Destination died: We have to reduce the number of deaths from homelessness

 Big Fred’s funeral. Ragged singing arises from the small congregation of people gathered to pay respects and remember his 51 years of life. Some, unable to recognise the words in the hymn book, mime along, mouths agape, goldfish-like. There is the familiar mix of people; those who lived with him on the streets and in hostels alongside support staff from various organisations. Later we speak with wry affection, masking the unspoken frustration, about his obstinate refusal to move away from the streets, until his collapsing health gave him no choice.  Not an easy man was Big Fred, prone to incandescent rages when he would rip his shirt off in absurd display of grandiose exhibitionism. 

Occasionally Fred would talk bitterly about living with foster-parents who resorted to tying him to a chair with a piece of clothes-line when he misbehaved. We remembered this when, yet again, his destructive behaviour led him to be evicted from a hostel and he landed back on the streets, not in order to excuse, but to understand.         

So we shuffle out tight-lipped, thank the vicar and return to our work.  Another funeral of a person whose blighted life has been ended prematurely by extensive periods of homelessness. 

And so what?  I’ve attended at least 50 such funerals. Many of the people we seek to help lead lives of consummate recklessness.  Excessive alcohol and drug misuse lay waste to many. Sleeping on damp cardboard in shop doorways produces grossly extreme medical case histories. We work with many people whose early lives are bleakly troubled and an early death is the almost inevitable consequence of inequitable life chances - right?     

Yet there is a danger that the familiar ritual of attending another funeral means we become immune to the gravity of a life ended early. Recently some of us working with people who have suffered frequent bouts of homelessness (I strive to avoid lurching into using the generic term ‘the homeless’ as if we are describing a tribe or ethnic group, rather than a debilitating experience) have become uncomfortable with the way we seem to accept this apparently inexorable cull of vulnerable individuals. Gnawing away at us is, I believe, unease that we have become too acquiescent of such deaths, too ready to rationalise them as part of the job and not demanding enough in wishing to investigate more systematically how people have died and whether some deaths can be prevented.   

There is an unintentional insensitivity in which we record the deaths of people who have experienced homelessness. Take, for example, the CHAIN data scrupulously inputted by the various street outreach teams working across the capital which provides information on people met sleeping rough and their subsequent journey from the street and into accommodation. If you search hard enough you will discover in the most recent annual statistics that under ‘departure from temporary accommodation: other’, the destination for 24 people was ‘died’.  Under ‘departure from long-term accommodation’, you will find that ‘the reason for leaving’ for 32 individuals is described as ‘death of tenant’, chillingly a figure that accounts for 10% of the ‘tenancy ends’ over the year.        

It is nobody’s fault but it feels wrong that these figures are hidden away, un-interrogated and unwittingly dehumanised. Happily there are moves afoot to ensure that we pay greater attention to these grim statistics. Homeless Link and Housing Justice are hosting an event in June to place these mortality figures in the spotlight. Those organising the event are heartened by the enormous interest in it and the rising eagerness, indeed determination, to explore how we can reduce the number of deaths amongst the highly vulnerable population served by the homelessness sector. 

It would, of course, be unfair not to acknowledge the great importance that providers and commissioners place on applying formal safeguarding arrangements in order to reduce risk and protect the vulnerable, or the many instances of humane, effective responses that have followed in reaction to unexpected deaths.

One of the best examples that I am aware of in recent times followed the tragic death of a rough sleeper in Lambeth in the winter of 2010. To its enormous credit, the local authority initiated a serious case review to explore whether anything could have been done to have prevented this death. The review concluded that, in future, the Mental Capacity Act (2005) should be more frequently applied in circumstances where an individual is unable to make rational decisions on their own behalf.  

It would be extremely instructive to track the number of serious case reviews that have been initiated following the death of a vulnerable person with a history of homelessness. What have we learnt from these, what were the factors that led to the investigation being triggered and have there been similar tragedies where serious case reviews have not followed as a response and, if so, why?    

