Reverend James McCartney –  Executive Director

Increasing numbers of people are drifting onto the streets of the UK, homeless. In England there were 88,410 homeless households that applied for homeless assistance between April 2016 and March 2017 (NAO, 2017). The most recent National Audit Office findings show a 60% increase, with people in temporary accommodation, since March 2011. Equally, 105,240 households were threatened with homelessness and helped to remain in their own home supported by local authorities, a 63% increase since 2009-2010. Similarly, a quantitative analysis, of rough sleeping, on a single night in the autumn of 2016, showed approximately 4134, an increase of 134% since the autumn of 2010.

All this brings back memories of my early years working with homeless people in Central London in the mid-1980s. Although it’s now a lot worse with the emergence of new psychoactive substances that have slowly engulfed many drug users gradually over the last decade, but now at increasing and alarming levels. Although there is still limited available data, the EMCDDA, highlights the problems we face with particular risk groups, such as certain prison populations and people who inject. The biopsychosocial model is increasingly challenged by this cohort, especially those of us working with psychosocial interventions.

The psychological attribute of many who are rough sleepers is chronic drug and or alcohol addiction. We need to place rough sleeping within a psychological context within a broader developmental paradigm, comprising three sets of changes,  biological, cognitive and social transitions.  For 30 years I have worked in the field of homelessness and 23 years within addiction.  As a strategist working in the development of psychosocial interventions I find myself drawn more and more to the world of Neuroscience as it begins to answer some of the persistent behavioural patterns I have witnessed over the last 30 years.  Biopsychology has  enabled us to gain a greater understanding of brain maturation and the pivotal role of adolescence in the hard wiring of brain functioning. Those teenage years, prefacing early adulthood, are crucial for stable long term development. Brain imaging techniques such as FMR and PET have made it possible to observe such changes (Lenroot & Giedd, 2006), linked to behavioural, emotional and cognitive development and long term stability. The question I ask myself – “how  effective is the social context in working with cognitive functioning, with brains already hardwired and influenced by the adolescent years of maturation and the fixation period of early adulthood?”

You can have  all the re-enforcement strategies in the world but the genetic interplay between neutrons and behaviour can be the driving force that keeps people in a cul-de-sac of helplessness. Of course no  comprehensive  theory is applicable to all individuals and situations, but there is a common pattern I have witnessed over the last 30 years. Certain behaviours have an inability to fit in and respond to the norm,  poor school attainment, disengagement in education in early adolescence,  a negative peer influence in teenage years with a social alignment with similar minded people,  has had an impact in the hardwiring of brain.  Concurrently, this seems to provide a cocktail that fires up a code of behaviour that is hard to break.

Although we need to find more suitable housing, finding people a place to live is not solving the whole problem in fact it could be making it worse. You find some people prefer to be on the streets and feel safer and less intimidated than living in hostels. It can be hard for us to imagine this is the case. But imagine what it must be like to live in a place of utter chaos, devoid of rationality, ridden with drugs, drug dealers waiting outside, having to hand all your benefits over because you are in debt, argumentative noise and bullying, others high on spice, in state of a catatonia? Imagine, if you can, the utter devastation this has on the human mind, for the person who has never been accustomed to this, and for those who have known nothing other than this,  with motivation shattered and the possibility of hope buried long ago?

In the therapeutic world, we often hear “they have not had enough,” but put yourself in the mindset of those whose biological makeup is much stronger than the social context for change and the behavioural dynamic interacting with the cognitive process, that can bring about change? Of course there are those who break through, but they are often in a minority.

Unravelling on our streets is a problem that we can no longer brush under the carpet.  It will involve courageous strategy with innovative minds to construct a new paradigm, of transforming the hostel culture with a therapeutic discipline, less rigid than the rehab, yet with a flexibility that can make change possible.

3 October 2017