Friday, September 22News For London

Shame and sickness on the streets: the state of mental and physical health

Homelessness has more than doubled since 2010, with over 7,600 sleeping rough in London at some point in 2015. But what are the long-term physical and mental health problems facing our increasing homeless population?

Featured image credit: Creative Commons, labelled for reuse with modification
Featured image credit: Creative Commons, labelled for reuse with modification

A man in dress shoes swears violently at me as he trips, standing heavily on my leg. I sit up straighter in my sleeping bag.

Outside Moorgate station, it’s 7.56pm on a bitterly cold Friday evening: my sixth hour of homelessness lies just ahead. Around me, smartly dressed Londoners make their way from stressful city jobs to upmarket cocktail bars. I can hear the chatter of the end of a hard week’s work. Sat with my head down, someone tosses a pound coin into my lap and mutters something about a sandwich.

I am not hungry, and I am not homeless. The pound, and any like it, will be donated to St Mungo’s charity for the homeless. I am a student of both medicine and journalism. I’m sat in a clean sleeping bag with a hot water bottle, a packed meal and friends keeping watch from a nearby bar.

I’ve prepared for the cold, for hunger and for safety, but nothing prepared me for the rest.

Sat here asking for money I feel deeply embarrassed and ashamed. I can feel that my mental health is starting to suffer, I’m terrified that acquaintances will see and recognise me here. I want desperately to jump up and shout to everyone “I’m just pretending! This isn’t real!”

The majority of transactions in ordinary life are equal: the money that most people use for food and shelter has largely been earned. As a homeless person, this entitlement has been stripped from you and they’re relying on charity and kindness to survive.

Is feeling ashamed a common problem in the homeless?

Many other homeless people describe feeling ashamed of this unequal transaction. Danny was homeless for a year in 2011. He didn’t get along with the mother of his child. When she asked him to leave he slept on the streets in-between staying in shelters and occasionally with friends. “I could have made more effort to ask people like my cousins for help,” he tells me. “But how do you ring someone up and say ‘I’m homeless, can you please help me?’ It’s so embarrassing, you feel dead ashamed that you’ve let your life get like that so you don’t tell anyone.”

Not all homeless people experience these feelings of shame. Steph is a formerly homeless 24-year-old. Her self-image as a homeless person was different to Danny’s. “I was at a women-only refuge centre for a few months and I wasn’t made to feel ashamed,” she says. “The workers and other women were really great, and I really didn’t feel ashamed of my situation. I was proud that I had the courage to leave a violent boyfriend and it built my self esteem.”

Dr Annabel Pitcher, a psychiatrist in South London, believes that feeling ashamed is a problem commonly seen in homeless people. She explains that mental health problems associated with self-image are often a surprise to doctors, who are expecting to see conditions such as alcohol dependency, drug addiction and schizophrenia. “For many people, losing their home is a sign of hitting rock bottom and they feel like a failure. Many experience feelings of guilt as they often rely on the kindness of strangers, either through charities or outright donations, to fund their next meal. This guilt can lead to depression.”

Which other health problems threaten our homeless population?

Poor health, both mental and physical, is one of the biggest problems facing people without a home. Dr Helena Calvert, a central London GP of many years, speaks about the barriers to good health she sees in her homeless patients, and which problems she sees most commonly.

In This audio clip, Dr Helena Calvert speaks about her experience as a doctor treating homless patients, from the difficulties in contacting them to the extreme environments they face.

Original infographic created by Charlotte Staley, showing how the homeless population compare in health to the general population. Figures obtained from Homeless.org.
Original infographic created by Charlotte Staley, showing how the homeless population compare in health to the general population. Figures obtained from Homeless.org.
Original infographic created by Charlotte Staley, showing the problems with nutrition, alcohol and smoking commonly encountered by the homeless population. Figures obtained from Homeless.org.
Original infographic created by Charlotte Staley, showing the problems with nutrition, alcohol and smoking commonly encountered by the homeless population. Figures obtained from Homeless.org.

Why do we help homeless people?

For every homeless person feeling ashamed, guilty and ultimately depressed through accepting help and charity, there is a kind benefactor offering donations. Why do we give to homeless people? Is it because we want to ease their suffering, or because we want to feel good about ourselves?

“There is a theory that a truly selfless good deed must be accidental,” explains Dr Pitcher. “But from an evolutionary standpoint, I would argue that this isn’t the case,” she continues. “For society to have progressed as it has, people have had to help one another. The pleasurable feeling one gets when helping another probably contributed massively to how socially evolved humans are.”

Homeless charities Crisis, Shelter and St Mungo’s are able to offer help to anyone who has become, or is in danger of becoming homeless. They are also able to accept donations from anyone wishing to help.