Our guide to helping rough sleepers this winter

In the festive season, it is not only homelessness charities that are acutely aware of rough sleepers and those in destitute living conditions. It is impossible to ignore London’s growing homelessness problem when you can’t bear the ten-minute walk to the tube, let alone the thought of trying to survive a night outside.

The sight of rough sleepers in the coldest months can also bring a sense of hopelessness for those who can’t see a way to help- so we decided to make a list of things you can do to help homeless people this Christmas and in the following months, from helping them access outreach charities to recognising the signs of health emergencies.

1 – Download the Streetlink App

The best way to get rough sleepers the help they need is to use the Streetlink App or website to alert local outreach teams of rough sleepers. The more detail you can put about where and when the rough sleeper will be bedded down, the better. Describe their appearance and clothing and exactly where they are sleeping for the best chance of them being found. Outreach teams can offer a warm place to sleep and get the rough sleeper on the road to recovery with the support they need to get back on their feet.

You can also volunteer with Thamesreach’s London Street Rescue to go out with trained outreach workers and offer people experiencing homelessness somewhere to sleep. This can make a real difference, and the more volunteers there are, the more people they can reach and take to safety.

2 – Night Shelters

Supporting night shelters can help them to literally save lives by providing a safe and warm space for rough sleepers to stay. When the weather is expected to be below freezing for a few nights, emergency shelters open for extra space. Here is Homeless Link’s list of 2019/20 London winter night shelters, organised by London Borough.

Shelters often rely on volunteers- if you can spare the time, get involved! You can also contact a local shelter to see if you can offer donations of money, food, clothing, hygiene products, or bedding. Make sure you get in touch first to check that your resources can go where they are most needed.

Local to us in Lewisham are the 999 Club in Deptford, and Greenwich Winter Night Shelter. Check out their websites if you want to get involved.

Give clothing or bedding

If someone is rough sleeping, they are at risk of severe health conditions or even death from the cold weather at this time of year. If you are giving clothing or bedding, make sure it’s in decent condition and will last. Good things to give include:

  • Coats, hats, scarves, socks – you can find warm things fairly cheap in high street shops. If you have an old coat in good condition, consider donating it
  • Sleeping bags and blankets – if it’s raining, duvets may not be the best idea as they won’t last long and they can be absorbent
  • Polystyrene or roll mats- these insulate against the cold ground

If you’re not sure, ask someone what they need!

Food and Drink – and a chat!

Buying a cup of tea for someone is a great way of warming them up. Ask a rough sleeper their name and have a chat if you’ve got time- you’ll find you have more in common than you would have expected. Rough sleepers often find they feel invisible and ignored by society, and at Christmas passers by may find it easier to look away due to guilt. You might turn someone’s day around by stopping to chat, and that is well worth your 5 minutes.

Important: it is a myth that alcohol warms you up. If someone is extremely cold, alcohol can be dangerous. Alcohol makes you feel warm as it makes your blood rise to the skin’s surface but away from vital organs. This is why people who have been drinking are more prone to severe illness if they get too cold.

Health Awareness

Homeless people die in winter. According to Crisis, the average age of death for a male rough sleeper is 47. For female rough sleepers, it is only 43.

If you see someone who looks really unwell, don’t assume it’s nothing. Check and ask if they’re ok, and if they are not responsive, call 999.

Signs of hypothermia include:

  • shivering
  • cold and pale skin
  • slurred speech
  • fast breathing
  • tiredness
  • confusion

If you think someone has hypothermia, call 999.

People abusing drugs and alcohol are more susceptible to hypothermia- that often includes rough sleepers.

Drug overdose can also kill- according to the Harm Reduction Coalition, signs of opioid (e.g heroin) overdose include:

  • Loss of consciousness
  • Unresponsive to outside stimulus
  • Awake, but unable to talk
  • Breathing is very slow and shallow, erratic, or has stopped
  • For lighter skinned people, the skin tone turns bluish purple, for darker skinned people, it turns grayish or ashen.
  • Choking sounds, or a snore-like gurgling noise (sometimes called the “death rattle”)
  • Vomiting
  • Body is very limp
  • Face is very pale or clammy
  • Fingernails and lips turn blue or purplish black
  • Pulse (heartbeat) is slow, erratic, or not there at all

If you see someone who may have overdosed, call 999 immediately and put the person in the recovery position. Death from overdose can be prevented, as paramedics and some police carry a special injection called Naloxone which can save people who have overdosed.

Talk to Frank has a more detailed guide of how to help a drug user in an emergency.

Make sure you tell paramedics everything you know- they won’t call the police if someone has used illegal drugs.

Get Political

The fact this blog post has to exist is an outrage. Homelessness needs to be stopped altogether, which means the government need to do better. Since 2010, the number of people sleeping rough has risen by 165%.

We always urge you to write to your MP! Make it clear that this issue matters to you. You can find your MP’s contact details here. Going forward, we must insist that this government keeps their commitment to ending rough sleeping.

Hit social media while you’re at it- share this blog, let people know that these issues are rife in our society.

Any Ideas?

We’re always trying to think of the best ways to help people who are experiencing homelessness. If you have any tips or ideas that we’ve missed, do let us know!

Welfare Benefits: The Domino Effect

A Bench Outreach advice worker talks about the slippery slope of benefits problems and how one DWP judgement can have devastating consequences.

