We can end homelessness with a shift in thinking

20 July 2022
Edinburgh sky

In his column for Third Force News, Cyrenians CEO Ewan Aitken says that by treating homelessness as we do other public health crises, we can end the preventable trauma faced by hundreds of thousands.


In a country where we’ve faced over a decade of increasing poverty and rising housing insecurity, there is a real danger of homelessness being seen as an inevitable part of life.  

Every year, tens of thousands of people in Scotland are facing homelessness, and many, many more are living with the looming threat of it. And that’s not just a humanitarian or moral issue – we need to view it as a public health challenge. People with experience of homelessness are almost twice as likely as others to face mental and physical health problems, and massively more likely to have substance use dependencies – and over 70% report dealing with all three. If you're homeless, you’re 4 times more likely to need urgent hospital care, and the result is a grim life expectancy of just 47.   

Homelessness cuts deep, and even when you’re back in housing, the impacts last long after the fact – we know that the trauma, the constant instability, and the physical impacts that build up on the path to and from homelessness have lifelong impacts on mental and physical wellbeing, and can create a cycle of crisis which can last generations.  

If we can prevent that, why wouldn’t we?  

Homelessness is one of the most obvious markers we have of inequality, but it’s one that generally comes a long way down the road. By the time someone’s experiencing homelessness, it almost always means there have been breakdowns of relationships and support , formal and informal, opportunities to help missed, and preventable traumas piling up. Over the past decades, Scotland has made huge improvements to how we support those experiencing homelessness (although there are still, of course, major gaps) - but by the time someone’s facing homelessness, we’ve already let things get too far.  

There are so many examples in recent memory of times we’ve saved huge amounts of money, resources and, most importantly, human lives by taking a preventative approach. To stop people dying on roads, we invest in seatbelts and safety features – we don’t just pour money into emergency services. We still need ambulances for when safety measures fail, but wearing a seatbelt and driving under the speed limit saves far more lives than the best-funded ambulance service imaginable.

Just the same, we can and should keep investing in crisis responses for homelessness – housing, support and accessible services. But the fewer people need to use those crisis services, the better. Why would we wait to offer help until after the storm hits? A pound spent now on keeping a young person engaged at school and safe at home doesn’t just save hundreds down the line on emergency homelessness support – it also stops them from having to live through that trauma and harm. It means they are more likely to flourish as we would want to flourish  

The recent Scottish Government consultation on prevention duties is a welcome step towards acknowledging that we can stop homelessness before it happens, and laying out the duty to do so. But it’s going to take more than legislation to tackle homelessness at its roots – to make lasting change, we need a culture of collaboration that starts long before a potential crisis of homelessness is visible. We need to be building up resources and capacity and a funding model for upstream support services, before the crisis point, making sure we’re all ready and able to connect people with the support they need, when they need it.   

It’s good that the government is recognising the need to build homelessness prevention into every level of services. But that understanding is only step one – for a real change in the public health of our nation, we need to move on from short-term thinking and really focus on making the changes that, yes, might not have immediate, obvious impacts, but which, with time, patience and resources, could make the trauma of homelessness a thing of the past.