Background
Despite the large body of research on homelessness and mental health, little is known about the lived experience of homeless people with a mental health problem. This qualitative research project aimed to explore these experiences through in-depth interviews with 8 homeless people using a phenomenological approach. Participants were recruited through GPs in two homeless accommodations in Dublin.

 

Findings
Although commonalities could be found across narratives, the individuality of experiences and differing needs of each person emerged. Mental health diagnoses ranged from anxiety to psychosis. The ways in which individuals coped with their situation also varied, for example, through use of drugs or medication, focusing on their children, or focusing on detoxification as a step in their recovery. For some, their mental health condition was a permanent and accepted part of their lives while others either saw it as part of their past or something that would change as soon as their situation changed for example, being housed. The unique identity and experience of each participant jarred with the label of the seemingly homogeneous grouping the researcher sought to explore i.e.“homeless people with a mental health problem”.

 

Positive outcomes for participants were facilitated through successful relationships with someone working within the homeless services (e.g. keyworker, mental health specialist or GP). Outcomes varied from securing housing to alleviating the symptoms of depression through listening and encouragement.

 

Narratives suggested a lack of access to a range of mental health services and supports. However, this was interpreted by participants as a result of their own lack of awareness of services rather than an absence of services: “…the services don’t just jump out at you[…]there is good services but eh, they’re hard enough to find.”. Most participants were unclear about the meaning of “services for mental health”. What was clear, however, was that all participants were engaged with services in the form of methadone clinics. Nevertheless, this did not necessarily mean they were in receipt of support for their mental health condition. It was also clear that being homeless had a negative impact on the participants’ mental health. While participants’ mental health conditions appeared to be worn peripherally in a way that did not define them, their homeless status was considered more critical and central to their lives. Solutions in terms of housing were seen as a necessity that could only benefit their mental health and general wellbeing.

 

Conclusions
As is often the case with small-scale qualitative studies, the findings are not generalisable to all homeless individuals who have mental health problems. However, the study raises questions around the visibility of services and points to the merits of mental health training for frontline workers. The study calls for housing-led initiatives in particular the Housing First model for homeless people with mental health problems.

 

For further details on this study please email: primarycare@healthequity.ie