1. THE FORGOTTENONESTHE MARGINALIZATIONOF THEDISENFRACHISEDMental Health and Homelessness:

2. Mr Johnson admitted he is goingto struggle to hit a target ofending rough sleeping by 31December.Could this be a possible place to sleep ? 3. .forgotten street SW1 4. Generally it isconsidered that having a safe,affordablehome is a basic Human needhomelessness can contribute to a person developing amental health problem. The stress related to trying tomanage these issues can also make people with existing mental health problems more vulnerable torelapse were their mental health deteriorates requiringmore support. 5. Some homeless peoplewith chronic psychosis may appear well 6. . In the substance misuse treatment population alone, 670 people are thought to have apersonality disorder, with 1,274 from thehomeless populationIdentifying the needs of this population proves a challenge due to the lack of an evidence for interventions and consensus aroundthe proportion of people who need specialist care. 7. Mental health problems can both cause and be a consequence ofhomelessness. 8. professionals are reluctant toundertake compulsoryadmission, evenwhen there is clear evidence of self neglect andvulnerability. 9. To admit or not toadmit?An inpatient warddoes notseem appropriate.This creates theapparent dilemmaaround admissionfor social ratherthan medicalreasons. A good nights sleep ? 10. Homeless people are among the mostvulnerable in our society, often suffering fromsignificant and multiple health inequalities.professionals who support them report thatthey are often marginalised and left withoutsufficient and effective support to deliver theirservice. 11. There are fewer than five specialist clinical psychologyposts in England specifically servinghomeless populations. 12. Admit or not to admit continuedAssessing the severity of illness may also be difficult, in that hostel / shelterstaff and residents may be very tolerant of challenging or unusual behaviourand this can lead to health and social care staff being inappropriatelyreassured. Some homeless people with chronic psychosis may appear so welladapted to their condition, albeit to living on the streets, that professionals arereluctant to undertake compulsory admission, even when there is clearevidence of self neglect and vulnerability. This reluctance can result in delaysin the obtaining of key information which might, for instance, trigger therestarting of previously prescribed medication which may enable the person toaccept and retain accommodation. Admission for assessment andinvestigation should be considered seriously in these cases. 13. The evidence is clear, whilstprogress has been made, too manyhomelesspeople still experience mental illhealth, and we have not yet got righttheframeworks and services to respondto their needs. We also need torecognisethe full spectrum of mental healthproblems from common mentalhealth issuesto psychosis; the differing needs ofHAVE THINGSparticular groups of homelesspeople; and toREALLYensure services and approaches aretailored accordingly.IMPROVED ?