Many of the clients who come to see me are on Employment and Support Allowance (ESA). This means that they are not currently fit to work due to a mental or physical health problem (or both). Eligibility for ESA is determined through a lengthy form to fill in and attending medical assessments at regular intervals. These assessments usually take place in Marylebone – over an hour and a half on the bus from Deptford on the bus if you are on a low income, or a pricey taxi if you’re not well enough to use public transport.

If you are considered “fit for work” at your medical assessment, or you miss a medical for an “unacceptable” reason then your ESA stops. Immediately.  You can ask for a review of the decision (a mandatory reconsideration) and subsequently appeal but it’s not a quick process. How do you manage when there’s no money coming in in the mean time?

Losing one benefit is bad enough but what I see, time and time again, is that it sets in motion a “domino effect”. Receiving ESA means that you qualify for Housing Benefit which pays your rent (or part of your rent) and council tax reduction which is administered by the council. If your ESA is stopped, the DWP write to your local council who will immediately stop your Housing Benefit and council tax reduction.

This seems like madness. Just because your ESA has been stopped, does not mean you’re actually fit for work and it certainly doesn’t mean you’ve got a job and money in the bank to pay the rent. All this does is stack up rent arrears and increase stress and anxiety for clients who are already struggling.

Image result for job centre

The problem is not just confined to ESA. I saw a client, Sandra, last week who is the main carer for her son. He is in receipt of Disability Living Allowance (DLA), and she is reliant on Income Support, Carer’s Allowance and Housing Benefit. Sandra submitted her son’s DLA form slightly late as she was waiting for medical evidence.

Because the form was submitted late, her son’s DLA was stopped.

Because DLA had been stopped, Sandra was no longer entitled to Carer’s Allowance and this was automatically stopped.

Because Carer’s Allowance had been stopped, Sandra was no longer eligible for Income Support and this was automatically stopped.

Because Income Support had been stopped, Sandra was no longer eligible for Housing Benefit and this was automatically stopped. Her housing association had written to her to advise her that she was already in rent arrears.

Does any of this make sense as a compassionate and functional system? I don’t believe that it saves anyone any money and certainly not any time – it takes the best part of an hour to get through to ESA on the phone. It pushes the work out to advice services and charities which are already under pressure. It causes vulnerable people endless worry and sleepless nights.

People have asked if Universal Credit (UC) would stop problems like this. The short answer is no. There are hundreds of thousands of people still on legacy benefits such as ESA and Income Support. It is likely that many would be significantly worse off by moving to UC under natural migration.

In addition, the link between UC and HMRC means that the benefits system can trawl through all your previous earnings. It can, and will, flag up if you’ve earned even a penny more than eligibility for, say, Carer’s Allowance in the past and claw it back. There’s no limitation period so you can have ongoing deductions for overpayments from 15 years ago.

Of course if you weren’t eligible for Carer’s Allowance, you subsequently wouldn’t have been eligible for Income Support… and the domino effect continues.

The danger of “Tough on Crime” Rhetoric

As gang and knife crime have become ever-present in the news, the government tries to comfort the public with a ‘tough on crime’ agenda. But are more arrests and longer prison sentences really the answer?

Crime has been a growing concern in UK politics recently. With austerity meaning cuts to police forces and the Ministry of Justice undergoing 40% cuts by 2020, services have been struggling. With the administrative load of the criminal justice system alone being a huge burden, the prevention of crime itself has suffered.

In the current political climate (October 2019), political parties are rallying for an expected general election. Each is trying to win over the public after the last few years of difficult austerity and public spending cuts. After Mayor of London Sadiq Khan has been criticised for the ongoing knife crime epidemic in London, the Conservative Party are keen to promote a ‘tough on crime’ image. On his appointment has Prime Minister, Boris Johnson was quick to announce that he would be funding 20,000 new police officers and 10,000 new prison places. Meanwhile, Home Secretary Priti Patel describes the Tory party as ‘the party of law and order in Britain’.

This stance is clearly popular. For those scared to walk home at night in their own neighbourhoods, those who have lost children and family members to knife crime, and those who are victims of crime, an increase in police numbers sounds reassuring. Putting more people in prison sounds like the best way to keep ‘us’ safe. So far, the government have encouraged this way of thinking by promoting surface-level reforms without tackling the issues at their core.

At the conservative party conference, Patel said ‘we stand against the criminals, the gangs, the drug barons, the thugs, the terrorists who seek to do us harm.’

She went on to say: ‘To the British people: we hear you […] and to the criminals, I simply say this: we are coming after you.’

This kind of language is deliberate and damaging.

It stresses the idea that some people just are ‘criminals’, people whom ‘the rest of us’ have nothing to do with. What does ‘us’ mean in Patel’s statement? I would argue that her use of this ‘them and us’ idea appeals to the middle and upper classes, those who see themselves as totally separate from anyone who might commit a crime. It appeals to those who are statistically less vulnerable to being drawn into or affected by criminal activity. Meanwhile, those young people who are at risk of involvement in gang crime and knife crime, generally those in the poorest areas of the country, feel even more alienated. When the Home Secretary differentiates between ‘the British people’ and criminals, those young people who feel they have no choice but to get involved in criminal activity, who feel unsupported and unrepresented, see their lack of representation in the government reinforced. They are being told they are not valued British citizens. In reality, they need their voice to be heard and to be supported to prevent them from turning to crime.

The idea that people are turning into criminals because they aren’t being punished hard enough is proven to be quite shaky logic. It seems obvious- all criminals are ‘bad people’ who need to be treated as such. That’s why prison is so unpleasant in the UK- to deter people from committing any more crimes, right?