There will be those who will feel that any suggestion of complacency about the deaths of vulnerable people who have suffered from homelessnesss is unfair and insulting to those working with them. Yet I believe our stoical acknowledgement that death will come prematurely to many of those we support mustn't cross the line into a passive acquiescence of numbers that should more often make us recoil with dismay. For, bluntly, if we are not in the  business of helping people live long and fulfilling lives, then we must individually question what business we have being in this line of work at all.

This blog was published in Inside Housing on May 31st 2013

Faith and spirituality in the lives of homeless people

Naturally, I never allow my petty prejudices to taint my relationships with people - except for when I do. Take the other day. I’m walking along Peckham High Street and coming towards me with his familiar scuttling gait is Leonard Taylor. I’m eager to talk with Leonard as I know he has been re-housed locally after 17 years living rough. The last I’d heard he was struggling to settle, appearing in his old haunts, hanging around the soup runs, talking nostalgically about his former life of sleeping on cardboard in shop doorways and deploring the arid existence of the resettled homeless person: housed but friendless. 

Yet the usually remorselessly dour Leonard responds joyfully when I inquire about his situation.  He explains that he had a knock on the door from some Jehovah’s Witnesses and, after taking up their offer to attend a service, has joined the local congregation.  Immediately flashing up in my mind are the following highly pejorative verbs: brainwash, capture, indoctrinate. ‘Are they being good to you Len’ is my downbeat question, rather naïvely exposing my feelings regarding this turn of events.

In response, Len explains to me that he is a very happy man as he has never felt part of a group before, one in which people look after each other and where the fact that he had slept rough doesn’t matter. So much better than those day centres for the homeless he concluded, before turning off sharply towards Lidl.

I reflected on my conversation with Len as I read a new piece of research called Lost & Found which explores faith and spirituality in the lives of homeless people.[1] The author Carwyn Gravell is, like me, an atheist. Central to the research are illuminating interviews with 75 homeless people that took place at a variety of centres for the homeless. His findings make uncomfortable reading for those of us who think that services for people with support needs should be ‘user led’. Just five of the 75 people interviewed had been given the opportunity to talk with staff about faith or spiritual matters, even though the majority had a desire to do so, reasoning that being asked about such areas of their life validated their identity as people rather than as ‘service users with problems’.

The damning conclusion from the research is that discussing faith and spirituality is largely regarded as being outside the remit of many support workers even where they are employed by faith-based organisations as these are subjects fraught with risk associated with being perceived as proselytising and are dangerously personal. You get the picture: apprehensive support worker begins to feel wobbly as the subject veers towards faith, belief and issues of morality and desperately seeks to paddle back to the safer conversational waters of resettlement plans and utility bills.

Actually, I have enormous sympathy for staff working with people who have support needs. It is not simply a fear of entering uncharted territory that acts as a constraint. Expectations from commissioners and the organisations they fund can be contradictory.  There is a strong drive to ensure that all service users have support plans with achievable outcomes. These should be measurable, so are usually practical in nature, for example, improving your employability. There are obligations to gauge risk and protect service users. Risk assessments, serious incident reports and safeguarding alerts are now de rigueur.  

Concurrently there is an inexorable and welcome move towards service users playing a greater role in determining their own destinies by being given more opportunity to influence support plans. Personalisation is leading to service users receiving individual budgets to purchase activities and services directly themselves. Sometimes their selections carry a degree of risk (you want to climb Snowdon, can’t we just go to the park?)  

Yet surely our systems promote inhibition and suppress opportunity for the individual to blossom where they discourage discursive reflection on matters such as faith and the role of religion. As they struggle with competing demands, it is not surprising that support staff feel reticent about moving into territory where they can be accused of being unfocused or criticised for increasing levels of risk.

Wishing to reflect further on the meaning of faith, I seek counsel from Don Rodrigues, a Thames Reach volunteer. After his marriage broke up, Don spent many months homeless and suffered debilitating depression, triggered by his fears about losing contact with his children. On many a cold night he was consigned to taking the night bus to Heathrow Terminal 5 in a desperate attempt to keep warm. 

