The relationship between homelessness and mental health is more like a cause-and-effect relationship. In the article named ‘The Homeless Mentally ill’ appeared first in Harvard Mental Health Letter (2005) and this article; author claimed that almost one-third of all homeless people in America has a serious mental problem such as bipolar disorder, schizophrenia and major mental depression. The relationship between the homelessness and mental health is like circular in fashion as each one contributes on other; sometimes, mutual contribution spins out of control (Gulati et al. 2018). According to Urbanoski et al. (2018), homelessness is traumatic for the individuals and it leads to the depression to the people and it often develops the stress leading mental illness. Moreover, London is developed in the economy; however, one-fifth of the homeless people suffer from the mental illness while 14% of them are women. Homeless people in London sometimes have to sleep under the open sky and sometimes, the homeless people sleep in cars, tents, buses and even trains. Additionally, the report stated that sleeping without the roof causes the victims of violence for the people and it makes 17 times more likely to suffer verbal and physical abuse compared to common public (Essali et al. 2012).
This study aims to conduct a research on the subject matter of homelessness contributes to a mental health problem in London. Lambeth, a borough of London observes major homeless issues. There are some homeless shelters which provide places to live for the homeless distressed people. This research is aiming to provide aim and objectives which will be addressed in the final research. A literature review is provided setting the background of the research based on the previous research studies. Data collection process and the process of data analysis are also given in the research methodology section. In the final section, anticipated findings of the research are provided identifying the strengths and weaknesses of the research. The findings of the study would benefit the public health issue in London as the findings will be highlighted the core relationship between homelessness and mental health of people.
As stated by Snow (2013), there is a contrast in European technologically and economically advanced society on misery and the size of the homeless population. The authors further remarked that homeless people present in the general population and they achieve the prominence during the rimes of stress and economic stress. The new visibility of the homeless people on the streets can prompt a deal of public speculation in European regions and in the United States. The number of homeless people has been increased in European regions and the reasons are high employment, change in the structure of the families, decrease in the public support programme and unavailability of the low-cost housing (Urbanoski et al. 2018). The relationship between the homelessness and mental health is cyclic in nature as poor mental health can lead to the homelessness as well. As opined by Bhugra (2017), poverty, personal vulnerability and disaffiliation are factors of homelessness of the people as homeless people face the issues of sustainable employment and little income. Lack of mental balance leads to the delusional thinking and it leads to withdrawal from the friends, people and family persons.
The stress of the people during the homelessness leads to exacerbating previous mental agony and it leads to the more fear, anxiety, sleeplessness and depression. The experience of homelessness along with mental illness can be hazardous for the people as the individuals can face the issue of physical hazards (Greenberg and Rosenheck 2016). In this situation, the people want the supportive atmosphere, fulfilling the basic needs and having the accessible care. On the other side, safe accommodation and affordable housing bring security and safety to the people’s lives and this advantage gives gateway to access health service along with enhancing the social and community inclusion. It is very important to simply put a good home for the physical health along with mental peace. Homelessness condition leads to the poor mental condition and it makes harder for the people to handle the mental pressure during the condition of homeless. As found out by Herbers et al. (2017), in the year 2015, almost 33% of the single homeless people reported to have a mental health problem and rate of depression was high in the UK. Among the homeless people; psychological issues like substance misuse, trauma and social exclusion are very common and these things can lead to the mental problems.
Homelessness is one of the stigmatised situations of the society and people without roof experiences the components of the stigma associated with this. Financial condition and societal factors are associated with the homelessness and these people are officially marked, segregated and labelled to unwanted characteristics (Perry and Craig 2015). Homelessness leads to sheer mental pressure to the people as they have no place to take shelter and most common stereotypes concerning with mental health are mainly two types; these people are generally viewed as responsible for their own conditions and these people are viewed as unpredictable and dangerous for the common people leading to avoidance and fear. Stereotypes result to often perceive the public with homelessness as mentally ill and untouchable. The common people cannot think that homeless people are mentally ill and they cannot make decisions for their own (Narendorf 2017). Homelessness of the people leads to the schizophrenia and these people can be dangerous for the common public. On the other side, media provides inaccurate illustration and exaggerate violence portraying the mental illness of the homeless people. Sometimes, common people tend to exaggerate the relationship between the mental illness and dangerousness associated with this.