Now, we know that’s not true, but it seems to be the logic applied by he Conservative party and some other politicians to try and get votes. Admittedly, the idea of spending MORE of the public’s hard-earned taxes on rehabilitation and support for the very people who commit crimes is a bit of a challenge to sell to voters.

We already imprison more people than any other country in Western Europe. Inspections of our prisons have found conditions to be shockingly bad; last year, Liverpool prison was found to have the ‘worst conditions inspectors have seen’, with rats, cockroaches, leaking toilets and broken windows just some of the features. Meanwhile, prison numbers are 8,700 above the prisons service’s own overcrowding limits.

You may think these conditions make prison less appealing, reducing crime. But in reality, the poor conditions mean prisoners feel abandoned by the state- once released, they may understandably lack motivation to contribute to the society that treated them so badly. In a previous blog we talked about the lack of support for those coming out of prison and into homelessness, another contributor to feelings of helplessness faced by ex-offenders. As a result, reoffending rates are extremely high:

“Prison has a poor record for reducing reoffending—nearly half of adults (48%) are reconvicted within one year of release.”

THE PRISON REFORM TRUST, PRISON: THE FACTS, P14.

These shocking statistics prove that we’re doing something wrong. In an attempt to save money through overcrowding in prisons and lack of support for prison leavers, the criminal justice system loses a huge amount of money as reoffenders end up back in prison instead of being supported to live independent and meaningful lives.

You may wonder why we are bothered about this issue as a homeless charity. Well, we work with a huge number of very vulnerable people. At least half of them have been in prison at some point in their lives, many from a young age. It is heart-breaking to think that had they been supported at the age of 17 to find meaning and pursue opportunities in their lives, they may have had totally different lives now. If someone had listened to them when they felt disenfranchised and angry, they may have turned their lives around.

When a 50-year-old comes into my office having been in prison on and off for 30 years and found themselves on the streets, it feels like a waste of a life that could have been much happier.

When someone with learning difficulties gets into a fight or is arrested for possession of cannabis, it seems so obvious that they should be getting support to overcome their issues. Locking them away may be the last straw to turn them to a life of criminality.

When yet another community centre struggles to continue due to austerity’s funding cuts and more kids are left without activities, opportunities and positive spaces to grow in, how can we expect those from poorer backgrounds to work against the odds without a helping hand?

A huge percentage of those in prison have committed crimes out of desperation and lack of opportunity. The government’s ‘tough on crime’ rhetoric simply isn’t going to reduce crime. We know that.

Contrary to what she may have us believe, the criminals Priti Patel talked about in her speech are in fact British people. They are products of a system that doesn’t support young people’s services, support workers, and local communities. They have been let down by those in power.

Photo by 3839153

What can I do to help?

As British citizens in a democracy, we have power. We must draw political attention to these issues that continue to ingrain poverty into our society.

You can write to your MP- feel free to quote from or link to this blog. You can find your MP’s details here, just make sure you include your name and address in your email/letter. It’s important to raise awareness of these issues! Share the blog, talk to your friends, colleagues and families about these issues, and support local charities who support vulnerable people.

Thanks for reading.

Universal Credit: The Limits of Computer Illiteracy

In a world that increasingly depends on computers, the internet, and online communication, the barrier to accessing benefits is getting worse for those who struggle with technology.

Frustratingly, at least half of my working hours are spent helping people to access crucial benefits and housing services online, purely because so many clients have never had the opportunity to learn to use a computer. These services are supposed to be user-friendly, simple, self-explanatory. The main flaw? They are not designed to be accessible without a computer.

Today’s blog looks into the problems faced by those who are not computer literate, and the empathy and patience needed by professionals who help them, especially DWP staff.

Universal Credit: all ‘accessible’ online

Universal Credit, the new Welfare Benefits system, undergoes a huge amount of criticism. However, for most of my clients it has just one major problem: it is pretty much only accessible online.

To register for Universal Credit, the only way to get benefits for the vast majority of new claimants, you have to make an application online. This itself is a big barrier to many claimants, and is something we help people with all the time. But the process is never simple!

Barrier number 1: Poorer individuals and families may not have access to a computer at home. Library and community centre computers are a vital resource, but these services are not always open and often the computers are slowly dying from decades of use. The next best option is to get an appointment with an advice worker- that’s if there is a charity or citizens advice nearby that can help, if you can physically make it there, and if you can fit in an appointment around childcare or working hours. If you don’t know how to use a computer, that’s the only option.

Barrier number 2: For someone with learning difficulties or mental health problems, understanding that they need a username, password, memorable answers, and 16-digit identification code can just be too much. Many are struggling to cope day-to-day; remembering to eat and come to appointments is a struggle, let alone remembering a password.

Barrier number 3: Next, the claimant must have an email address- you can’t open a Universal Credit account without an email address, as they have to email you a verification code. Some clients have never emailed in their life, others have forgotten their email address long ago. Sometimes, a client will remember their email address, but when it comes to getting the verification code, they can’t remember how to log into their email. The Universal Credit website will not let you progress beyond this, meaning I’m often making email accounts as well as benefits applications for clients.

Barrier number 4: After entering what feels like endless details, the claimant has to make an appointment with their Job Centre to open the claim. To do so, you have to call Universal Credit.