Don speaks with quiet dignity about the three groups of ‘professionals’ in his life that helped him to recover his confidence and self-esteem.  There was the doctors’ practice which assisted him to repair his mental health, the charity, Thames Reach, which enabled him to develop new skills and the Ruach City Church where the pastors helped him to rebuild his spiritual life through prayer and service to others. 

He describes the interlinking importance of health, work and spirituality with enviable lucidity. I ask him to sum up what it was that the pastors were able to give him and, without pause, he states ‘The certainty that your future is greater than your past’.  It was great sentiment to end on, to which I could add only an atheist’s 'amen'. 

A version of this blog was published in Inside Housing on 19th April 2013

---

[1] Lost & Found – faith and spirituality in the lives of homeless people – Lemos&Crane (2013)

Out of sight - sleeping rough in car parks and corridors

From the seventh floor of the multi-storey car-park at this late hour the view is rather magnificent, but a cruel wind is whipping up the rubbish and there is not a soul around. I’m a Thames Reach London Street Rescue team volunteer tonight searching for rough sleepers with my colleague Rob and we have received a self-referral from a man sleeping rough in the car-park. It’s been a frustrating night. In Hounslow we discovered plenty of cardboard bedding but not the group of Lithuanians we feared could be sleeping rough. Under Kew Bridge and in a park in Putney the lone rough sleepers we have been tasked with contacting were not in their usual places. I ruminate on the unsettling paradox of being grievously disappointed not to find someone sleeping rough in sub-zero temperature.

But here on the stairwell we find our man, a 21-year old Pole called Karol. His is a story which is virtually a generic tale of youth homelessness. He came to this country as a fourteen year old unable to speak a word of English. He found his feet at school after a difficult start, but then his mother re-married and he couldn’t get on with his step-father. Over time the tension between them intensified and culminated in a thrown punch and a swift eviction from the family home. Karol has no intention of returning and has been sleeping rough intermittently, with occasional respite on a friend’s sofa. He sleeps close to the lift as from this position he can hear it jerk into motion in the middle of the night, advertising the approach of the car-park attendant on his rounds. Karol can then scurry out of sight and return when he has passed by.  It doesn’t lead to a restful night’s sleep.

His deepest frustration lies with the local council’s Housing Options service. As an able bodied young man he has no statutory entitlement to housing, which he accepts with equanimity. What he can’t comprehend is why the housing advisor should hand him a list of hostels that offers some hope but, as he studiously rings each of the numbers provided and finds that most are no longer in operation or connect him to projects for which he is ineligible, turns out to be a distressing hoax, or so he perceives it. ‘This list is just to fob me off’, he rages, throwing his hands up in dismay.

The No Second Night Out hub is the only chance of somewhere out of the cold for Karol tonight and, late in the evening, they inform us of a space. Walking into the building with my woolly hat pulled down to my eye-brows I am impressed with how solicitous the member of staff keeping pace with me is, indeed unnervingly so. Then I realise she thinks that I am booking in and Karol is the volunteer. So we swop places. The room is full of men sleeping on the floor in various states of dishevelment, one of whom is emitting a monstrous, spluttering porcine snore that ricochets around the space.

Taking in the very basic provision, Karol pragmatically calculates that staying at the hub is a step worth taking as it gives him the opportunity of exploring his options. It’s not the kind of place where he would want to stay for more than two or three days, but that is the point of the hub; no frills, no danger of settling in, but good quality advice and assistance and an unambiguous offer of help, called a single service offer.

We have one last call to follow up, a self-referral from a man who wants to meet us outside the entrance of a housing block. Once there, we ring him on his mobile phone and he limps towards us out of the gloom. Malcolm is currently bedding down in the corridor by the door of the flat where, for six years, he lived with his mother until she died in 2011. He continued to stay there after her death but was evicted three weeks ago. He embarks on a convoluted tale involving tenancy succession rights and rent arrears. Bewildered and painfully unassertive, he seems utterly helpless in the face of this humiliating catastrophe.

