‘Psychologically informed reflections on identifying and supporting the unique needs of homeless young women on International Women’s Day’…

11.03.2022: As I write this week’s PIE blog, as the lead for Psychologically Informed Environments (PIE), at the national youth homeless charity — Centrepoint, I am aware that March is ‘Women’s History Month’ and in particular, this week was International Women’s Day (see #IWD) on Tuesday 8th March. This is an important day, marked globally, that celebrates the social, economic, cultural and political achievements of women whilst also marking a ‘call to action to accelerating women’s equality’. This year’s theme is #BreakTheBias and is focused on us all imagining ‘an equal world — a world free of bias, stereotypes and discrimination. A world that’s diverse, equitable and inclusive. A world where difference is valued and celebrated’ wherein ‘together we can forge women’s equality’ (c.f. https://www.internationalwomensday.com/). Some of the focuses of this year’s International Women’s Day have included women and technology, women at work, women creatives, women’s health, and women in sport, although this day has actually been around for over a century, with the first gathering noted to have occurred in 1911!

I was therefore reflecting this week on the issues that continue to face many women today. Whilst of course progress towards equality has occurred over the past century, particularly within Western countries, there are still many areas even in the UK that are unequal including pay, caring and childcare responsibilities, and the safety of women and girls. Moreover, in many countries of the world, women are still far from equal in society, and face significant discrimination, inequality and harm. In other words, 51% of the population are still far from where we should be globally in terms of equality. In this blog however, I wanted to focus on one particular area — the issue of women and homelessness, and how we can respond to this from a psychologically informed or PIE perspective.

At Centrepoint, we were honoured to have one very special woman as the Patron of our charity for many years; namely HRH Princess Diana. Her support and passion (e.g. https://www.youtube.com/watch?v=54eau_3R260), highlighted the issue of young people and homelessness, particularly although not exclusively regarding young homeless women. This Royal patronage has continued with her son HRH Prince William (c.f. https://centrepoint.org.uk/about-us/who-we-are/our-patron/), who continues her good work and support of the charity since his mother’s death.

Sadly, despite Centrepoint as a charity being around for over 50 years, there continues to be an increasing number of young people, including women who find themselves homeless in the UK today (c.f. https://www.theguardian.com/society/2021/jun/30/rise-in-women-sleeping-rough-hidden-crisis-england-charities-warn), many of whom face specific challenges and issues solely because of their sex. A recent survey by St. Basils (West Midlands Youth Homeless Charity and Centrepoint partner) found that 35% of those using services under the ‘Everyone In’ scheme were young women aged 16–25 years. Our own Centrepoint (2019) data found that 48% of young people in our services were female (see example case study here: https://centrepoint.org.uk/youth-homelessness/real-stories/tanias-story-caring-for-others/).

However, research on the prevalence of homelessness highlights that homeless women are a minority compared to men, particularly if this is measured by access to emergency shelters or ‘rough sleeping’ street counts (e.g. Pleace, 1997; Fitzpatrick et al, 2013). For example, MHCLG research found that in 2016, only 12% of those sleeping rough were women, rising to 14% in 2017. Information collected in London by CHAIN between 2012 and 2017 found between 12.3% and 15% of those sleeping rough were women, although it was noted that they had higher levels of mental health needs and were significantly more likely to have a history of past trauma than men (see also Bretherton & Pleace, 2018 and the Centrepoint case study here: https://centrepoint.org.uk/youth-homelessness/real-stories/cassies-story/). Of most concern that whilst numbers of women sleeping rough were lower than men, data shows an increase in female youth homelessness, as women recorded sleeping rough were more likely to be aged 25 years or less than men (Quilgars et al, 2008; Bretherton & Pleace, 2018).