Calling Universal Credit

As you can imagine, calling the DWP is never particularly efficient or enjoyable. Calling Universal Credit is often infuriating. At every stage there is an automated message that tells you it’s MUCH better to just go online and sort it out there. You then go through several automated questions, options to dial, and get through to someone after seemingly hours (but often more like 45 minutes) of listening to the tinny hold music version of Vivaldi’s Four Seasons. Poor Vivaldi.

On a more serious note, this phonecall procedure makes you feel unwanted. The repeated attempts to persuade you to go online instead, the long time on hold, the reams of automated questions: they don’t want to talk to you at all. The worst thing is, you are only going to call if you aren’t able to navigate the online system. Being told to go back online is even more frustrating in this situation: if my client could understand the website, they wouldn’t be choosing to go through the painful process of calling.

Often, the advice you get when you eventually speak to a real person is actually quite helpful. Sometimes however, the processes for sorting out a Universal Credit issue are ridiculous. For example, if a client has forgotten their password, they need their personal 16 digit code. 16 random digits obviously aren’t memorable. They will have been written down on a piece of paper by someone at the Job Centre several months ago. When a client is homeless or vulnerably housed, the chances of keeping track of that piece of paper are low. For us in Deptford, our nearest Job Centre can take an hour to get to on the bus. If a client loses their 16 digit number, they have to make an appointment with the Job Centre to get it back before they can reset their password.

For some of our more vulnerable clients, this is simply too much. Having to call, wait, make an appointment, remember the appointment in 2 weeks, travel there, get the number, then make another appointment with me to sort out their account, is just a ridiculous amount to do when everyday life is a struggle. Some clients we see only once, and then they clearly give up with the process, never to get their benefits sorted out. This means they will certainly be destitute if they do not find work. For some, this means resorting to sex work or criminal activity to get by.

When Something Goes Wrong

Universal Credit generally do not send letters, even if you request. “Everything is available to see on your online journal!”, they smugly state at every opportunity.

This can lead to huge problems for claimants. If they can’t look at their online account, they may miss a Job Centre appointment that they’ve been reminded about via email or text on a phone or computer they don’t know how to use. Once, I opened a client’s account for him, only to see in big writing: “Job Centre Appointment in one hour”! He quickly ran to catch the bus and just made it- a near miss. Missing a Job Centre appointment can mean a cut to benefits; it can mean the difference between being able to eat and having to miss meals later in the month.

If the DWP makes a mistake (this happens a lot) and a client doesn’t receive their benefits for some reason, the client may not even realise until a month later, when their money doesn’t come through. Without being able to check online, they will have totally missed that anything was wrong until it’s too late. If they can’t manage to get an appointment with a benefits adviser, they will just have to wait until someone can help them log on and make sense of it all.

So What Can We Do About It?

  1. We must remind each successive government (as they seem to be coming and going every 5 minutes) that their decisions are hurting vulnerable people. They must see beyond their bubble of society where everyone is technologically savvy and privileged, and see the reality of those who experience poverty. We always say this, but seriously: write to your MP. They have to reply to you- your concerns are their job. Remind them there are issues other than Brexit.

We’ve made it very easy: just use this template letter and pop it into an email. You can find your MP’s contact details here.

2. Support local charities. To find out what help is available in your area for benefits/housing advice, there’s a great database on Homeless Link, here. We may be biased, but local organisations can make a huge difference to people’s lives and help them navigate the system we are currently stuck with.

3. Spread the word! Share this article, tell your mates, tell your family. Shout it from the rooftops because this system is not fair. If you have influence, use it to amplify the voices of those who are not heard.

Prison and homelessness

Time after time, we see people come out of prison and have nowhere to go. How can we expect people to reintegrate into society when society lets them down?

Every time a person comes to my housing drop-in session who has just come out of prison, it feels like such a direct and undeniable failure of the state. The phrase “I came out of prison last week and have nowhere to go” is one I hear a lot, and it really emphasises the feeling that the system dealing with these people is totally broken.

Considering it is virtually impossible for a person in prison to communicate with people outside to sort out accommodation for themselves, the ‘support’ aimed at helping prisoners resettle and avoid homelessness is extremely limited, if accessed at all. This is extremely frustrating for homeless charities because we know how easily vulnerable people can become entrenched in homelessness, making it much more difficult to get out of when the whole situation should have been avoided in the first place.

The Homelessness Reduction Act 2017 requires prisons and probation providers to refer people who might be at risk of becoming homeless to the local housing authority. In practice, this system does not seem to work. A 2017 review of Through the Gate services which provide resettlement support found that more than one in seven prisoners were released without knowing where they would sleep that night.[1] For those who are given support by prisons, this may be the bare minimum, such as a referral to a homeless night shelter.

Prison services should, at the very least, inform local charities when a prisoner at risk of homelessness is going to be released. We are not provided with a time or date of release, and it is left to the ex-prisoner to find their way to a charity and drop in, often to find we have no appointments or staff available to offer help. If they cannot find help by the end of their day of release, they may well be sleeping outside that night.

Although on the surface it looks like mechanisms are in place to take care of people after release, any further research will show that, for most, they do not work. Charities see the evidence of this all the time, as we pick up the slack of the severely under-funded criminal justice system.

Homelessness and Re-offending

For a country that struggles with massive re-offending rates, the lack of support for those coming out of prison should be taken so much more seriously. Statistics show that prison does not help reduce the risk of re-offending:

“Prison has a poor record for reducing reoffending—nearly half of adults (48%) are reconvicted within one year of release.”