According to Greenberg and Rosenheck (2016), increased prevalence of psychotic illness among the homeless people may need a special model of social and psychiatric care. Individual vulnerabilities and structural change is the main reason of the homelessness. Homeless people do not have relation with the friends and family for long time. As stated by Bramley and Fitzpatrick (2018), healthcare prevention for the people who are homeless is definitely a challenge for the public health monitoring. The governmental agencies address barriers to develop the mental health of the homeless population which can lead to the lasting gain of the people. For the homeless people; integrating treatment is needed with housing interventions and substance dependence. The intervention of the people is aimed at the people who are homeless with severe mental illness. These types of people can be given housing programmes, rehabilitation along with life skills, crisis intervention so that they can get the services. As opined by Reeve (2017), the government agencies describe the intervention policy as the employment training to the homeless people and if the people are mentally misbalanced, they can be given access to the medical care and psychiatric care as well. It has been observed that normal community mental health cannot be sufficient for homeless mentally disabled people. If the homeless mental health people are given with traditional mental health care; this service delivery does not match their housing needs and welfare.
The interconnection between the mental illness and the homeless is multifaceted. In the case of mental health problem, biological risk can increase the likelihood of the mental health and subsequent homelessness. If the mentally ill people get their own home; the people have to face again their triggers and stressors where they experience trauma, abuse and it can reduce their function and it increases the risk of homelessness again (McIntosh et al. 2016). In London, the number of sleepers in the open road has been increased by 15% in just one year (from 2016-2017) (Healthyplace.com 2018). National Audit Office (NAO) in London revealed the data where it is shown the numbers of sleepers have been increased by 34% since the Conservative Power took the power (Ward et al. 2015). Some of the homeless families approached the councils and they had got the temporary accommodation. Amidst the prosperous condition in London, more people find themselves helpless and they are forced to sleep in dangerous as well as freezing condition. Murphy et al. (2017) observed that the Government of the UK pledges to handle rough sleeping and it includes the homelessness along with the mental health of the people. The authors further stated that the Government has ample numbers of shelters for the homeless people, the worst pain is the housing crisis.
Gap in literature
Most of the previous researches focused on the interrelationship between homelessness and mental health issues. The scholarly articles mainly mentioned the cause-effect relationship between mental health and homelessness of the people and the authors mainly stated that these two factors are cyclical in nature. However, the question of this particular research is to highlight how homelessness attributes mental health of the people. The researchers found out the financial and social factors behind the homelessness of the people which lead to the mental health of the people. However, it is not evidenced by risks of homelessness; many of the homeless people with the mental illness accept the services and treatment.
The aim of the research is to demonstrate how homelessness contributes to mental health problems among single homeless adults in London.
Research objectives are:
This research will focus on the homelessness and its contribution towards mental health issue. This particular research will be based on secondary data. The researcher will take permission from the university before starting the research. The researcher will also follow the ethical considerations as well by using the correct data like documentary records, archives and case notes. This particular research follows the social research approach as the targets of the research are the homeless people. The researcher will interpret and use secondary data and the researcher will not be biased taking the research data from the secondary sources. The researcher will use only relevant and up to date journal articles. The researcher will follow the Data Protection Act 1998 where the researcher will destroy the data after completing the research. Under the terms of Data Protection Act 1998, the researcher will ask if the authors are willing for their data to be archived and make them available for the final research (Watcher et al. 2017). In secondary research data; the researcher will put proper citations along with correct references. Sometimes, the researcher may face the ambiguity as two secondary data sources may give two different types of information; in this scenario; the researcher will further research to put the information. Data of the researcher must be de-identified before the researcher release and use of data should not result in any damage. Informed consent of the second data includes the terms of sharing from public agencies and archives. Sometimes, secondary data is involved in strong anonymisation.