So why are these ‘rough sleeping’ figures lower for females than males when we have an almost equal sex distribution of male to female young people accessing our Centrepoint supported accommodations services? Recent research (Bretherton & Pleace, 2018) from the homeless charity St. Mungo’s (c.f. https://www.mungos.org/app/uploads/2018/10/Women-and-Rough-Sleeping-Report-2018-Summary.pdf) has explored this issue and found that women experiencing homelessness are often ‘hidden from view’ (i.e. the so-called ‘hidden homeless’), and consequently may not being getting equitable access to homelessness services or considered in official homelessness figures. Official homeless statistics often measure rates of homelessness by the number of people ‘sleeping rough’ on our streets, however homelessness is much more complex than this and can include those ‘sofa surfing’, staying in unsuitable or temporary accommodation or in refuges rather than homeless hostels. Of course, given the high rates of violence against women and girls in the UK (c.f. https://www.bbc.co.uk/news/explainers-56365412) it is perhaps not surprising that many homeless women do not ‘sleep rough’ or attempt to conceal themselves from others to keep safe. Therefore, numbers for homeless women are ‘almost certainly being undercounted’ as they are missed from the official figures. This can result in homeless services being unaware of the need, and therefore are not designed for and delivered appropriately for a female homeless population.

As well as the particular dangers of ‘rough sleeping’, there are also other sex-specific issues that face a female homelessness population. For example, Bretherton & Pleace (2018) found evidence of other risks to safety for homeless women, which they describe in their report as ‘horrendous’ experiences. This can include sexual abuse/violence, physical violence, being robbed, being harassed for sex by male members of the public (as it is often wrongly assumed that homeless women are ‘sex workers’; Lofstrand & Thorn, 2004), as well as stigmatising and hostile attitudes from the general population as well as statutory services. It can even be a challenge to manage basic biological functions (e.g. menstruation) and sexual health / contraception if you are female and homeless. Many homeless women also reported concealing themselves or their sex, or walking through the night and sleeping in the day to try to keep safe. Others reported ‘pairing up’ with homeless males, even if this could lead to other risks such as vulnerability to exploitation, in order to minimise the risks of being a lone homeless female.

As a result of the above, Bretherton & Pleace (2018) also highlighted that women often take a different trajectory to street homelessness than men. They found that women tended to have a greater reliance on informal housing arrangements with family, friends or acquaintances (i.e. ‘sofa surfing’) and only seek help from homeless services when they have exhausted all of these options (Bretherton, 2017), particularly if they have children (Pleace et al, 2008). As a result, many women that present to homeless services are likely to be ‘in crises’ and have literally ‘nowhere else to turn’ at that point. Consequently, many homeless women are significantly traumatised; their self-esteem and trust in others is damaged and they noted that they felt they were being blamed for being homeless, even if the events that led them to that situation were out of their control.

One of the most significant predictors of female homelessness has unsurprisingly been found to be the specific traumatic experience of domestic violence (e.g. Mayock et al, 2016; Bretherton & Please, 2018). For example, one-third (33%) of female residents within St. Mungo’s services reported that domestic violence was the reason for their homelessness. Many women remain in relationships that are toxic, abusive or unhealthy because they are financially dependent or unable to source housing separate from their partner, unless they are able to get a place in a domestic violence refugee, which have been reduced over recent years so that demand outstrips supply (c.f. https://www.womensaid.org.uk/evidence-hub/research-and-publications/the-domestic-abuse-report/). Moreover, women often need to ‘prove their victim status’ before being able to access help, which may involve multiple police contacts and other statutory services before they are ‘believed’, which can be re-traumatising and create barriers to accessing the help they need.

