Homelessnewss, Women and Mental Health: Service Provider Perspectives

Aims:
People who are homeless disproportionally experience mental health problems compared to the general population, however struggle to get the support they need. There is growing recognition of the gendered nature of homelessness and the need for more research exploring women’s experiences. This study sought to explore what helps and hinders women experiencing homelessness when accessing NHS mental health services, and how COVID-19 has impacted service access.

Method:
Fifteen semi-structured interviews were conducted with employees working with women in third sector organisations offering a diverse range of services to women experiencing homelessness. Interviews were transcribed and analysed using Thematic Analysis to identify common barriers and facilitators to mental health service access.

Findings:
Four themes were identified: 1. Double Impact of Gendered Abuse and Trauma, which outlines how gendered trauma can increase the risk of mental health problems but also reduce the likelihood women seek mental health support. 2. NHS Mental Health Services seen as Stretched Gatekeepers relates to the NHS being under-resourced, with complex and exclusionary referral pathways and support only available in a crisis. 3. Generic Mental Health Services are Unforgiving and Retraumatising outlines how services can be inflexible and punitive, lack awareness of gendered trauma and be discriminatory and coercive. 4. Ambivalent Interface between Third Sector and NHS Mental Health Services indicates how service providers offer significant mental health support to women but can feel unsupported by NHS mental health services in doing so. This theme outlines the value of specialist homelessness mental health services.

Conclusion:
Mental health services are difficult to access for women experiencing homelessness. Women experience gendered barriers to mental healthcare which services need to consider. Specialist homelessness mental health services can facilitate access to mental healthcare by focusing on outreach, offering more flexible services, and building longer-term trusting relationships with women.