Asked by
of Drefelin
To ask Her Majesty’s Government what assessment they have made of
the effectiveness of the £30 million programme to provide
specialist mental health services for people sleeping rough, as
detailed in the NHS Long Term Plan; and what plans they have to
publish an evaluation of the outcomes of that programme.
The Parliamentary Under-Secretary of State, Department of Health
and Social Care () (Con)
This Government are committed to ending rough sleeping by the end
of this Parliament. The long-term plan set a target of 20
high-need areas to receive new specialist mental health provision
for people sleeping rough by 2023-24. In fact, the NHS has
exceeded that target, with 23 sites. There are plans to share
learning from these sites to identify the key successes and
effective approaches, and NHS England plans to undertake a formal
evaluation before the end of the programme.
of Drefelin (CB)
I thank the Minister for that Answer and look forward very much
to the publication of that work. We know that common mental
health conditions are twice as high among people who have
experienced homelessness, and psychosis is 15 times as high.
Obviously, I commend the Government’s commitment to end rough
sleeping. Does the Minister know what figure has been settled on
for the number of people sleeping rough with specialist mental
health services needs? If one has been settled on, is that the
criterion that will be used to review progress with the NHS
long-term plan when that is refreshed?
(Con)
I thank the noble Baroness for her Question and for her continued
conversations with me on a number of different health-related
issues; I am learning quite a lot from those. I understand that
the data will be collected at some point, and I hope that that
will be done regularly. If the noble Baroness will allow me, I
write to her with more details, but I know that the top-level
answer to that question is that we are about to get the data.
(Lab)
My Lords, about two-thirds of people who are homeless cite
alcohol misuse as one of the reasons that first made them
homeless, and for about one in 10 people who die homeless,
alcohol is the main cause of death. Can the Minister assure us
that all this work will include a proper alcohol treatment
programme, so that the underlying problems are dealt with in
addition to the other mental health problems?
(Con)
The noble Baroness makes the very important point that a number
of people who are homeless suffer from alcoholism and alcohol
abuse—and indeed drug abuse. For some of these people, the issues
they are suffering from are often interrelated. Therefore, in the
joined-up thinking we are looking at, charities, civil society
organisations and the NHS are making sure that we treat the
various symptoms in an integrated way.
(Con)
My Lords, given the success of the Everyone In campaign, through
which 15,000 rough sleepers were given accommodation to protect
them from Covid, does my noble friend agree that that progress
must be maintained? Given that many rough sleepers have mental
health issues, can my noble friend say whether the specialist
funding for mental health services for rough sleepers will be
extended beyond the next two years?
(Con)
I thank my noble friend for raising that important point. The new
rough sleeping strategy from the Department for Levelling Up,
Housing and Communities will set out how departments will work
together to end rough sleeping. This will build on the recent
success to which my noble friend refers to ensure that rough
sleeping is prevented in the first instance and responded to when
it occurs. We are going to work closely with the Department for
Levelling Up, Housing and Communities and other departments, as
well the voluntary and social enterprise sector and others, to
make sure that we are all joined up.
(LD)
My Lords, the most common health problems among homeless people
are substance abuse, as the Minister just mentioned, and mental
health problems; often it is a combination of the two. Given this
correlation, can the Minister say what the Government are doing
to reconnect addiction services with health services in order to
treat homeless people with multiple health problems? Does the
Minister agree that specialist addiction services should be
jointly commissioned by the NHS and local authorities to ensure
full integration?
(Con)
Like many other noble Lords, the noble Baroness has raised a very
important aspect of this issue. She is absolutely right that
people with drug addiction often have physical and mental health
needs as well. Mental health problems and trauma are often
central to an individual’s dependence on drugs, alcohol or other
forms of abuse. As set out in the drugs strategy, we are working
with NHS England to ensure that there is joined-up service
provision between specialist mental health services and substance
misuse services for people with co-occurring issues, including
those who are experiencing rough sleeping. We are also going to
make sure that the next phase of integrated care system
development includes leadership on drugs and alcohol to integrate
both physical and mental healthcare and substance misuse
services.