The trauma associated with domestic violence can also last longer than the actual experience. Even if a woman escapes their domestic violence situation, this traumatic experience can affect future ‘help seeking’. For example, women may avoid homelessness services because they can lack appropriate physically safe facilities and support (e.g. being mixed-sex) and being around other unknown males can be re-triggering or challenging for them. Most services in the UK are set up for a male homeless population, and there are relatively few female only homelessness services (Bretherton & Pleace, 2018). In addition, as domestic violence trauma has occurred within what should be ‘trusting’ relationships, survivors may struggle to trust others in the future, impacting on their engagement with housing staff, particularly if male and they may also be hypersensitive to ‘perceived threats’. It is therefore critical that services provided to a female homeless population are aware of this, and design and deliver psychologically or trauma informed services that are physically and psychologically safe through relational, procedural and physical security, and work to give the individual control and choice through empowerment and trusting honest and consistent relationships. Of course, recovery from trauma is possible (c.f. https://centrepoint.org.uk/youth-homelessness/real-stories/carries-story/) but this can take time and effort from staff working with the individual.

Another issue that particularly effects women is the issue of ‘family homelessness’ or the high rates of single mothers requiring support. For example, Greene & Ringwalt (1998) study in the USA found that pregnancy rates among homeless young women are significantly higher than housed young women. In the UK, lone women parents with dependent children represent the bulk of family homelessness (Pleace et al, 2008) and from 2007–2017, almost half of all the UK households accepted as statutorily homeless were lone female parents (MHCLG, 2018). In addition, sometimes homelessness is associated with a loss of children to the statutory care system (Jones, 1999; Reeve et al, 2006) with the associated trauma. However, sometimes women can be protected from homelessness because of the statutory systems (e.g. welfare, social services, health and housing) that are set up to intervene to protect children, thereby secondarily protecting the mother (Baptista, 2010). Being aware of the unique challenges of parenting and motherhood when homeless is therefore important, in order that both the mothers and the child’s physical and psychological needs are met alongside any housing need. Consequently, Centrepoint currently has several ‘young parents’ services that aim to support young females in this position, who work to support homeless young mothers and their children to positive outcomes (e.g. https://centrepoint.org.uk/youth-homelessness/real-stories/shantes-story/ or https://centrepoint.org.uk/youth-homelessness/real-stories/bethanys-story/). Our PIE team is also working with staff in Support and Housing to develop specific training for these services, and improve the physical environment to be more ‘child-friendly’.

In summary, when reflecting on the issues that face homeless women, it is important to remember that women are not a homogenous group, and there is an intersectionality with issues of race or class in terms of discrimination. We need better research and data, as per a PIE approach, on the prevalence of the female homeless population, as well as their risks and ‘what works’ with this group in order that we can respond appropriately and continue to develop PIE approaches to meet their specific needs. In the meantime, generic PIE approaches can be very helpful in creating an environment that is not only physically and psychological safe, but also considers these specific sex based needs. Merely, expecting young women to thrive in a supported accommodation environment that may have been traditionally set up for young men is unlikely to produce the best possible outcomes.

Therefore, there is arguably a place for women only services or specific areas within mixed sex services, in addition to staff training and reflective practice support to ensure that staff understand the specific risks that young homeless women face, particularly around relationships, vulnerability, sexual health and violence. It is important to have honest conversations with our young homeless women about their specific risks as well as being aware of the likelihood of significant past trauma and how this may affect their current presentation or behaviours, which may manifest differently to males (e.g. self-harm / mental health issues as opposed to aggressive or challenging behaviours). It may also be that we ensure that opportunities in education, training and employment are equal and realistic (e.g. if combined with childcare). We may need to have an awareness of social service issues, and our duty of care in line with appropriate legislation (e.g. Children’s Act, 1989) that are relevant to our young homeless women with children. Finally, I hope that by raising and reflecting on these issues in this week’s PIE blog, as part of International Women’s Day, this can be the beginning of an important conversation within the homeless sector to #RemoveTheBias that homeless young women can face…

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Consultant Clinical & Forensic Psychologist & Centrepoint Psychologically Informed Environment (PIE) Lead @orange_madbird

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Dr Helen Miles

Dr Helen Miles

Consultant Clinical & Forensic Psychologist & Centrepoint Psychologically Informed Environment (PIE) Lead @orange_madbird

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