To understand the challenge of ending homelessness we must understand that this is not a static problem. The scale of the problem may ebb or flow according to political priorities or the economic climate, as we know all too well as the cost-of-living crisis means that numbers of people experiencing homelessness are rising once more in the United Kingdom. Within these numbers, however, are larger flows of new people entering homelessness while others exit. For all the good work of people working within the homelessness system, a substantial number of people exit homelessness on their own initiative. Such individuals prove to be more resourceful than the system intended to help them.

This is important context for this policy paper about the intersection of homelessness and disability. It highlights consistent higher levels of physical disabilities and health conditions within homeless households and shows its prevalence is likely to be underestimated by official data. Distressingly, it finds that barriers faced by people with a disability make it harder to get support and to exit homelessness. These obstacles include difficulties in getting a diagnosis from a GP, in order to get support; unsuitable environments such as noisy homeless hostels that can overwhelm people with some neurodevelopmental conditions; and acute shortages of accessible housing with lifts, ramps, mobility aids and lowered surfaces that are essential to daily living for people with certain disabilities. That people impacted by both disability and homelessness face such barriers seems wrong on multiple levels. Moreover, it means their chances of exiting homelessness on their own initiative are severely limited. They depend on the system working well in every instance.

As we know, some disabilities are not visible. One of the many important and deeply concerning insights of this paper is how rates of homelessness among people with learning disabilities and autistic people may be considerably underrepresented by official data. One survey of support for single people affected by homelessness found that on a single day 13% of individuals visiting day centres and 13% of people living in specialist accommodation had a learning disability. In the general population 2% of people are estimated to have a learning disability. Separate studies of caseloads of homelessness outreach staff and homelessness services have estimated that 12.3% and 18.5% respectively of people they supported had autism, compared with prevalence of autism of between 1 and 2% in the general population. We should not treat such figures as definite; we should, however, see them as prompts for urgent investigation and research into specific interventions tailored to the needs of these individuals.     

This publication is the fourth of our series of policy papers looking at homelessness through the lens of inequality and how this interacts with specific population groups. The first looked at homelessness among young people who spend part of their childhood in the local authority care system. The focus of the second was on homelessness and people who are lesbian, gay, bisexual, transgender or whose sexuality or gender identity is not heterosexual or aligned to their sex registered at birth. The third considered the relationship between homelessness and ethnicity. 

These groups are not, of course, mutually exclusive; some people will be in more than one or indeed all four. Our policy papers looked at care experience, sexuality and gender identity, ethnicity and disability separately because there are factors specific to each that interact with homelessness in discrete ways.

And yet, there are strong commonalities. Prevalence of homelessness is higher within each group. This is especially shocking for children leaving local authority care in England: a quarter of people experiencing homelessness have been in care at some point in their lives, data show. Data collection about people who are affected by homelessness   

within each of these populations is poor and inconsistent. All are under-researched. And there is a pressing need for new thinking to try out and test new approaches to relieve and prevent homelessness in each population.

This is our challenge if we are to bring an end to homelessness in the UK for good. We must build a stronger evidence base for what works and, just as important, what does not for different sub-populations. We must put these insights at the fingertips of people who deliver and commission homelessness services. And, perhaps most of all, we must create a capacity and culture change within the system so that this becomes the norm: so that evidence-based practice is embedded and, whenever a plausible solution is suggested, it becomes second nature for everyone in the room to ask: is there an evidence base for whether this will work for those most at risk?

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Dr Lígia Teixeira is Chief Executive of the Centre for Homelessness Impact

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