The Lord Speaker ()
My Lords, we now have a guaranteed virtual contribution from the
noble Lord, .
(Lab) [V]
My Lords, I commend to the Minister’s attention, if he is not
already aware of it, the work of Art and Homelessness
International and its 500 or so member organisations. In working
with the NHS and local authorities on ways to support people
sleeping rough, will Ministers take into account the impressive
evidence that enabling them to engage with creative and cultural
programmes— I think of The Choir With No Name, Streetwise Opera,
Museum of Homelessness and the work of the Booth Centre—leads to
improved well-being, resilience, agency and skills and thus to
improved prospects for sustaining tenancies and employment?
(Con)
I am sure we are all grateful that the noble Lord was able to ask
his question on this issue. I pay particular tribute to the noble
Lord for all his work and for raising awareness of the creative
sector across a whole range of health and social care issues. I
am not aware of the projects to which he refers, so I will be
happy if he writes to me about them. In a previous political
career as a Member of the European Parliament for London, I would
meet lots of civil society organisations right across London,
including homeless projects, and I was amazed by the diversity of
provision. It was not a simple matter: they were tackling a
number of different issues because often, the needs of homeless
people are complex and there is not just one simple solution to
the issue.
(Con)
My Lords, my noble friend will know that the people who are still
sleeping rough after a year are generally those who started off
with mental health problems. What action are the Government
taking to prevent people hitting the streets in the first place?
Is there a co-ordinated approach with the housing sector?
(Con)
My noble friend raises the very important issue of prevention.
When we look at the causes of homelessness, they are often
complex, and we might consider that all of us—including noble
Lords, perhaps—are only one or two steps away from homelessness.
Someone loses their job, their relationship breaks up and they
then lose their home—or it is the other way around: their
relationship breaks up and they lose their job, and after a while
of relying on a friend’s good will, they stop sleeping on their
sofa and they end up homeless. So, it is really important that we
understand all the different steps by which people become
homeless and make sure not just that they get accommodation but
that we tackle the underlying problems that led to them being
homeless.
(Lab)
My Lords, with a health audit by Homeless Link showing that some
four out of five people experiencing homelessness need support
with their mental health, how will the Government ensure that
they get the help they need in areas that do not have the
necessary specialist mental health services that are being funded
through the long-term plan? Further to this, will the Minister
commit to a continued expansion of specialist homeless healthcare
services throughout the NHS as part of a renewed rough sleeping
strategy?
(Con)
I thank the noble Baroness for those questions on what are very
important issues. Our plans to transform NHS mental health
services as part of the long-term plan include investing an
additional £2.3 billion a year by 2023-24, which we think will
enable an extra 2 million people in England to access NHS-funded
mental health support by 2023-24. On targeting much further down,
we are hoping that some of the work we do through community
mental health frameworks will give 370,000 adults with serious
mental illness greater control over their care and support. We
have to look at this in a multifaceted way, and we are looking at
psychological therapies, improved physical healthcare, access to
employment support, trauma-informed care and support for those
with self-harm and substance misuse problems. We announced £30
million to establish these specialist mental health provisions,
and we want to learn from those to see what the best way is of
rolling out more in the future.
(Lab)
My Lords, have the Government carried out an analysis of why
there has been a massive increase in the number of people rough
sleeping on our streets? What does the analysis say, and what are
the Government going to do about it?
(Con)
Indeed, in some measures, the number of rough sleepers in every
region of England have actually decreased. There were 2,440
people expected to have been sleeping rough on a single night in
autumn 2021, which was an eight-year low. We have also seen some
of the problems associated with experiencing homelessness, such
as suicide, fall, but that is not a sign to get complacent. That
is why we want to roll out this programme. We have exceeded the
target of 20, and we will continue rolling it out.
