that strategy together and we’re obviously very keen to see how the department of health is working with that. It needs input from lots of different government departments to make it work.

“The last time figures were published we saw a 134 per cent increase [in rough sleeping] since 2010. And our sense is that the number of people with mental health problems is increasing faster than the number overall.”

The charity published a report in 2016 entitled Stop the Scandal, which found people living on the streets with conditions including depression and anxiety, psychosis, post-traumatic stress and bipolar disorder being failed
by the system.

Their research also pointed to people sleeping rough with mental ill-health remaining on the street for longer, with little or no outreach from services.


The Big Issue magazine is a social enterprise, a business that reinvests its profits in helping others who are homeless, at risk of homelessness, or whose lives are blighted by poverty.

Williamson adds: “The report was called Stop the Scandal because the sense that there are people with mental health problems who are left without effective help, sleeping in doorways and on our streets is totally unacceptable.

“In the manifesto last year there was a commitment to tackling rough sleeping. Ministers and the Prime Minister have repeated it since then. Now we want to see urgent action to move this forward. We need much more pace than we have seen. People are dying on our streets because of changes in policy not because of changes in human nature.”

The problem of mental health and homelessness is recognised by many in the sector as a chicken-and-egg issue, or as mental health charity Mind call it, “a two-way relationship”.

Spokeswoman Jenni Regan says: “People with mental health problems can end up homeless as a result of struggling to manage on a day-to-day basis, and people who become homeless can develop mental health problems.

Mental health services are hard to access if you are homeless

“Being unemployed, living in poverty, having poor social networks and no safe place to stay can all have a big impact on well-being and make people more vulnerable to mental distress. Another problem is that people who are homeless can find it difficult to register with a GP, and get the mental and physical health care they need.

“Mental health services are hard to access if you are homeless.”

It’s exactly these pitfalls that organisations such as Glasgow City Mission aim to bridge. Graham Stevens works with the homeless community in the centre of the city and says it is often a question of people becoming the casualties of an inflexible system.

“People who bring themselves here often have multiple and complex needs and haven’t been able to achieve adequate support or help from other places in society. Too often people have to fit around systems rather than systems fitting around people.

“Since the recession we’ve noticed an increase in the number of people coming to us. Some might have lost a job, or the other services they use have had cutbacks to their budget. It’s still a very precarious world out there for a lot of people.

Universal Credit coming in presents a lot of hoops for people to jump through and it can be very difficult. People with complex needs often don’t have the support to help them complete forms. We’ve seen that sort of thing eroded over recent years.”

Homeless man
Rough sleepers with psychiatric issues spend longer on the streets

But support for people dealing with mental illness is about more than filling out forms.

When her son John took his own life after years of mental ill-health, Isabel McCue established Theatre Nemo to provide a creative outlet for people struggling through the strictures of the psychiatric system. Since then, the charity has broadened its remit to include working in prisons, where mental ill-health is a major issue. She has seen first-hand the desperate scenario of people trapped on a systematic merry-go-round of street-prison-street.

“A lot of people coming out of prison have big problems trying to get back into the community,” McCue says. “Even if they can get a house, which they often can’t, they often don’t know how to keep it.

“A lot of these people have had adverse childhood experiences and studies have shown that a lot of addictions and poor mental health can be related to things that happened when they were children.

“A lot of these people, when they come out of prison, are capable of achieving in their life with the right support, but if they end up homeless they often end up back in prison.”

Last year, we covered the inspiring story of Big Issue vendor Mark Siequien, who told us about piecing his life together after time in prison, with no home, a drug addiction, a diagnosis of a schizoid illness and depression.

If ex-prisoners end up homeless they often end up back in prison

Taking a giant leap into the unknown, it was volunteering at a monkey sanctuary in South Africa that marked a turning point. On return to the UK, Mark decided not to isolate himself and started selling The Big Issue to, in his words, “re-socialise”.

“Even if I didn’t sell very many magazines, it would mean I’d be out there again talking to people,” he says. “I saw a lot of the same people every day and after a while they would start to talk to me each morning. Regulars would ask me how I was doing and I’d speak to them.

“I realised that my attitude to people was wrong. Everyone has their struggles.”