The Prison Reform Trust, Prison: The Facts, p14.

The same research found that resettlement teams were leaving work they should have been doing for workers in the community to deal with post-release. Through the Gate services were found not to have provided any prisoners with help to enter education or employment after release. [1]

These problems raise the question of how closely linked post-prison release homelessness and re-offending might be. It is not uncommon for homeless clients to tell me they are considering committing a crime just so that they have somewhere secure to sleep. If they have no help getting into work or meaningful activities, they may feel there is no alternative solution. This article tells the story of an autistic homeless man, aged only 23, whose ASBO banned him from begging and sitting outside shops. On arriving in court following several ‘offences’ of rough sleeping, begging, or ‘loitering’, he asked the judge to give him a prison sentence just for the sake of a simpler life.

There is a wealth of research that supports links between poverty and crime. Those living in poorer areas, where young people’s services and community funding have been cut, may be more likely to fall into criminal activity. Many people we see that have been in prison as an adult have been in trouble with police from a young age. Young offenders institutions are unsafe environments that do not provide the support that can encourage young people to change their lives and contribute to society before they get entrenched in crime. When a client with a history of conviction comes to us aged 50 and they still aren’t receiving the support they need, it seems an inevitable and endless cycle.

How has this Happened?

The Ministry of Justice has suffered 40% funding cuts in recent years.[2] Unlike the NHS, social services, and childcare for example, criminal justice cuts do not gain public attention. As is brilliantly articulated in The Secret Barrister’s Stories of the Law and How it’s Broken, (2018), most people do not think the criminal justice system will ever affect them. The fact is, it could affect anyone. As far as we are concerned at Bench, it definitely affects the more vulnerable in society. It should not be the job of charities to resettle people on their release. Prison does not rehabilitate offenders as it should. These are people who have not been helped to integrate in society.

When people are spat out of prison and straight onto the street, why on earth would they feel compelled to contribute to the society that refused to help them at their most vulnerable time?

What can I do?

  1. You can write to your MP. The more we show that we take these problems seriously, the more they have to listen. There are things other than Brexit, and MPs desperately need to remember that. For this particular issue, you can use this template and copy it into an email. To find out who your MP is and find their contact details, click here.
  2. Fund local charities or volunteer if you can. OK, we’re biased on this one, but we really do need all the help we can get. You can look for local charities or find out how to support Bench Outreach on our website, here.
  3. Find out more- the more you inform yourself about the issues, the more equipped you are to argue that we need change. If you have access to it, one book referenced in the article, The Secret Barrister’s Stories of the Law and How it’s Broken, is a great place to start when it comes to the many failings of the criminal justice system. (They’re not paying us to plug it, I just finished reading it this morning and loved it!)
  4. Spread the word- complain about it to whoever will listen. Share this article. People should know what’s going wrong- you never know who may come up with an answer.

Thanks for reading, do let us know what you think in the comments.

Photo by jplenio

[1] Criminal Justice Joint Inspection, An Inspection of Through the Gate Resettlement Services for Prisoners Serving 12 Months or More, June 2017, p.8.

[2] The Secret Barrister, Stories of the Law and How it’s Broken, London: Macmillan, 2018.

Housing and Benefits Advice: A Typical Week

A brief insight into what kinds of problems are faced by homeless or vulnerably housed clients- this article describes what a typical (part-time) week might look like for a housing and benefits adviser at Bench Outreach. (Precise details changed to protect clients).

MONDAY

Monday morning is for chasing people up. I’ve got a heck of a to-do-list and several calls to make. I’ve made applications for three different clients to supported housing projects, but haven’t heard anything back for a over a month.

I find out that they are all still on the waiting list; I call each of them to explain. They are upset because they have been sleeping rough for long periods of time, but as they are not considered to be in priority need by the council, this is their best option to be housed. I feel uneasy as I end the calls, clients accepting they will just have to make do sleeping outside or in the night shelter for even longer.

In the afternoon, I hold a drop-in clinic at a local community centre in the poorest estate in Deptford. It’s noisy- there’s a children’s holiday club going on in the same room. We huddle in a corner and try and bash out a few benefits problems and social housing applications. Some clients are angry because, although they are overcrowded and need to move their families into a better council house, they have been waiting for well over a year. The council does not have enough properties and simply can’t help people quickly enough.

TUESDAY

I have several appointments booked today. The first one does not show up; often clients cannot attend if they are too sick, cannot afford travel, or simply have lives too hectic to manage. They may not be able to contact me if they don’t have a phone. Some are simply too anxious or depressed to attend.

Someone drops into Bench in a very emotional state because he has received a letter from the DWP about his benefits, but he is illiterate so he does not understand it. The letter says his ESA has been stopped- we think this is an administrative error and spend an hour on the phone waiting on hold, before being told it was just a mistake. No apology. This client has gone without money for a couple of weeks now and is behind on bills as a result. We make a plan together to pay the outstanding bills, and I manage to calm him down.

My next client has been issued a notice of seeking possession for a Section 21 eviction: a “no fault eviction”. She has lived in this flat for 11 years. She has built up a small amount of arrears because her rent has gone up beyond what housing benefits will cover, and she’s been £10 a week short for a few months. The landlord wants their money; I call them to negotiate, but they are adamant they will be evicting this client. The client is terrified and clearly badly affected already by this instability. I tell her I will update her with viewings of different properties nearby when I hear about them. This client does not know how to use a computer at all, so looking online independently is impossible.

