Arrangements for adult service users who are homeless in English mental health trusts




Journal Title

Journal ISSN



Volume Title


Mental Health Review Journal



Peer reviewed



Purpose: This paper reports on an analysis of arrangements in English mental health trusts to meet the needs of adult homeless people. Mental ill-health is disproportionately higher amongst the homeless yet they are underrepresented in accessing mental health services. In recent years, government strategy to improve health outcomes for the homeless and practice guidance on work with this service user group has emphasised the need for NHS services to improve care pathways and service provision for the homeless, and collaborate more closely with homelessness organisations.

Design/methodology/approach: Responses to Freedom of Information requests sent to trusts were analysed. The requests asked trusts for information concerning partnerships with external agencies, particular projects/staff, training trust professionals have access to, referral pathways, and intervention models/approaches informing work with homeless service users.

Findings: Forty-nine trusts provided information that could be used in the analysis. Just under half of these had dedicated arrangements or resources, including outreach teams and clinical staff co-located in homeless organisations. The remaining trusts indicated they either had some limited specific arrangements, such as links between local homeless agencies and existing services, or no dedicated arrangements. Training to help trust professionals address issues associated with homelessness tended to be minimal if provided at all.

Originality/value: This analysis adds further evidence to concerns that homeless people’s mental health needs are not being adequately considered by services at a local level and that there is a lack of appropriate pathways through which they can access treatment and care.


This article is an output from a collaboration between academics at the University of Nottingham, Liverpool Hope University and De Montfort University. The focus of the collaboration is the use of Freedom of Information requests as a research tool, illustrated through a survey of NHS Mental Health Trusts about the services they provide.


Freedom of Information, Homelessness, Outreach, Partnership Working, Staffing/resources


Lucas, S., Archard, P., Tangen, J. Murphy, D (2017) Arrangements for adult service users who are homeless in English mental health trusts. Mental Health Review Journal


Research Institute

Institute for Research in Criminology, Community, Education and Social Justice