To date the council has been unable to help him, but he has an appointment with it pending and we conclude that with some advocacy support there is some chance that we can pull him out of this steep downward trajectory that will otherwise culminate in him sleeping rough on a cold pavement.

This is a story of two very different men connected by the disquieting similarity in their experiences of seeking help from local authorities. Both describe with bemusement journeys that involve taking numbered tickets from machines, waiting in queues, finding it is the wrong queue, being given lists of addresses with numbers that don’t exist, hearing baffling, incomprehensible phrases - local connection, statutory rights, eligibility, rights of succession, priority groups.  A palpable Kafkaesque horror emerges in the telling.  And, if there is one lesson to take away, it is that to stand a decent chance of getting a hearing and a satisfactory outcome then a knowledgeable advocate is, if not essential, then a huge advantage.

We also have experiences of housing advisors providing advice which is accurate and comprehensible imparted with politeness and compassion in circumstances where the options at their disposal are often desperately limited. But the variableness of response is simply not acceptable and if we are to hold back the encroaching tide of new rough sleepers then timely, effective, preventative housing advice has to be delivered with far greater consistency.

So at around 1.30am I get on my bike and pedal home, reflecting on the fact that the two men we have seen self-referred and wanted to be found and musing over how many more people there are sleeping rough in blocks of flats, on stairwells, in derelict buildings and in car-parks, hiding themselves away across the capital.

 A shorter version of this blog was published in Inside Housing on March 1st 2013

Life on the edge: getting by in recession torn Britain

‘Shirker’ is an interesting word. A shirker is someone who avoids doing work, originating from the German word schurke, meaning rogue. That, according to some politicians, is what you are if you are not a striver. My colleague Iunus was a rogue. He had an expensive heroin and crack habit and shoplifted three times a day along Oxford Street to sate it. He specialised in stealing women’s lingerie. Easy to wrap up in a ball and insert along the arms of your jacket. He was good at it too and at his peak (or nadir) he stole to order, following precise instructions on size. He puffs out his cheeks and shakes his head with shame as he remembers that life.

If you shoplift with that regularity there is a price to pay and Iunus has been to prison on more than 20 occasions with a maximum stay of four months. He moved through the classic recidivist cycle – short sentence, little discharge preparation, out on the streets on release, early renewal of relationship with his dealer, a few months out and back to prison.

Things are not the same for Iunus. Something happened.  People showed faith in him, he stopped using hard drugs, improved his English, developed some skills, changed his attitude. In short, he made himself employable. He is currently the smiling face you meet at reception at our new centre, the Employment Academy.  He is utterly trusted.  He greets guests, prepares rooms for events, reports repairs, opens the building in the morning and locks up at night. 

He’s facing some challenges, is Iunus. This is bleak mid-winter in double-dip recession Britain.  Iunus is one of the working poor and he has a criminal history that is dead and buried but the ghost of it can still arise to snap at his heels. You may think you have some embarrassing gaps in your CV, but explaining twenty spells in prison in a job interview is possibly on a different level. Iunus claims no welfare benefits at present and doesn’t intend to. The welfare benefit reforms appal him and he believes he will be completely undone by the bureaucracy involved in making a fresh claim. He steps forward for as many shifts with different Thames Reach teams as is permissible. This week when he was not at the Employment Academy he was doing outreach work in Croydon. It’s a tense business juggling shifts to bring in the £400 a week needed to survive in his housing association flat. He reels off the bills – council tax, rent, gas, water, electricity; a mantra with the familiar monotony of the shipping forecast. He’s got some great skills. Not just an instinctive understanding of how to deliver good customer care but fluency in Portuguese, Urdu, Hindi, English and Spanish. 

C-jae shares reception duty with Iunus in a voluntary capacity. He grew up in south London and trained in repro-graphics. In the current economic climate jobs in this specialist area are scarce. C-jae has struggled to find work, at one stage boldly establishing his own t-shirt printing business with New Enterprise Allowance funding, available to people on Job Seeker’s Allowance, investing money in a heat press and focusing on e-bay sales. But the bureaucracy did for him with delays in NEA payments leading to rent arrears and eventually the loss of his accommodation. He sofa hopped for four months, using up the goodwill of friends, eventually being given help to access a basic studio flat in the private rented sector where he pays £800 a month, scraping in under the Local Housing Allowance ceiling. 

