Background to the Research

• Research has shown that homelessness and poor living conditions are closely associated with ill-health and that the incidence of illness among homeless people is higher than among the general population.
• Within NI, there has generally been a dearth of studies into the health status of the homeless population and none have focused on access to, and use of, primary health care services.
• The main objective of this research was therefore to examine the relationship between homelessness and access to primary health care provision.
  

Research Approach

• The research was conducted in three stages and used both quantitative and qualitative methods. These involved
  • Ten focus group discussions with 60 single homeless people resident in hostel accommodation across NI.
  • 641 questionnaires distributed to all single homeless people resident in hostels, with a 53% response rate.
  • Thirteen semi-structured interviews conducted with a selection of health care professionals.
    

Main Findings

Focus group discussions

• A small number of participants who had experienced rough sleeping referred to the debilitating effects this had on their physical and mental wellbeing.
• A small number of participants said there were positive aspects to living in hostels, including practical support and help to access services.
• Most participants smoked and some said this helped alleviate boredom and settled their nerves.
• A number of participants said the rules and curfews of hostels controlled their intake of alcohol.
• Many participants experienced stress due to living in hostels, feeling alienated and isolated. They also tended to suffer from depression because of feelings of powerlessness to change their current situation.
• In general, participants were registered with a GP; some had a positive relationship with their GP while others did not.

Survey results

• 78% of respondents were male and 22% were female and nearly half (49%) had been homeless for more than a year.
• The three main reasons given for being homeless were family conflict, relationship breakdown and intimidation.
• 58% of respondents said their health was good although 90% had had at least one health problem over the previous six months and nearly half (47%) had a long-term health problem.
• Whilst most respondents were satisfied with the service they received from their GP, 23% felt he/she did not take their health problem seriously enough.
• The main barriers to accessing healthcare services were distance and travel difficulties.

Interviews with Health Professionals

• Health care professionals said there were complications in providing ongoing care for homeless people due to them moving from one hostel to another.
• They also felt that homeless people did not give a high priority to their health needs because other factors were of greater importance to them.
• Male single homeless people were less likely than females to look after their health or access services.
• Health care professionals thought that a lack of a medical history could hinder their care of homeless people.
• Homeless people lack sufficient information about the availability of local health care services and are therefore disempowered and lack confidence when in contact with health professionals.
• Some health professionals believed that others within their profession often held negative views about homeless people that could impact on the provision of prescriptions.