Some good news! A client has engaged with mental health services to try and get help for their psychological problems. They have also agreed to get help with their alcohol dependence. This is great- it can be an extremely daunting thing for vulnerable adults to reach out when they need help. Hopefully this is the beginning of more independence, happiness, and health for this client.

WEDNESDAY

This morning I’m running a housing advice drop-in at a local drug and alcohol support clinic. When I arrive, there are already three people waiting. The first feels unsafe in their rented flat because violent drug-dealers are looking for them. They are not eligible for help from the council because if they leave the property, they become ‘voluntarily homeless.’ The client has called the police, but has not been taken seriously due to their prolonged history of drug use and precarious mental health.

Another client is in her sixties, and is feeling domestic violence. I refer her to a local refuge who will arrange a safe time for her to escape. Her family no longer want her around because of her drug problem. She began using partly due to the strain of this abusive relationship, and tells me she is fed up and has thought of ending it all. I offer to call an ambulance if she is feeling suicidal; she declines and gratefully agrees to the refuge option.

In the afternoon I attend the Lewisham Homelessness Forum- there are around 30 different charity workers, council homeless prevention workers, and DWP employees who have come together to discuss how we can target certain problems and update each other on our work in the borough. It’s uplifting to see so many different organisations all working together to help vulnerable people. We discuss issues like modern slavery awareness, how we can contact the government to make larger-scale changes, and how organisations can support each other if they need help.

The forum is also a wake-up call. We discuss the tragic deaths of 2 rough sleepers in the borough. It’s crucial to keep talking about homelessness and why it is ruining and ending people’s lives.

As our advice workers all work for Bench part-time, a three day week has been used for this article.

MORE INFO:

If you want to find out more about our services, head over to benchoutreach.com or email us at declan@benchoutreach.com. If you’re looking for housing and benefits advice, give us a call on 020 8694 7740.

You can also follow us on twitter @benchoutreach or like us on Facebook as Bench Outreach. Give this article a share if you want to help spread the word about the problems faced by homeless people.

If you’re as fed up as we are with the problems that this particularly vulnerable group of people faces, you can write to your MP. You can find out who your MP and their email address here. If you’d like to use our template letter, you can find it here and copy it into the email to your MP. It’s a really simple way of raising your voice and getting these crucial problems talked about. We need to work together if we want to tackle this problem and save lives.

Medical Reports: Lies and Misrepresentations

Having gone through the often extremely stressful experience of a DWP medical assessment, those claiming benefits then have to deal with the resulting report: a report that may bare no resemblance to what actually happened in the examination.

[TW: mentions addiction, eating disorders and mental health]

As a fairly new employee at Bench Outreach, I’d heard some horror stories about the lies told in medical assessment reports about vulnerable clients before. This happens when the assessor makes assumptions or miscommunicates a claimant’s medical problems, affecting their benefits claims. I had not seen it myself until very recently, and it was quite an unpleasant surprise.

Recently, a client I had accompanied to an ESA medical assessment received the resulting medical report in the post. I was totally shocked to read the contents. It did not properly represent their severe mental health problems or alcohol addiction at all.

As I mentioned in a previous post about medical assessments, some clients get extremely anxious and can not handle the environment of the assessment very well at all. The client I accompanied was shaking, sweating and could not understand simple questions as they would normally be able to.* The client needed prompting, reassuring and supporting during the assessment itself, which I was able to help with. They were wearing unclean clothes, including a stained t shirt, and looked very unwell due to lack of sleep and mental health.

The report said ‘coped well with assessment.’ It said ‘was well-dressed’. It said ‘behaved normally.’

These stock answers totally undermine the stress and strain of the assessment for the client, and misrepresent their severe mental health problems.

[Photo by Pixabay]

This was particularly striking because I had been in the room at the time of the assessment, taking notes right in front of the assessor. The idea that they could then write something that did not represent what actually happened, despite having a witness there, is particularly worrying for those who do not have anyone to go with them. For those without an advice worker to provide that support and to challenge the decision made, the system seems particularly harsh. It can even seem exploitative of the vulnerable position of those who do not have the understanding or stability to challenge a decision confidently.

Mental Health is still not being taken seriously.

There were several assumptions made based on the physical health of the client. This is far too common. For example, the report said the client ‘can brush their teeth daily.’ The client, while physically able, suffers severely from self-neglect as they do not have the willpower or mental well being to look after their self. They do not brush their teeth, and say they can barely wash due to depression.

The client also emphasised their suicidal feelings strongly in the assessment, but the report played this down, saying the client had ‘lack of intent’ as they had previously changed their mind about attempts to take their own life. This massively undermined the risk of suicide for this client, who regularly calls me to say they are feeling suicidal.

For this client and so many others, just getting through each day is a huge achievement. To juggle extra commitments like work-related activities, which have been assigned to this particular client following the assessment, can really push someone over the edge if their mental health is not stable.

Not only might they have work-related requirements to fulfil, but their money will be affected if they do not carry these out. Sanctions can be placed on those who do not fulfil requirements, which leads to them getting even less money from their benefits. The loss of income can in turn dangerously affect mental health, and the cycle continues.

The national conversation about mental health is definitely improving but we have such a long way to go. Judging by this and so many other medical reports, mental health still is not seen as a good enough reason to not be able to do basic tasks. It is still not seen as debilitating, despite obvious evidence that it can be.