C-jae is grittily determined. He’s got himself a further qualification, an NVQ in adult social care and has done a training programme called volunteering to employment to extend his skills set. He’s feeling anxious as his landlord will not be renewing his assured short-hold tenancy and there is the looming prospect of being assigned to the Work Programme. C-Jae is of the view that joining the Work Programme will hamper his chances of getting a job when he is so close to finding one. He’s heard stories of daily appointments and copious paperwork that he fears will act as a restraint, causing him to lose momentum, break stride. He grimaces as he describes the inflexibility of his job centre where he was informed, wrongly, that he could only do 16 hours a week as a volunteer without his benefits being affected.

C-jae talks eloquently about the great blanket of depression that can cloak you when you face long-term employment and the sweaty fear that grips when you think too long about having to get by on £71 a week JSA and live in accommodation where a landlord’s whim can leave you once again having to knock on the door of friends to plead for a few days kip on the sofa.

This evening the three of us lock up and leave the building together. They are remorselessly cheerful as we go our separate ways. Two men striving to find a way of climbing up towards the sunlit uplands of housing and job security and maybe even a loving relationship too but who sometimes appear to be walking close to the edge of a very precipitous drop. Maybe it’s the bitter cold and smothering January darkness, but unlike them I am gripped by a bout of despair.  There is no getting away from it; these are wretched times.    

This article was published in Inside Housing magazine on January 25th 2013

Anne Naysmith's lifestyle choice?

I’m often told that the number of women sleeping rough is underestimated because women feel especially vulnerable on the street and hide themselves away in places where they will be difficult to find. The certainty with which this is stated is in stark contrast to the hesitancy that follows when you ask for some evidence of where these women rough sleepers might be. Despite outreach teams scouring not only the familiar rough sleeping areas but also housing estates, woodland and even riding the night buses to find rough sleepers, the number of women sleeping rough in London as a proportion of the overall homeless population stands at just 12%.

Far from facing a problem of being hidden, I am concerned that women rough sleepers have a disadvantage that arises from their very visibility and prominence. There has always been a danger that we romanticise rough sleeping, viewing it as a form of rugged individualism, a lifestyle choice adopted by impressively eccentric characters making a stand to live outside ‘the system’. I fear that women on the streets are particularly prone to this complacent stereotyping. The lone woman rough sleeper, often pejoratively referred to as a ‘bag lady’ remains an iconic figure. Didn’t Alan Bennett even write a poignantly amusing play about one such homeless woman? They are a national treasure! This cloying sentimentality bedevils our approach to women rough sleepers, so we are particularly prone to find plenty of reasons why we must preserve their right to stay – and die – on our streets.

Which leads me to the disturbing case of Anne Naysmith. Anne is a 75-year old woman who has been sleeping rough for a number of years, first in an abandoned car and more recently on a patch of land beside a railway station in west London. She is a fascinating character, not least because of her background as a former concert pianist and her quintessential Englishness. Recently, Transport for London unwittingly removed some shrubs and plants that had been cultivated by Anne. Outrage followed as this was perceived as a bungled and insensitive violation of her space by the authorities.

The BBC News footage that followed is illuminating. It shows Anne shuffling around the car park area where she sleeps rough, her feet swathed in strips of filthy material. Later, the camera lingers on her grubbing in a plastic bag for food. This is a woman in poor mental and physical health, shockingly destitute and in desperate need of accommodation and support.

Yet the news item is concerned about only one aspect of Anne’s situation, and that is the alleged desecration of her area of land by the powers that be. No questions are raised about why it should be that a 75-year old woman is sleeping rough on a grubby piece of waste ground and what is being done to help her to a place of safety.

