GP: homeless patients need more security

A GP working in a surgery dedicated to providing healthcare to homeless people has described how around three-quarters of his patients are there for mental health support, but temporary housing and insecure living arrangements can hinder their recovery.

Dr Wan-Ley Yeung, clinical lead for Salford’s homeless GP service, spends three days a week with patients at the service, situated at homeless drop-in centre Salford Loaves and Fishes.

Dr Yeung told Big Issue North how he believes Greater Manchester mayor Andy Burnham’s A Bed Every Night scheme, launched in November 2018, has been successful in helping people get off the streets, but many of Dr Yeung’s patients are now experiencing a different form of homelessness.

Long-term accommodation

More than 2,600 rough sleepers have been helped off the streets since A Bed Every Night launched, with 950 people since finding longer-term accommodation, according to figures from November 2019.

Burnham himself has admitted his flagship policy is “not perfect”, but last year announced a £6 million funding package for the second phase of the scheme, which will seek to improve the quality of support.

Dr Yeung emphasised the importance of long-term accommodation when it comes to helping people who have experienced psychological trauma.

“I think a lot of people find when they get put in A Bed Every Night [accommodation] they kind of get lost because the council doesn’t feel like it is under a duty to find them a property anymore, so they just get left in these B&Bs and things, which isn’t ideal,” Dr Yeung said.

“It’s great because they’re off the street so people aren’t dying on the street, but it’s still not great for their health because it’s temporary and there’s no security and no certainty.

“A lot of our patients have a lot of deep psychological traumas which need addressing, but it’s very hard when you have such a temporary and fluid environment around you to address those [traumas], because you really need to be in a stable place to start going into the past.”

‘Chicken and egg situation’

The homeless GP service has been running for a number of years in the city but recently moved into its new base at Salford Loaves and Fishes in Paddington Close, Pendleton. This means the GP service is now co-located with the charity, which provides meals, activities and support services for homeless people, and other agencies that deliver drugs, alcohol, smoking and accommodation support.

Dr Yeung typically sees around 30 patients a week, and says from his experience the link between homelessness and mental health is often a “chicken and egg” situation.

“Is it that the homelessness has brought about mental ill health, or is it that the mental health has brought about the homelessness? In my experience, it’s a bit of both,” said Dr Yeung. “It’s just so obvious. It’s a basic human right to have security and safety, and if you don’t have that how can you move forward in any other part of your life?”

When it comes to what the government needs to do to improve the lives of vulnerable people, Dr Yeung said: “A lot of my patients have mental health problems, and that’s often from adverse childhood experiences and traumatic experiences in childhood, and that goes back to the poverty agenda and growing up in a deprived area without opportunity, so all roads tend to lead to poverty and how that is being managed, which in my opinion isn’t great at the moment.

“The government needs people in deprived areas to be given the opportunities in order to pull themselves out of that lifestyle, so everyone has more of an equitable role in society.

“People should have the same education, they should have the same sport and leisure activities, they should be able to eat good diets.

“There needs to be a cultural shift in how we want our society to be. I think with everything that’s going on politically people are still very selfish in wanting things on their own doorstep and how they can improve things there, but they’re not thinking about the bigger society.”

Breakdown

One of Dr Yeung’s patients told Big Issue North how he fell into homelessness after falling behind with rent payments. He has been visiting the Salford homeless GP service for a number of years and says it recently supported him after a mental breakdown.

He said: “I recently got a place in a different part of Salford, and I was absolutely devastated because it meant I wasn’t allowed to use this service any more. I had to go to a GP service where I lived.

“Over the past five years I’ve built up a really good relationship with Dr Yeung and the staff here. I recently had a mental breakdown, and everyone here has been absolutely brilliant. If I ever have any problems I come and explain things to them. As long as I’m classed as homeless I will be coming here.”