Two people who experienced mental health and homelessness in Northern Ireland say more needs to be done to ensure the right measures are in place to support those who are struggling.
They were speaking as new research is published today by Simon Community NI and Depaul, highlighting the significant inter-relationship between mental health and homelessness.
The report ‘Mental Health & Homelessness’ identifies homelessness as more than a housing issue, but the consequence of multiple disadvantages, with mental health both playing a role and having an impact.
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Its authors say the report reveals a catastrophic situation that cannot be ignored and they are calling on politicians and decision makers to stop thinking that homelessness is just a housing issue, but identify it as a fundamental health issue that requires urgent action.
One of those surveyed was Patricia, who is originally from Belfast and grew up in the care system. She has had mental health issues and addictions from a young age.
Now aged in her 40s, Patricia had been living on the streets of Belfast for six years and was dependent on alcohol. She spent many nights in the freezing cold but with support from Depaul, she's now living in permanent accommodation and got married two years ago.
"Growing up in the care system, I had mental health problems from a really young age and I was left throughout my 20s with flashbacks," she explained.
"That led to addiction and that was me on the street. I do believe that if I'd had that help, I'd maybe have taken a different path in life. I'm still getting support from Depaul and taking each day as it comes.
"People think that once you're in recovery that's it but it doesn't work like that. I think you need support once you're in recovery to continue your journey."
Elsewhere, Sean, 42, from West Belfast, was homeless on and off for 16 years following a relationship breakdown. He stayed in different temporary accommodations and night shelters and on the street.
Now a homeless activist, Sean has been living in his current home for three years but has struggled with his mental health including anxiety and depression.
"If you don't deal with your mental health, your homeless life is going to become much worse - it goes hand in hand," he explained.
"If you get the right help at the right time for your mental health, you mightn't become homeless and might be able to work on your problems and resolve your issues.
"Sometimes you can't even get a GP when you're homeless because you don't have that fixed address so it's really hard for people facing these issues to know where to go."
Sean is also coping with other health issues and is still being supported by the Simon Community. He has highlighted the need to have someone who can see past the issues, or "the scars" as he calls them, to the person beneath and he had that in his support worker, Chrissy, from the Simon Community.
The report also includes the results of a survey carried out with 170 people experiencing homelessness, which reveals that 70% of participants reported receiving a mental health disorder diagnosis. The overwhelming majority (84%) had received this diagnosis before becoming homeless.
The most common diagnoses are for depression, anxiety disorders and PTSD, but also include suicidal behaviours, personality disorders, self-harm, and schizophrenia.
One of the report's authors, Deirdre Canavan, Senior Services Manager for Depaul in Northern Ireland, is calling for a specific action plan for those experiencing homelessness within the Mental Health Strategy.
She said: "We could see that there was a growing issue of people presenting as homeless with mental health issues and their ability to be able to access services at a time in which they needed them was problematic.
"We wanted to have a conversation with those with lived experience, those that are homeless or who have experienced homelessness and poor mental health issues as well as providers in the voluntary sector.
"The reports clearly lays out that there was a consistent view from those people that it was very challenging to be able access mental health services when they needed them.
"The transient nature of their housing situation of living in one place today and somewhere else tomorrow made it a real issue to be able to register with a GP, in particular for those already on medication and trying to get a prescription."
Co-author Karen McAllister, Head of Research & Development at Simon Community said homelessness is both stigmatising and isolating which can be a cause and consequence of mental illness.
"Mental health is inextricably linked to homelessness and we have known for a long time that homelessness is more than a housing issue, it's a fundamental health issue," she said.
"We are at a critical juncture but there are solutions there. If we had a legal mandate for the government departments with responsibility for housing, health and social care, justice and education to work together and find more effective solutions, then we could end homelessness.
"If we had homelessness recognised within the Mental Health Strategy for Northern Ireland, it would support our most vulnerable. There is a roadmap for change if we had a government to support us but if we do nothing, we're at a cliff edge and what we'll see is more people dying and becoming homeless."
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