‘Less house, more HOME; why we need a psychologically informed approach to addressing homelessness’…

29.07.2022: As I write this week’s PIE blog, as the lead for Psychologically Informed Environments (PIE), at the national youth homeless charity — Centrepoint, I have been reflecting further on the notion of a ‘Home’; what this means and if differs from a ‘House’. Last night I had the pleasure of attending an event with our Ukrainian guests hosted by our local MP whose office was instrumental in helping them obtain their VISA’s under the ‘UK Homes for Ukraine’ scheme. During the event, many local statutory and voluntary agencies were present and they gave information about the variety of support available to Ukrainian refugees fleeing the war in their country. This got be thinking again about the importance of providing more than just a house or ‘roof over someone’s head’ when they are homeless. On reflection, even the title of the scheme ‘UK Homes for Ukraine’ is interesting. It is not ‘houses’ for Ukraine after all, suggesting that there is acknowledgement that a house alone does not provide everything a person needs when they are homeless. In fact, we do not even talk about being ‘houseless’ when you do not have a place to live, it’s being ‘homeless’. Arguably, given the importance of language in defining our understanding of the world, this suggests that even without thinking we widely accept that the issue is being without a ‘home’ not just being without a ‘house’.

Looking up the definition of ‘Home’ in an English Dictionary this week, I noted that there are many meanings ranging from a place to live to even sports references, such as the ‘home game’! However, several meanings reflect or expand on the idea that a home is just a house because they relate to that key concept in a PIE; namely ‘relationships’ (Keats et al, 2012). For example, a ‘home’ is defined (Cambridge English Dictionary, 2022) as ‘the house or apartment where you live, especially with your family’ as well as ‘the type or family you come from’ and ‘someone’s place of origin or the place where a person feels they belong’. Even the definitions of ‘home’ therefore acknowledge the importance of this sense of connection or relationships with others. Therefore, when we are thinking about how we can #EndYouthHomelessness, I would argue that whilst there is importance in ensuring sufficient housing for young people, it is also important that we consider more than this and as a result, a PIE approach to addressing homelessness must be part of this conversation.

One of the earliest developers of a PIE approach in the UK, within the adult homeless charity St Mungo’s has noted the importance of PIE in the homeless sector for exactly this reason. He notes that non-PIE homeless work has ‘automatically prioritised physical shelter, provided by a roof, over the psychological shelter and security that can only be formed over time, in the mind, through relationships’. Moreover, he goes on to note that ‘without the right psychological conditions, the offer of a roof alone can never be enough and may even be damaging because it signals a failure to understand and honour the depth of emotional damage behind the homelessness’. In other words, helping an individual to move away from homelessness and #changethestory is more than just the physical accommodation that is provided. In fact, sometimes this is the easy(ish) part!

For example, when my Ukrainian guests arrived a few months ago now, giving them a place to stay with us was only the start of their journey to rebuild their lives after having had to flee a war zone in Ukraine to safety in the UK. It has been important to support them to adjust to their new environment as well as providing them with encouragement to see that they can have a future within UK society. We have had to complete an immense amount of paperwork to allow them to access the services that they need such as welfare, health and education / employment. They have also needed time to adjust and have emotional support to process their experiences to date, much of which was unsurprisingly quite traumatic. I think that this is in some ways very similar to the homeless young people we support in Centrepoint who arrive at our supported accommodation services. Many of the tasks I have undertaken with our Ukrainian guests and the support they have needed is not dissimilar to that undertaken by our amazing key-workers in our accommodation services, or provided by our additional support teams (e.g. CP Works; Employment, Education & Training, Health Team or Legal Team).