We have seen similar cases surrounding eating disorders and substance or alcohol abuse. These illnesses are not seen as ‘bad enough’, as they are often invisible. There was a blatant lack of empathy from the assessor who saw my client surrounding his alcoholism. The monotone voice and tired expression was by no means encouraging, and I’m sure for many would have discouraged them from fully explaining their situation. For those with issues surrounding addiction, this is not a supportive environment and the feelings of guilt or embarrassment experienced by many with these problems could easily surface, inhibiting a decent assessment.

What can you do?

Things may seem impossibly difficult, but there are some things you can do to help. Never underestimate the power of individual actions!

  1. Write to your MP. The more we bring this problem up in parliament, the more likely we are to see change. You can find out who your MP is and their email address by clicking here, and if you need some help knowing what to say, you can copy and paste this template letter to email them, to raise your voice and encourage your MP to make a difference.
  2. Support local charities! (OK, so we’re biased, but hear me out!) Charities often don’t have the resources to accompany clients to their assessments. It’s always good to have an adviser or a volunteer to go with a client and hold the assessor accountable. Could you offer your time to go and help out? If you don’t have time but can donate money, that’s always hugely appreciated as well. Find out how to support Bench Outreach here.
  3. Share our posts and other news/articles you come across. Social media can actually be a good thing sometimes! So many people aren’t aware of these problems- I’ll confess that before I worked for Bench, neither was I. There are people suffering without a voice; use your online presence to amplify their voices. And your offline presence- start a conversation, get chatting!

Thanks for reading and supporting our work! Follow us on twitter (@benchoutreach) or like us on Facebook to stay up to date and get updates on further blog posts.

*This client gave permission to be mentioned anonymously.

Medical Assessments- Urgent Changes Needed

Some people find the medical assessments needed for certain benefits are unnecessarily stressful or even traumatic.

In order to prove you are eligible for certain Welfare Benefits, there are medical assessments for claimants. These generally apply to disability-related benefits, such as Personal Independence Payment (PIP) and Employment and Support Allowance (ESA).

Before attending an assessment for ESA, a claimant has to fill out an extensive Capability for Work form detailing all their medical conditions, medications, and costs associated with their illness or disability. There are far more questions about physical health or physical disability than about mental health. Following this 25 page form, the claimant is given an assessment date.

Clients have had assessment dates given to them with very short notice. They may not be mentally stable enough to go to an appointment with only a week’s notice, but may also be too frightened that it will negatively affect their application if they postpone it.

For our clients in Deptford, making the journey to the ESA assessment centre all the way in Marylebone can be daunting, or altogether impossible on their own. Consequently we often accompany clients to their assessments just so they have the courage to go. There’s another reason we like to accompany them: we’ve found that when an adviser goes along and takes note of everything said in the appointment, the claimant generally gets a fairer assessment.

You can sometimes claim travel money back from the DWP for a taxi, but only afterwards, and clients often don’t physically have enough money to pay for the cab in the first place, even if they can later be reimbursed.

The assessment itself is anticipated with a lot of anxiety for some clients. For those suffering with anxiety or depression, it can be a really daunting task to go through with. As an advice worker, I’ve had to reassure clients during the assessment to avoid total emotional breakdown, one client experiencing a panic attack at the beginning of the assessment.

Blue and Gray Stethoscope

In this experience, the assessor was not particularly sympathetic about the client’s need to calm down. The client was clearly struggling- they were sweating, shaking, and were not understanding simple questions they would normally be fine with. They were terrified they would be deemed capable for work when in fact they had not been able to work for many years.

MP Ruth George argued to the House of Commons that the conditions in medical assessments were damaging:

‘Not only do people have to undergo these cold, terrifying and impersonal assessments where they are concerned that they are being marked down … I have heard from women who say they have been curled up on the floor crying at having to remember their sexual abuse, with the assessor not even looking at them but simply repeating the question.’

You can read the full debate here.

The set questions seem to hinder the assessor from communicating in an understanding way. They may not have the appropriate training to communicate with those who may have learning difficulties and do not always explain things in a way that can be fully understood by the claimant.

Finally, medical assessors have been known to stretch the truth, putting in generic answers that fit in with the criteria of the examination, rather than taking fully into account what the claimant actually says. We genuinely see finished reports that state things the claimant never said, deeming them fit for work or ineligible for the benefits in question. (New post on lies in medical reports coming soon.)

Something has to change. Better informed environments that don’t traumatise claimants are a necessity for the system to be fair. The Welfare State is supposed to be a safety net for those who are disadvantaged, yet the most vulnerable people often feel they have to pass an intimidating exam just to prove they are in need.

Understanding Homeless Women

An insight into the issues facing homeless women and the need to treat them as a specific vulnerable client group.

Introduction

Homeless women may not be accessing services that fully understand their needs. As gender equality improves in so many areas of British society, there are still some services and systems which have been designed without fully considering the needs of women. These issues may range from the need for female sanitary products, to the lack of understanding of female physical health conditions such as endometriosis or menopausal symptoms. Services which are not gender-specific need to be aware of the issues that arise specifically for women when they become homeless, so that they can provide the right kind of support.

Access to Services

Homeless women in the city tend to be somewhat invisible; several studies suggest the vast majority of homeless women are squatting, ‘sofa surfing’, or clinging onto exploitative or abusive relationships to avoid rough sleeping.[1] Compared with men, they are less likely to be street homeless; a Crisis study found that 51% of homeless women were staying with family or friends,[2] meanwhile many women do sex work in return for somewhere to sleep. This means that homeless women, who may be particularly vulnerable, are often the hardest to find and help. In cases of abusive relationships for example, a woman may be too afraid of their partner to seek help, especially if they rely on that partner for accommodation.