It seems there is a fundamental difference between how we view a woman housed and a woman living rough on the streets. A concerned neighbour living next door to a housed Anne, seeing her coming and going dressed in rags, rummaging for food in bins and showing clear signs of mental distress would probably contact the council and expect actions to alleviate her suffering and improve her living situation. Yet, because she is on the street a different reality intercedes, one which apparently inhibits the natural reaction of outrage and shock that an elderly woman is living in destitution and replaces it with something else – a confused notion that this is about a choice to live this way and to challenge this right is somehow a disrespectful intrusion.

The debate about the extent to which personal autonomy should be overridden where individuals place themselves in situations of extreme risk is not new. When our outreach team found Mary sleeping rough we initially did everything we could to persuade her to move voluntarily from the street. But she persisted to resist our offers of accommodation and with her mental and physical health deteriorating and winter looming we took the painful step, supported by a doctor who accompanied us onto the street to meet her on a number of occasions, of having Mary sectioned under the Mental Health Act and taken off the streets and into hospital. After initially being distressed she gradually settled and recovered her health, later moving to a registered care home from where she has reconnected with her daughter.

Anne Naysmith’s predicament is being monitored closely by the outreach workers and other professionals who remain enormously concerned by her plight. Like Mary, she has rejected many offers of accommodation. There will be those who will counsel that she is making a lifestyle choice based on a largely rational consideration of her predicament and that by persisting to urge her to move inside we are misguidedly attempting to foist our own set of values on her.

To this I can only respond that on one bleak occasion at the funeral of a rough sleeper who died on the street, I attempted to explain the doctrine of the lifestyle choice to his children. They listened in dignified silence until my dribbling explanation petered out, but I could guess what they were thinking and it was, in essence, if it had been your father you were meeting every night in that shop doorway, a greater humanity would have trumped your belief in a lifestyle choice. And I knew that they were right.


This blog was published in Inside Housing on November 16th 2012

Sentimentalising Peggy

In Temple Gardens with the Thames close by she sits on a bench this homeless women, slumped forward, face pressed into a mound of belongings that she has stacked on her trolley with intricate care.  Her face is pressed hard into the dirty clothing on top of her assortment of bags. Is she smothering herself?  I stop and watch, but her breathing is deep and regular; the sleep of the constantly exhausted.

And, along with the Temple Court barristers and office workers, I walk on by. She is a local character, part of the scene. The outreach teams working with the homeless will certainly know her.  I might ask about her when I get back to the office, but I’ve convinced myself.  And then, with a flush of guilt, I remember Peggy.

For four years in the 1980s I was an outreach worker covering a patch stretching across most of central London from Kings Cross station down to Victoria at a time when the number of rough sleepers was vastly greater than today. Under the Queen Elizabeth Hall on London’s South Bank around 120 homeless men and women slept rough and there were many more scattered around Waterloo station. One of these was Peggy. Her features remain indelibly stamped in my memory. Grey hair held up in a bun, wisps escaping to frame her etiolated face, pale blue eyes, hunched shoulders, a gentle and genteel soul; everybody’s grandmother.  

Peggy had been around for a long time and there was an absurd urban myth surrounding her, oft-repeated by other rough sleepers, which was that she had come to Waterloo station to meet her lover returning from the war but he did not arrive having died in combat in the war’s final days.  Heartbroken and with her mind unbalanced, she had continued to hover wraith-like around the station. 

Over a two-year period I talked with Peggy almost every night of my working week.  The work was tough and frequently demoralising with the growing number of rough sleepers far outnumbering hostel vacancies.  At the end of the evening we would walk up to Waterloo station to talk with Peggy who was invariably on the same platform where the Waterloo station staff kept a protective eye on her. 

We went through a conversational ritual that became increasingly comfortable, which went something as follows:

Me: Peggy, how are you tonight?  It really must be time for you to try a hostel.  Aren’t you finding it cold?  Wouldn’t you like a nice warm bed and a meal?

Peggy: Thank you very much dear, that is very kind of you, but I am OK for tonight, I think. 

She would give a gentle smile, heave up her bags, and shuffle off along the platform and we would head back to the office at the end of another testing shift, comforted by the pleasant, light relief of the chat with Peggy, the final curtain on the night’s performance.       

