Homeless families in England report high levels of depressionBMJ 2004; 328 doi: http://dx.doi.org/10.1136/bmj.328.7453.1396-c (Published 10 June 2004) Cite this as: BMJ 2004;328:1396
Depression is one of the main problems affecting the health of people living in temporary accommodation, according to a report by Shelter, a UK organisation dedicated to tackling homelessness and bad housing.
The report is based on a survey conducted by Shelter of 2000 homeless households (single people and families). A total of 417 households, from nine local authorities in London, the South East, South West, North, and Midlands, replied to the survey. Of the 375 households who responded to the specific section on health 78% reported at least one specific health problem.
Fifty six per cent of the 375 respondents reported feeling depressed. Around half of the parents with children and 71% of childless people reported feeling depressed.
In its report Shelter said that there were many reasons for the respondents' depression, including the current housing situation, previous traumatic experiences, and uncertainty about the future.
Apart from depression, most households reported a specific health problem such as eczema or asthma. Almost half (49%) of the households stated that their health was affected because of living in temporary accommodation. About two fifths (38%) of households who responded to the survey reported that since becoming homeless they had to visit their GP or hospital more often.
The survey also shows the impact of temporary accommodation on children's mental and emotional wellbeing. More than two fifths (42%) of the parents said their child was “often unhappy and depressed” and also experienced bullying and behavioural problems.
Dr Vivienne Nathanson, the BMA's head of science and ethics, said: “The BMA welcomes Shelter's report. Recognition of the link between poor housing and ill health started in the 1800s, so it is appalling that in the 21st century we are still raising concerns about this issue.”
At the end of September 2003 more than 90 000 homeless households and more than 100 000 homeless children were living in temporary accommodation provided by local authorities in England, according to the Office of the Deputy Prime Minister.
The additional annual public expenditure associated with the use of temporary accommodation is around £500m ($920m; €745m), including about £10m on additional visits to the GP in a quarter of households because of worse health.
Shelter has based its response to the government's 2004 spending review on the survey's findings. The spending review will decide government spending for 2006-7 and 2007-8.
The report concludes that the long term solution is more investment in affordable social housing. It also says that various funding schemes should be a priority to address people's health needs, including an “innovation fund,” provided through the Office of the Deputy Prime Minister's Homelessness and Housing Support Directorate, to meet the health, employment, and social care needs of all homeless people. It also suggests that the same directorate should provide new funding for support workers for homeless children.
Dr Nathanson added: “Poor housing can cause psychological and physical health problems, and the best way to reduce health inequalities in this country is to improve living standards. The BMA is concerned about a number of issues related to housing and health, but, like Shelter, we are particularly worried about children growing up in overcrowded, substandard bed and breakfast accommodation. The effects on their mental health are of major concern.”
Shelter said the responses to the survey provided strong evidence of the negative effects on people's health, their opportunities to work, and children's education.
Adam Sampson, Shelter's director, said: “For the tens of thousands of children who are shoved from pillar to post because of the shortage of affordable homes, the term “temporary accommodation” is a terrible parody. There is nothing temporary about the damage done to their education and mental and physical health or the cost to the taxpayer, who is left to pick up the bill. The government must give these children an equal chance in life by making serious investment in affordable housing a top priority in the spending review.”
Survey of homeless households living in temporary accommodation: Report of preliminary findings and implications for policy and the 2004 Spending Review is available from Shelter (tel) 020 7505 2162