Furthermore, Declan Flynn, CEO of Bench Outreach, finds that women simply are not accessing support.[3] Only 24% of those accessing day centres in England are women.[4] Women may not be comfortable in a queue for a night shelter or day centre with mostly men. This is likely to be related to the number of women who have experienced domestic or sexual abuse; St Mungos’ (2014) reported that nearly 50% of their female clients were victims of domestic abuse while 19% had a history of childhood abuse.[5] Considering this, women may be reluctant to spend time with large groups of men, or may be too anxious or unable to communicate with men at all. Many clients have high levels of anxiety or other mental health conditions that may make them feel very nervous about turning up to an unfamiliar place where the atmosphere can be unpredictable or where other service-users may be aggressive or intimidating.

Another reason for women’s reluctance to seek help is the pressure from society on women in general. Societal ideals for women are of cleanliness, physical attractiveness, and a responsibility for family. Most homeless people find access to personal hygiene difficult in itself, meanwhile women have the additional expectation of maintaining their appearance.

Photo by Pixabay

Risk of Abuse

In addition, 36% of female rough sleepers experienced physical violence in the last year, compared with 29% of men.[6] Whilst these atrocities affect both genders, clearly women are treated badly more frequently; this suggests homeless women are looked down on and dehumanised more by strangers and by society in general. This added hardship can lead to feelings of shame and poor self-esteem for homeless women that make them more reluctant to discuss their circumstances. Social pressure is particularly an issue for women who have histories of sexual abuse or sex work; so-called ‘slut shaming’ is prevalent in our society and might reduce homeless women’s self-esteem and willingness to seek help.[7] The same report also stated that 44% of homeless people ‘felt they did not deserve help and felt stigmatised and ashamed of their circumstances’.[8]

Mental Health

Mental health can be another barrier to recovery. Homeless women seem to have higher rates of deliberate self-harm and suicidal thoughts, and are more likely to experience certain risk factors to mental health, such as abuse as a child.[9] They’re also more likely to suffer from PTSD due to histories of abuse. Whilst mental health awareness is improving throughout the UK, it is often the homeless who are either forgotten or deemed to have too complex needs.

Periods

Menstruation can be yet another problem for some – access to tampons and other period products is not always an option to homeless people.[10] This accounts for embarrassment and discomfort for those who cannot afford sanitary products, but even more seriously there is the risk of toxic shock syndrome from using tampons for too long, and general hygiene issues of using things like socks or paper in place of appropriate sanitary products (this great video give an insight). Homelessness for people who have periods is complicated even further by this hurdle.

Fortunately, awareness of the issue of period products for homeless women is rising, particularly due to the film I, Daniel Blake. (2016) There are various charities popping up which are doing a great job at helping those in poverty deal with periods, such as The Homeless Period and Bloody Good Period.

Conclusion- What Needs to be Done?

Understanding the problems which are specific to women is crucial. Looking at the above analysis, it seems homeless services need to consider these issues to fully appreciate the needs of homeless women. Many charities and initiatives exist to support vulnerable women and as services improve, women’s confidence in other services and their willingness to seek help in other areas will surely increase. The services which are not specific to women need to keep on top of these problems- as anyone who works with homeless people will know, there is never a one-size-fits-all solution, and this applies to gender differences as well.

At Bench Outreach we are always thinking about how we can be better. It’s often difficult for small charities to provide specialised services, but it’s clear that taking into account the issues faced by women is crucial. We endeavour to support homeless women as a specific vulnerable group and are always looking for learning opportunities to improve our services and help more people.


[1] Leona L Bachrach, “Homeless Women: A Context for Health Planning.” The Milbank Quarterly, vol. 65, no. 3, 1987, JSTOR, http://www.jstor.org/stable/3349944, pp378-9.

[2] Kesia Reeve, Rionach Casey and Rosalind Goudie, “Homeless Women”, 2006, p25, https://www4.shu.ac.uk/research/cresr/sites/shu.ac.uk/files/homeless-women-striving-survive.pdf accessed online 01/07/2019.

[3] Declan Flynn, conversation at Bench Outreach, 21/06/2017.

[4] Policy and Research Team at Homeless Link, “Annual Review of Single Homelessness” 2016, http://www.homeless.org.uk/sites/default/files/site-attachments/Full%20report%20- %20Support%20for%20single%20people%202016.pdf, accessed online 25/07/2017, p20.

[5] St Mungo’s Broadway, “Rebuilding Shattered Lives”, 2014.

[6] Ben Sanders and Francesca Albanese, Crisis UK, “It’s No Life At All: Rough sleepers’ experiences of violence and abuse on the streets of England and Wales”, 2016, pp11-12.

[7] Policy and Research Team at Homeless Link, Annual Review of Single Homelessness 2016, p15.

[8] Ben Sanders and Francesca Albanese, Crisis UK, It’s No Life At All: Rough sleepers’ experiences of violence and abuse on the streets of England and Wales, 2016, p16.

[9] Sian Rees, “Mental Ill Health in the Adult Single Homeless Population”, 2009, p.vi.

[10] https://www.youtube.com/watch?v=ABch4VYOJZ0&t=15s 18/10/2017, https://www.youtube.com/watch?v=j88sOT1SBqk 4/05/2017.

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