title: What constitutes a good enough life for someone with lived experience of homelessness and drug or alcohol addiction?
Creators: name: Campbell, Benjamin
Publisher: name: University of Liverpool Repository
Year: 2020

description: Types of homelessness are wide-ranging and can include street homelessness, staying in temporary accommodation like shelters or hostels, and unsuitable accommodation like squats, tents or other temporary dwellings (Bramley, 2017). A vast amount of time, money and resource has been allocated to determine the causes of homelessness, but the problem persists. A recent count of rough sleepers in the United Kingdom shows a rise of 134% over the preceding six years (National Audit Office, 2017). For the homeless individual, the realities of being unhoused are in stark contrast to the average housed individual: increased risk of long-term physical health problems (Homeless Link, 2014), cognitive and neurological impairments (Backer &amp; Howard, 2007), and mental health difficulties (Rees, 2009). Homeless individuals are also at great risk of physical and sexual assault (Breakey &amp; Fisher, 1990) and more likely to develop suicidal thoughts and behaviours over time than the general population (Eynan et al., 2002). There are systemic consequences of homelessness, including an increased spend by health services; an estimated £85 million per year (Department of Health, 2010). Despite various strategies to both prevent and intervene, homelessness remains a significant problem for health and social care agencies and a challenging moral dilemma for society. Although there is a significant body of research examining the antecedents of homelessness, the multi-dimensional and systemic factors that can lead to a person becoming homeless are often denied or minimised. This can create a situation where society perpetuates the problem of exclusion that it seeks to alleviate (Jordan, 1996; Wilkinson &amp; Pickett, 2009; Cooper &amp; White, 2017). This can lead to demoralisation and disappointment among front line support staff working in services (Adlam, Kluttig, &amp; Lee, 2018). Responses to lack of success in services reaching out can vary but can lead to the individual retreating further from reach (Armstrong, 2018) and services becoming increasingly difficult to access (Fitzpatrick &amp; Pleace, 2012). The systematic literature review (Chapter One) sought to explore the contribution of the Capability Approach to the provision of mental health services. The Capability Approach is a human development framework which has contributed to the advancement of social justice and a recognition of the interaction of micro, meso and macro factors on an individual’s health and wellbeing around the world (Nussbaum, 2011). The application of the approach to mental health is more recent, and to date, there has not been a comprehensive exploration of how this approach has been applied to mental health services. The research paper (Chapter Two) addressed the experiences that formerly homeless individuals had in seeking help and support, and also asked professionals working in homeless services what it was like to provide services to homeless people. The systemic barriers and individual challenges were discussed. A qualitative methodology was used to capture the experiences of both groups of participants, using 1:1 interviews for individuals with lived experience, and focus groups with professionals.