Being Homeless and Experiencing Mental Health-Related Difficulties: Listening To and Learning From the Experiences of Service Users of a Designated Homeless Psychology Service

Homeless adults experience high levels of mental health-related difficulties, but experience barriers in accessing mainstream mental health services. To provide more equitable access, a small number of innovative services have developed in the UK. The current literature review explored the research evidence for their therapeutic impact. Based upon the narrative synthesis of 13 heterogeneous research studies, designated services for homeless adults were found to have a therapeutic impact, as measured on a range of outcomes. Methodological flaws however, were identified in all of the research studies reviewed. It was concluded that given the paucity of research in this field, clinical applicability was very limited. In particular, the need for further research into service users’ views of existing services was identified. The research study sought to understand service users’ experiences of: homelessness and mental health; psychological needs; a Homeless Psychology Service; and, their ideas regarding service development. Qualitative interviews were conducted with seven adults who had accessed a specialist Homeless Psychology Service in the UK. Analysis using Interpretative Phenomenological Analysis revealed that becoming and being homeless had a detrimental psychological impact on all participants. All but one of the participants benefited from engaging with the service (i.e. through catharsis, gaining insight, overcoming hopelessness, making positive changes). The findings provide insight into how they benefited or not and what makes homeless adults ‘different’. The findings support the need for specialist services which meet their needs by providing flexibility and by persistently seeking to combat ‘mistrust’ by encouraging engagement. The Homeless Psychology Service is promoted as a potential service model for future developments. The Critical Appraisal offers the Researchers’ reflections on conducting this study.