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We must face the messy, discomforting realities of rough sleeping if we are to end it

There is a shopping mall in London where over 50 people sleep rough every night. It represents the biggest congregation of rough sleepers in the capital.  At 7.30 in the morning when I was there recently it was clearing rapidly of rough sleepers who were being hastened along by the amiable security staff. Around 20 people were still gathering together their belongings. There was an astonishing range of nationalities - English, Indian, Eritrean, Portuguese, Italian, Lithuanian and Romanian. Some were heading off to work shifts in restaurants and on building sites. One man proudly flourished his CSCS card, that highly prized proof that the owner has the required training and qualifications to work in the construction industry. He would be returning that night to the relative comfort of the mall. Relative, that is, to the other places where outreach workers meet rough sleepers in 21st century London – on buses, in public toilets, in hospital A&E departments, along canal towpaths, at encampments on wasteland and under bridges.    

I didn’t notice the woman scuttling past but thankfully someone else did and brought her to our attention. She sat rocking gently, her hood drawn up to hide her face.  Moving closer, we could see that her face had been badly damaged. Such was the trauma of the event that had befallen her, she was temporarily rendered speechless and had wet herself. My female colleague sat beside her, gently inquiring about what had happened and eventually gained her permission to call an ambulance. She was homeless and her partner, also homeless, had carried out a sustained assault on her. As we left the shopping mall the ambulance crew was assisting her and the police were present.

These are the incidents that gnaw away, memories of which return unbidden when you least expect. Shortly after this event I was at a meeting with sector colleagues debating an important piece of research undertaken by the Universities of Cardiff and Heriot-Watt which explores the evidence for what works in ending rough sleeping.  The research, commissioned by homelessness charity Crisis will, I hope, influence the Advisory Panel of which I am a member, established by the Ministry of Housing, Communities and Local Government to support a Ministerial Task Force seeking to reduce rough sleeping, with a target of halving rough sleeping by 2022 and ending it by 2027. The research highlights the strong evidence base for the effectiveness of Housing First, an approach focusing on assisting the most entrenched rough sleepers to access self-contained housing rapidly, supported by a personalised support package to ensure that the accommodation is sustained.  It notes the success of assertive outreach work – that is, outreach work that focuses purposefully on people moving away from the street and which rejects the notion that rough sleeping is, or should be, a lifestyle choice. The research raises questions about the effectiveness of hostels and shelters, noting that more analysis is needed to establish the type of hostels and shelters which in terms of design and service delivery interventions contribute most to helping people escape rough sleeping for good.

At the meeting, despite the consensus around solutions for reducing rough sleeping there was something missing from our conclusions and the convivial space - good coffee surrounded by committed colleagues - did nothing to protect me from being assailed by memories of the smashed face of the woman in the mall. On reflection, I can only describe this moment as being beset by the sheer messiness of rough sleeping, embodied by the bewildering, often shocking encounters endured by the teams working with rough sleepers which expose a reality at odds with the orthodoxies we feel most comfortable with.

These, for example, centre on the causes of rough sleeping as being primarily a consequence of a lack of access to settled housing and the inadequacies of the benefits safety net. Of course, both are undeniably significant contributors to the relentless rise in rough sleeping. Yet those working on the front-line are wrestling with challenges that stretch far beyond issues of access to accommodation and benefit entitlement. They are confronted, for example, with extreme, very visible health issues. Research published in the Lancet in November 2017 found that the mortality rate among socially excluded groups including homeless people, people who sell sex and prisoners was nearly eight times higher than the population average for men and 12 times for women. On the streets, cataclysmic drug misuse is common with Spice, ‘the zombie drug‘, causing extreme behavioural issues and adding a new layer of risk. For outreach teams in some parts of the country, access to crisis drug treatment is the top priority.

Convention also means that we accept a sanitised version of rough sleeping. In this one-dimensional world the rough sleeper is forever the victim and their route off the street barred by a set of pantomime villains including unresponsive local authorities and uncaring private landlords. We prefer to skirt around uncomfortable truths such as the destructive behaviour of certain people who are part of the street scene. Some of these individuals are rough sleepers, others are not.  Some sleep rough intermittently because they are unable to sustain accommodation and there are those who occasionally sleep rough because now and then it suits them to be on the street.  As I said, it is messy.

The brutal reality is that while rough sleepers face regular, deplorable abuse and assaults on the street, the protagonists are sometimes other rough sleepers. The 17-year old man sleeping rough in a car park who was urgently assisted by our team with the support of the police, was being sold for sex by two other rough sleepers. When not at the car-park, his exploiters were at the flat of an older vulnerable man, colonised as a base from which to deal drugs.

Meanwhile, powerful pressures entice people back onto the streets including the money that can be gained by begging, much of it being passed on to drug dealers who are a continuous presence at many rough sleeping locations. The over-provision of street handouts offering food, clothing, sleeping bags and tents which flock to central London creates another perverse incentive for people to return to their former haunts, even if it means travelling many miles from their accommodation.    

During times when we have successfully reduced rough sleeping, most notably during the period of the Rough Sleepers Unit, a coalition of the determined was prepared to face up to, and reduce, the influence of the magnets drawing people back to the street and, working with the police, tackle the violence, exploitation and petty crime which takes place where vulnerable, desperate people bed down. But these are different times and I’m not sure that we have the courage to grasp what will be a rather painful nettle. All I can say is that I have the enduring image of a small woman’s battered face to help me overcome my reticence.

A reduced version of this blog was published in Inside Housing on March 2nd 2018


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