The stress associated with housing instability can intensify feelings of hopelessness and isolation, making individuals more vulnerable to self-harm and to suicidal thoughts and behaviours.
“Suicide is complex and is rarely caused by one thing. However, we do know that homelessness, housing insecurity, and poor housing can increase suicide risk.”
In 2021, 13.4% of the estimated deaths of homeless people (in England and Wales) were registered as suicide, emphasising the urgency to address this issue.
A report from the Suicide Prevention Consortium – ‘Tomorrow is too late: Suicide prevention support for people with no fixed address’ suggests some areas of improvement that could help to prevent suicide among people without a fixed address or those experiencing housing challenges.
*Suicide Prevention Consortium
The Suicide Prevention Consortium (SPC) is made up of four organisations: Samaritans, National Suicide Prevention Alliance, Support After Suicide Partnership and WithYou. As part of the VCSE Health and Wellbeing Alliance, it aims to bring the expertise of its member organisations and the voice of those with lived experience directly to policymakers, to improve suicide prevention in England
So, what can you do to help save lives of people with no fixed address?
The importance of a person-centred approach: A person-centred approach allows individuals to share their experiences and relevant information, which is especially important for those at risk of self-harm, suicide, and experiencing homelessness.
The complex nature of homelessness and housing insecurity means a multitude of factors could be influencing an individual's circumstances. By offering a safe space for individuals to discuss their experiences, you can work collaboratively to effectively tailor support.
This personalised approach is important during assessment and safety planning, ensuring that provided support comprehensively addresses the distinctive challenges and risks faced by those with housing challenges.
Addressing the housing situation during assessment: When supporting individuals in distress, especially those facing unstable housing or homelessness, it's important to consider the impact of their housing situation on their vulnerability to self-harm and suicide. If housing is contributing to distress, this should be a fundamental consideration in the assessment and safety planning process.
Alongside housing, it’s important to explore the person’s other needs, vulnerabilities, and strengths in a holistic way.
Use a psychosocial perspective as a framework to guide your exploration and work with the person to make sense of what's going on: Housing instability often goes hand-in-hand with a host of other biological, psychological, and social vulnerabilities, such as physical/mental illness, substance use, poverty, and/or trauma. Many of these vulnerabilities are also associated with a higher risk of self-harm or suicide.
Understanding these interconnected factors through a psychosocial lens allows for a nuanced and holistic assessment of the person’s needs. By moving beyond surface-level indicators, such as housing status, you can gain a clear and comprehensive picture of the person’s circumstances. The clearer the picture, the better placed you are to offer effective help and support. Be guided by the person in front of you: tune into what the person is saying and be compassionately curious to learn more.
Before moving to action, work with the person to make sense of what you have learnt, taking into consideration what
Personalised support and ongoing safety planning: Information gathered during assessment can be used to create a personalised safety plan. Safety planning with those experiencing housing insecurity requires a thoughtful approach which accounts for the unique challenges of their circumstances.
If housing insecurity is contributing to distress, you can address this as part of the safety plan.
Include strategies specifically aimed at addressing housing instability and any other associated issues.
This could involve, for example, connecting the individual with:
- local housing assistance programs
- case management services
- options for temporary shelter
While the key principles of safety planning remain relevant, it is important to include other associated problems such as debt or financial problems.
Reducing access to means, an important part of planning for safety, may involve identifying safe public spaces or community resources that are accessible in moments of crisis.
Professional contacts could include not only mental health and crisis services, but also:
- local housing assistance programs
- options for temporary shelter
- free debt advice.
Explore with the person effective ways of recognising and responding to increasing distress. Include strategies for coping with suicidal thoughts and urges to self-harm.
Any safety plans or contact details should be provided in a format that is accessible to the person and does not require a fixed address or internet access. For example, the information could be printed or sent via SMS texts.
Offer tailored support specific to suicide and self-harm: Explore with the person effective ways of recognising and responding to distress. Including strategies for coping with suicidal thoughts and self-harm that work for the person.
Any guidance should be made available in formats that do not require a fixed address or internet access.
Consider providing immediate support information: Ensure that individuals on waiting lists receive clear information on how to access immediate support in case of a crisis. Provide the information in a format that works for the person (e.g., printed cards, SMS texts) and include local and national crisis support contacts.
Explore communication needs: Explore the ongoing communication needs of the person, especially within mental health and other healthcare provisions. Many people experiencing homelessness may have limited access to phones or the internet, making traditional communication channels inaccessible. Explore what will work for the person to ensure they get timely information. You can directly ask individuals for their preferred communication method and note this in their records to ensure all future communications are accessible to them.
Listen to and learn from lived experience: The report gives some direct quotes from those with lived experience of homelessness. Take the time to read them, learn from them, and consider how you might contribute to improving your approach to those without a fixed address. Through actively engaging with their perspectives, you can gain valuable insights into the barriers and challenges that they face in their day-to-day lives.
We encourage you to have a read of the report. It is valuable work that will help save lives.
Storm Skills Training CIC would like to thank the organisations and individuals that developed and supported this project;
- Groundswell
- Homeless Link
- The Outside Project
- Pathway
- Christopher Frederick
- Sahar Khan
A full list of references can be found on page 22 of the report.