Method of investigations
In this research, the researcher will select the interpretive philosophy. Interpretivism research philosophy assumes that access to reality can only be possible through social construction, instrument and shared meaning. Development of the interpretivism is based on positivism in social science.
The researcher will select the deductive approach as this approach aims to test the theory. Deductive approach is used which starts with problem statement and the end result is based on the either confirmation of the hypothesis or rejection (Ledford and Gast 2018). In this research, observations regarding homelessness contribute to the mental health issues will be discussed and it will start with the social theory.
The researcher will select an exploratory research design as it will help the researcher to identify the problem statement. Exploratory research design mainly helps the researcher to address the subject topic which has not been addressed by the previous researchers. The researcher will explore the research topic through conclusive answers.
Data collection process
There are mainly two types of data collection process, primary data collection and secondary data collection.
In this research, secondary data sources will be considered in order to conduct the research. The researcher will obtain the secondary data from UK government publications, report, technical and trade journals, public records, online articles, books, journals, reports of various governmental agencies, statistical and historical documents. The researcher will follow the articles and news published by agencies through Mental Health and Homeless departments. The researcher will also follow information related to National Health Services (NHS).
The researcher will assess the reliability of the secondary data through an understanding of the premium articles with credible journal sources. The researcher will assess the data accuracy as it refers to the data value stored for the object. In order to be all the data to be accurate; the value of the data must be right and it should be represented in an unambiguous and consistent form (Palinkas et al. 2015). The researcher will use secondary data sources as it will provide help to gain the data accurate on homelessness which influences the mental health issue in London. However, it would be a bit difficult for the researcher to collect the exact data based on London’s homelessness. Secondary data will be helpful for this research as the researcher cannot collect the primary data from the mental health of people who are homeless. In this scenario, secondary data can provide accurate information as it will be economical and it will be time-saving for the researcher. As stated by Mackey and Gass (2015), secondary data helps to improve the understanding of the problem statement and it mainly gives the comparison for the data which is gathered by the researcher.
Sampling
In this research, the researcher will use a list of external secondary data sources which can be extensive. The researcher will use the sample of various health data, social surveys, statistics, population censuses, government data and online articles. The researcher will use approximate 40 articles including government data, statistical papers and website materials. Therefore, the sample size is 40.
Inclusion and exclusion criteria
Inclusion criteria are the features which are prospective subjects to be included in the research study. In this research, the inclusion criteria of the sampling of the secondary data source are that all the credible and collected data sources must be published after 2010. Therefore, the researcher will have credible and recent data which can be used as secondary data. Secondary data which have been published after 2010 will be taken as sampling. Exclusion criteria are those features which disqualify prospective subjects from inclusion in the study. The exclusion criteria of the sample are the ones which are not based on European context. Therefore, all the articles and secondary data must be based on the European context which helps the researcher to get the accurate data.
Method of data analysis
Collected data through secondary data sources will be analysed through thematic data analysis. Secondary data are mainly qualitative research data and qualitative data are mainly subjective in form. Thematic analysis is the common form of qualitative research. Thematic analysis mainly pinpoints, records and examines patterns within the data. The researcher will segregate the findings into five themes based on the across the data set.
After the literature review, it is clear that major depression, psychotic illness and drug prevalence is quite common among the homeless people. After exploring potential secondary data, it may be found that homeless people in London, mainly the Lambeth area are more likely to sleep homeless shelter at night and under the open sky. These people more likely to have drugs and alcohol and people face psychotic illness due to the mental pressure and ill-treatment from the family, friends and common people are very normal for them. However, the true magnitude of the issue is very difficult to understand as different approaches are taken by the Government in the UK. There are many factors which may lead to the homelessness, substance abuse, unemployment and domestic violence; mental illness is untreated among the homeless. This research will strive to explore the implications of the health services for the mental illness among the homeless people. The traditional model of service delivery will not be able to treat the mental health of the homeless people in London.
