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A co-produced qualitative systematic review of the impact of trauma on the mental health (including substance use) of people experiencing homelessness

Emma Adams (Principal Investigator)

This study involved colleagues from Newcastle University, Northumbria University, Pathway, and people with lived experience.

People experiencing homelessness often face complex challenges around substance use, mental health and historical or recent trauma. Trauma can be an experience (physical or emotional) that is life-threatening, harmful, or out of the ordinary and has lasting impacts on all aspects of wellbeing. Much of the information we know about trauma within homeless populations focuses on events in childhood. However, there is a need to understand how trauma during homelessness impacts mental health if we want to ensure people experiencing homelessness have access to the right support at the right time. Working with people with lived experience of homelessness, we are synthesising the global evidence on trauma during adulthood homelessness and the impact it has on mental health and substance use.





Across the studies, homelessness was linked with psychological trauma, expressed in terms of shock, isolation and detachment, and wider accommodation-based issues.



Although the specific impacts varied, the recognition that trauma shaped people’s mental health, wellbeing and substance use was very prominent in the evidence.




Strategies for managing the feelings and mental health impacts from trauma often included substance use and taking steps to minimise risks to one’s safety.


Unsurprisingly people who experienced prolonged homelessness faced trauma more than once, in different forms, and often across their life. This led to longer-term responses that led to people either accepting their situation or realising that things could get better.


This study is ongoing. Recommendations will be shared as they are available.

Find out more




EA was funded as part of the Three NIHR Research Schools Mental Health Programme Career Development Award (MH036). 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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