Mental health in temporary accommodation - Martin’s story

“Just being there, you become a very unstable person”

It is a well-established fact that poor mental health and homelessness interact in negative ways. The Mental Health Foundation found some 45% of homeless individuals in England had received a mental health diagnosis in 2014, from severe depression and anxiety, to bipolar disorder and PTSD. The number is far greater, 80%, if we include those who don’t have a diagnosis. Research by Crisis has shown that people experiencing homelessness were nearly twice as likely to have experienced mental health problems as the general population.

It is not a linear relationship; problems with mental health and trauma can lead to homelessness, and once homeless, they tend to be exacerbated. As we have written before, temporary accommodation is no place to heal from trauma.

At Justlife we are not just informed by our reading and collaborations, although both are vital, but also from talking directly to people who have experienced living in temporary accommodation (TA) first hand. So, for this mental health awareness week, we have asked Martin to share his story.

Martin is a 59-year-old man who is diagnosed with extreme anxiety and depression. He lost his mother unexpectedly, which affected him profoundly, and eventually led to an eviction.

“When she died I just fell to pieces. I never really recovered from my mother’s death. I became mentally ill, I couldn’t work, I was just drinking”

For eleven and a half years he was vulnerably housed, without a home to call his own, and yet he didn’t meet the threshold to be deemed homeless by Local Authority. This was a period of high levels of stress, loneliness and depression that was detrimental to his mental health; the original trauma of losing his mother was not addressed.

“Having experienced so much trauma, it’s a mental scar. I suppose the illness is always there.”

Three years ago, he snapped by his own description. He suffered a psychotic episode which led him to attempt to take his own life by cutting the artery in his neck. He was taken to hospital where an operation saved his life. After three weeks, an outreach team from the Council organised for him to go into temporary accommodation on discharge.

“I could see that people were helping me and it was very well coordinated. I felt quite relieved I was being looked after”

Once in TA however, it got very difficult. Martin no longer felt safe; both staff and residents frightened him. The staff asked him to keep away from other people and so he felt very isolated and lonely, as well as scared. He considered suicide a couple of times.

“Late at night with lots of screaming and hollering. A very unpleasant experience, it was very traumatising, especially coz I was still in a state of trauma from what I did to myself. It was quite terrifying”

The Council put him in touch with a psychiatrist, who put him on medication, and a Justlife support worker who helped him with basics such as bedding, companionship and help navigating the admin of being homeless. He describes both as lifesaving.

After 13 months, the Justlife worker was able to help Martin into supported accommodation, where he now lives. He still struggles with his mental health, but with support in place, he is able to cope.

“I have to just try and cope with it as best I can. It’s a very difficult situation. I am not particularly happy about my circumstances, I just take each day as it comes, I’m just living day to day”.

It is hard not to imagine how different Martin’s life could have been, if he had received support after his mother’s death. Instead, he spent more than 11 years in insecure housing, feeling his mental health deteriorate until he reached a point where he attempted to take his own life. Opportunities were missed because he was not considered homeless.

Martin was full of praise for the hospital and Council teams that supported him at the time of his attempted suicide, but had this help come earlier, untold misery might have been spared. While it is important to recognise when things are done well, it is also important to understand the limitations. After his life was saved, Martin was sent back into a situation that was detrimental to his health.

“It’s very easy to have some type of breakdown, living in a place like that. Quite horrendous really. So, for me, coming out of hospital having attempted suicide, it was really quite detrimental to my health. In my opinion I shouldn’t have been put in an environment like that at all.”

With a lack of suitable accommodation and a rising demand, some may think he was lucky to get a place to stay at all. But the shortage of housing does not mean we can’t do better for the many Martins out there. Research shows that as a person’s housing becomes more stable the rate of serious mental illness decreases.

When we spoke to Martin he said that he found security staff in his temporary accommodation friendlier and easier to talk to than some of the other TA staff. He suggested that was because they had been trained to defuse and deal with difficult situations. He didn’t think this had been offered to other staff at the accommodation, who he said could be hostile.

The security staff may have been trained using a trauma informed approach. Trauma Informed Care (TIC) understands and considers the pervasive nature of trauma and promotes environments of healing and recovery, rather than practices and services that may inadvertently be re-traumatising. We know TIC is a powerful tool in dealing with very troubled individuals, making interactions safer and more productive for staff as well as the individual concerned. We also know that the longer trauma and mental health problems are left untreated, the more entrenched they become.

Martin’s story illustrates how big a difference a reasonably small but considered intervention can make; he was able to begin to turn his life around following diagnosis and medication from a psychiatrist, and trauma informed support from a Justlife support worker. If applied early, and taken to scale across the country, interventions such as these can make a real impact to the lives of the many Martins out there and are likely to save the public purse too on hospital admissions that are not needed.

Martin's name and picture has been changed.

Mind.org has advice on how you can access support for your mental health problems here.