A PIE approach argues that it is important that we focus on building a ‘home’ for the homeless young people we support, many of whom may have never had the opportunity to experience this in the past, or have lived in circumstances where it may have just been a ‘house’ and not a ‘home’. In other words, many of the homeless young people that come to Centrepoint have had significant levels of previous trauma or adverse childhood experiences. Research shows a significant number of people who become homeless have experienced complex trauma in their earlier lives (Johnson & Haigh, 2012) and the ‘complex needs’ that we often see amongst those experiencing homelessness are associated with early experiences of trauma (Maguire, 2006). In addition, traumatic events such as violent or sexual attacks can also often happen during periods of homelessness or temporary / vulnerable housing situations. Being homeless is also in itself traumatic because to be disconnected from others when we as humans are social creatures can also impact on our psychological well-being and create feelings of shame and powerlessness, especially as it is often ‘out of our control’ (Terr, 1991).

Just giving a young person a place to stay (or a ‘house’), whilst helpful and important, does not suddenly undo the past trauma they may have experienced and underpins the reason for their homelessness in the first place. Psychologists are aware that the impact of trauma often does not just stop when the young person is removed from the actual experience of that trauma. These negative experiences can affect them long after they have occurred, and can shape the way a young person sees themselves, others and the wider world. If they are not supported to process and move on from these experiences in a homely psychologically informed space that provides them with safety and support, then that trauma can feel ever present and can become an organising principle for that young person’s life. To put it another way, that young person may always be trying to cope with it and/or avoid the impact of it, resulting in challenging behaviours, mental health issues and dysfunctional coping strategies. They therefore need supportive PIE informed relationships, not just physical shelter (c.f. see previous blog here: https://drhelenmiles.medium.com/healing-or-harming-harnessing-the-positive-power-of-relationships-in-a-psychologically-8cbd32d0424c).

Consequently, a PIE approach is arguably essential in our frontline supported accommodation services to help staff to support homeless young people. However, I think it is also critical when thinking about the ‘bigger picture’, such as our wider organisational strategy to #EndYouthHomelessness by 2037. In recent weeks, I have therefore been working with senior colleagues across the organisation to operationalise this strategy further and to ensure PIE is embedded in all our strategic work moving forward. One example of this has been a piece of work entitled the ’11 boxes’. These are essentially areas that Centrepoint has identified need to be addressed if we are to ensure that any young person born now will not face homelessness when they turn 16 years of age. This work has highlighted again that homelessness does not occur in isolation, and there are many complex factors that underpin how and why a young person becomes homeless.

For example, family breakdown and conflict, current societal attitudes to young people, physical and mental health issues, disrupted transition points such as leaving social services care or the criminal justice system, domestic violence, and a lack of access to pro-social support and mentorship or education, training and employment opportunities can all result in a young person being at increased risk of homelessness. These risk factors are all areas where a psychologically informed, evidence based, collaborative and reflective approach is helpful. Of course, ensuring that suitable housing options including emergency housing provision is also important but this only provides the house, it does not help the young person create their first ‘home’. We often see that many young people can struggle to maintain their first tenancy (e.g. budgeting, paying bills, negotiating the complex systems to gain housing benefits or obtain work) especially if they have never been taught those critical life skills before they come to Centrepoint. As a result, they require our psychologically informed support offer to move on from their past challenges and develop these skills. Otherwise, sadly, they may be at increased risk of eviction and therefore becoming homeless again.

Consequently, as we approach the anniversary of our third year of our PIE journey in Centrepoint, and continue our evaluation of this work, I hope that the most significant shift in the organisation has been an understanding of the importance of a psychologically informed approach to addressing homelessness. This is evidenced in our now PIE informed Housing Operational Model, which even has the title ‘HOMES’! (c.f. https://drhelenmiles.medium.com/creating-psychologically-informed-homes-reflections-on-the-launch-of-centrepoint-s-new-d4015359eaca). I would also suggest that as the leading national charity addressing youth homelessness, we ensure that we keep our focus on creating ‘homes’ for young people. What we have in the UK is a lack of ‘homes’ not merely a lack of ‘houses’. The homeless young people referred to Centrepoint, as well as my current Ukrainian guests, need more than anything a place they can call ‘home’ where they can feel settled, move on from their previous experiences and the reasons underpinning their current state of homelessness, and build the future that they deserve. Adopting a PIE approach in the homeless sector is therefore helpful to ensure that we are not just providing ‘houses’ but that we are also providing ‘homes’…