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Access to mental health and substance use services for people experiencing homelessness


Emma Adams (Principal Investigator)

This study involved colleagues from Newcastle University, University of Bristol, UCL, charities (e.g., Crisis Skylight and Fulfilling Lives Newcastle/Gateshead), Tyne Housing, and people with lived experience.


People experiencing homelessness have higher rates of mental ill-health and substance use and lower access to health services compared to the general population. The stigma and barriers to accessing mental health and substance use support makes it harder for individuals to get the required treatment. In times of crisis, access to health and social services often becomes more difficult. We spoke to people experiencing homelessness and those who provided support to explore and understand access to mental health and substance use support in Newcastle and Gateshead. We worked with people who experienced homelessness to make sense of our findings.





COVID-19 presented an opportunity to learn from changes in service provision and has drawn attention to the need for more accessible and bespoke mental health and substance support for people experiencing homelessness, as well as the health and support complexities faced by this population.


Reactive changes to support provision often led to inadvertent exclusion. This included changes to hours of operation, digital service provision, and limited awareness of services. Barriers to access included: physical locations, repetition of recovery stories, individual readiness, and limited availability. Participants suggested creating services reflective of need and opportunities for choice and empowerment.


The lack of in-person support and increased isolation and loneliness led to relapses or new challenges for many people’s mental health and substance use. The “surreal” experience of the pandemic led to many people feeling uncertain about the future and when things would return to normal. Isolation and changes to relationships also played a role in mental health and substance use. For some, they used the isolated time to re-evaluate their recovery journey and focus on self-improvement.


Invest in mental health and substance use support for people experiencing homelessness that is personalised, responsive to need, inclusive, and trauma-informed.


Recognise that the needs and priorities of those experiencing homelessness changed throughout the pandemic and will likely continue to change over their cycle of homelessness.


Provide choice wherever possible in service provision, no matter how small.


Use simple and clear language to share information about services


Work with people with lived experience of homelessness to ensure services are delivered in appropriate and welcoming spaces.

Find out more


Conference abstracts







This research was funded by the National Institute for Health and Care Research (NIHR) School for Public Health Research (SPHR) development fund for early career researchers (ECRs) (PD-SPH-2015). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.

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