The major strength of the research is that this particular research is going to explore the health implication of the homeless people and this research area demands analysis to find out the reasons behind the homelessness and mental illness among single people in London. The strength of the research is that this particular research focuses narrowly on London which will increase the impact of the research. This research will technically explore the complex interrelationship between homelessness and mental illness from the secondary data sources by public health departments and social justice bodies. This research will bring out the prevalence of the mental illness among the homeless people. In addition, psychiatric diagnosis is becoming more discriminating and it has its link between illness and homelessness. The strength of this study is to identify the factors like housing, employment, education, social support, access to health and family cohesion related to mental health and homelessness.
This research is based on the secondary data; therefore, the research will be solely based on what other researches told in recent and previous time. The researcher needs to research the government reports and agencies’ statistics to show the recent condition. In addition, the researcher will not get first-hand data to understand the condition of London regarding homelessness and mental health. Secondary data do not fit in the framework of marketing research sometimes. The researcher will not get the direct responses from the public health staffs. Sometimes, secondary data lack the accuracy.
Reference List
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Bramley, G. and Fitzpatrick, S., 2018. Homelessness in the UK: who is most at risk?. Housing Studies, 33(1), pp.96-116.
Essali, A., Tarboush, M. and Awad, M., 2012. Specialist interventions for homeless people with the severe mental illness. The Cochrane Library. pp.1-15
Greenberg, G.A. and Rosenheck, R.A., 2016. Jail incarceration, homelessness, and mental health: A national study. Psychiatric services, 59(2), pp.170-177.
Gulati, G., Keating, N., O’Neill, A., Delaunois, I., Meagher, D. and Dunne, C.P., 2018. The prevalence of major mental illness, substance misuse and homelessness in Irish prisoners: systematic review and meta-analyses. Irish Journal of Psychological Medicine, pp.1-11.
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Herbers, J.E., Cutuli, J.J., Kolarova, L., Albu, A. and Sparks, L.A., 2017. Mental health and adaptation of children experiencing family homelessness. In Child and Family Well-Being and Homelessness (pp. 7-26). Springer, Cham.
Ledford, J.R. and Gast, D.L., 2018. Single case research methodology: Applications in special education and behavioural sciences. Abingdon: Routledge.
Mackey, A. and Gass, S.M., 2015. Second language research: Methodology and design. Abingdon: Routledge.
McIntosh, A.M., Stewart, R., John, A., Smith, D.J., Davis, K., Sudlow, C., Corvin, A., Nicodemus, K.K., Kingdon, D., Hassan, L. and Hotopf, M., 2016. Data science for mental health: a UK perspective on a global challenge. The Lancet Psychiatry, 3(10), pp.993-998.
Murphy, D., Ashwick, R., Palmer, E. and Busuttil, W., 2017. Describing the profile of a population of UK veterans seeking support for mental health difficulties. Journal of Mental Health, pp.1-8.
Narendorf, S.C., 2017. The intersection of homelessness and mental health: A mixed methods study of young adults who accessed psychiatric emergency services. Children and Youth Services Review, 81, pp.54-62.
Palinkas, L.A., Horwitz, S.M., Green, C.A., Wisdom, J.P., Duan, N. and Hoagwood, K., 2015. Purposeful sampling for qualitative data collection and analysis in mixed method implementation research. Administration and Policy in Mental Health and Mental Health Services Research, 42(5), pp.533-544.
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Snow, N.L., 2013. The Stigma of Homelessness as a Function of Mental Illness Comorbidity. The University of Drayton.
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