The homeless, isolation and social distancing

Chris O’Leary on the particular vulnerabilities to COVID-19 infection of people experiencing homelessness and how policy makers need to tread carefully not to make a bad problem worse

One group of people face a triple whammy because of the lockdown are those experiencing homelessness. Whether living on the street, in a hostel, or in temporary accommodation, homeless people are more at risk of contracting the disease, more likely (particularly those sleeping rough and experiencing multiple exclusion homelessness) to have underlying health problems, and also face reductions and changes in the services on which they rely.

The Centres for Disease Control (CDC) in the United States has issued guidance to public services and charities on what best to do in the current crisis, but no advice has yet been published here. Because there are significant differences between the UK and USA in terms of our homeless populations, much of the CDC advice is not applicable in a UK context, and some of it (for example, keeping homeless people on the streets) would probably not be politically acceptable here. But some of the advice is certainly sound, and UK homeless services, local authorities, and others involved in homeless policy should consider whether to follow the CDC advice.

Of particular importance is that homeless people should be involved in decisions that affect them and their social networks. Much work has been done in Manchester and elsewhere around co-production, in involving homeless people in decisions about what and how services they receive. It would be tempting to simply dump these initiatives and return to a top down approach to service provision. But steps to reduce transmission are likely to be less successful if homeless people are not given choice and voice in decisions about how services need to change during the lockdown. Importantly, involving homeless people in this way might actually increase the success of the lockdown; rough sleepers often have extensive social networks with each other, and can provide help and advice to services to help identify others and help keep them safe.

Several homeless charities have already raise significant concerns about the transmission risks at hostels, Somewhere Safe to Stay hubs, and other accommodation and support services for homeless people. Many hostels have group sleeping arrangements and communal spaces for eating etc, and significant work will be required to reduce transmission risks. The government has recently called for hotels to be used, and much work has been done here in Greater Manchester, directed by the Mayor Andy Burnham, to access such accommodation through the Greater Manchester Homeless Action Network. This is great, and will certainly help physically isolate people in a way that is simply not possible in most homeless hostels. But it is essential to remember that many rough sleepers will find it difficult to cope with the silence and isolation of being in a single hotel room, as they often have considerable experience of living and sleeping in communal arrangements. Wider support may be needed to ensure they are not cut off from friends at this time.

Homeless people living in temporary accommodation – in bed and breakfast and homeless hostels – often don’t have such networks. Temporary accommodation is often used to provide shelter to people who have been assessed as homeless and who are waiting to be housed by their local authority. More likely to be women and often with children, local councils will already be working hard to ensure their safety at this time. Recent changes to the Local Housing Allowance should be helpful here if the local authority uses the private sector to discharge its duties, and additional rent guarantees and support might also be useful.

It is also essential that the lockdown does not provide another excuse to stigmatise and criminalise rough sleepers. Last year, Manchester City Council proposed a whole raft of measures aimed at rough sleepers to ‘protect public spaces’, which had the effect of criminalising some of the most vulnerable and disadvantaged members of our society. During the lockdown, many rough sleepers will simply have nowhere else to go, and it is essentially that police and other agencies treat them slightly differently to others who make active decisions to ignore the Stay at Home restrictions. Street outreach must and should continue, working with other agencies to help identify and support rough sleepers in a way that is safe and supportive for all involved. That means that street outreach staff must have the same protections as A&E and hospital staff.

Finally, some homeless people will get sick, and will need hospital care. It is essential that, if and when they get better, their discharge from hospital is coordinated with local homelessness services and charities to ensure they do not return to street. This is also important if they don’t need overnight hospital care.

Dr. Chris O’Leary FHEA is the deputy director of The Policy Evaluation and Research Unit at Manchester Metropolitan University and a foremost researcher into policy making.

LATEST PUBLICATION: Albertson, K, Fox, C, O’Leary, C and Painter, G (2020) Towards a theoretical framework for social impact bonds, NonProfit Policy Forum, https://doi.org/10.1515/npf-2019-0056