We, as psychiatrists, have seen a staggering rise in the number of children and young people presenting with mental health conditions in recent years. This is in part due to the welcome expansion of services but also, more importantly, due to the growing prevalence of those struggling with conditions like anxiety, depression and eating disorders.
Nearly 140,000 young people are homeless in England alone, this is the highest figure since records began. These are children who, through no fault of their own, have had their lives upturned by financial difficulties, divorce and in more severe cases domestic violence or bereavement.
We know that children living in temporary accommodation are more likely to develop a mental disorder than almost any other group. This is not simply mental distress about being in a precarious situation, I am talking about children who develop full-blown mental illness. We also know that they are more likely than the general population to become homeless as adults too. Worryingly, they are also the group that struggles the most to access the right care and support.
Many of them spend months or even years moving from hostel to hostel, regularly sharing just one room with their parents and siblings, not knowing when or where their next hot meal will come from. This constant disruption to children’s lives is known to cause lasting cognitive deficits which can impact their ability to remember or understand things.
Studies have shown that children living under such circumstances are at a much higher risk of behavioural and emotional problems which have been associated with the development of a mental illness. A report on
The mental health needs of homeless young people, published in 2021, found that over half of this population group had mental health issues, a third of whom had a formal mental illness diagnosis. Severe depression and anxiety were the most commonly identified illnesses by far, but in some cases these children were in fact already living with post-traumatic stress disorder or bipolar disorder.
It is likely these figures are being underreported as many homeless children don’t access professional care.
This is extremely troubling because when mental health problems are left untreated, they can become more severe chronic illnesses which not only harm people’s health, but also their social and romantic relationships and their employment prospects in adulthood.
Additionally, those with a mental illness are at higher risk of becoming homeless. For example, rates of common mental conditions are twice as high, while rates of psychosis are up to 15 times higher among homeless adults.
It doesn’t have to be this way. Around half of mental health conditions arise before the age of 14, and three quarters before the age of 24. Early treatment is highly effective in children and young people, thus preventing them becoming adults with chronic relapsing remitting mental illness.
I meet many people in my practice with severe mental health conditions and it pains me to know that their lives would have been immeasurably improved if they had received help and support much earlier on in their lives.
There is an intrinsic link between mental ill health and homelessness which must be addressed if we are to ever tackle these two issues effectively. As a psychiatrist, I know that children who are treated quickly are much less likely to develop a serious and lasting condition.
Of course, wider societal issues will take longer to resolve, and it should be a source of national concern that rates of homelessness among children are rising. What is even more worrying is that these young people are often stigmatised despite often having to work harder than their peers to take care of their families, keep up in school and maintain friendships.
As a society, we can no longer allow these young people’s lives to be dictated by the need to survive on a day-to-day basis. We must do more to support them so that they have the same opportunities to thrive and succeed as everyone else.
Programmes like Homewards are committed to helping our nation understand the true impact of homelessness and developing innovative solutions. With their vision to bring about real change, we can end the blight of homelessness that affects young people and their families.
Dr Lade Smith CBE is a Member of the Homewards National Expert Panel for the Royal Foundation, and is President of the Royal College of Psychiatrists.