We occasionally took colleagues from other teams out with us and in the latter part of 1986 we were pleased to be accompanied on our night-shift by Dennis, a Community Psychiatric Nurse. Dennis was a New Zealander, extremely experienced and rather shocked by the levels of rough sleeping he was witnessing in London.  His considerable knowledge of mental and physical health issues was of great assistance to us that night.  His careful, but direct, explanations to rough sleepers concerning what would happen if they did not get leg ulcers treated or rasping coughs properly investigated made an impact and we all resolved to follow up on the requests for further advice and support the next day. At the end of the night I invited him to accompany me onto Waterloo station to meet up with Peggy. I fear that I probably referred to her as ‘a bit of a character’.  And there she was, pale, stooped, shaking her head from side to side gently and, as always, unfailingly polite to us.      

Back at the office, clutching a mug of tea, we discussed the night with Dennis and I found myself chuckling over Peggy and the unlikely story of her lover who hadn’t return from the war. Dennis was staring into his tea, frowning and clearly uncomfortable.  Then suddenly he raised his head and asked bluntly, ‘Why are you letting her live like that?’ There was a tremor of anger in his voice and we were stilled. He proceeded, in unremitting detail to take us through what he had seen.  In his view Peggy had some extremely serious health problems.  For example, she was suffering from severe edema (water retention leading to swelling around the he legs) which could possibly be connected to a thyroid disease.  She seemed to be experiencing auditory hallucinations or paracusia, probably brought on by extreme sleep deprivation.  I remember that Dennis’ conclusion was that Peggy was probably ‘in torment’.  We were chastened and embarrassed. This was not the ending that we had anticipated. 

I wish I could report that, within the week, we had encouraged Peggy to move away from Waterloo station but, alas, she remained obdurate, subsisting on the large sums of money given to her by generous members of the public, thrust into her hand without Peggy ever needing to openly beg.  We dithered and prevaricated and it was around this time that I first heard the words, ‘lifestyle choice’.  Talking to a mental health specialist about Peggy, one who had a different outlook to Dennis, they concluded that we had to accept that Peggy was making a lifestyle choice based on a largely rational consideration of her predicament and that foisting our own set of values on her was actually undermining her autonomy and individuality. At the time, I found this most reassuring. It was a welcome get-out. I could console myself that it was not down to me, it was up to her. 

As it happened, events conspired to save Peggy. Waterloo station had long been the haunt of homeless people but, by the end of the decade, this was coming to an end.  No longer could the homeless sleep on the station, and that even included the iconic Peggy.  So one evening we hired a car and Peggy, dishevelled and disorientated, was escorted from the station by kindly railway staff and, amidst emotional scenes, helped gently into the car and driven away to a temporary shelter. No longer would that end of the night ritual - the pre-departure conversation with Peggy - be played out.

I only saw Peggy on one more occasion and it was a moment that left me pensive and subdued. Around a year after she had left Waterloo I was visiting a second-stage hostel for older men and women in south London to deliver into the safe keeping of the staff there a rough sleeper who had been promised a room. It was one of the best hostels in London with single rooms, supportive staff and the option of a permanent stay.  As I was leaving I noticed a group of residents sitting on comfy chairs around a low table playing a board game, laughing and jesting in evident good spirits. Amongst the group and seemingly the centre of attention was a women unnervingly like Peggy, though she looked around ten years younger and was smartly dressed, with pinkish cheeks.  I couldn’t leave without checking and turned back to the staff office to ask about this woman who I thought recognised, though knowing already the answer, which I was aware I was bracing myself to receive.  It was indeed Peggy who, I was told, had slept rough for years but come on leaps and bounds since she’d moved into the hostel from a temporary shelter.  I didn’t go over to say hallo to Peggy. I am sure she would have been impeccably polite, but I risked seeing a shadow cross her face as she connected me with the many grim years of getting by on Waterloo station and that was a risk I was not prepared to take.   

  

The lone rough sleeping women, often pejoratively referred to as a ‘bag lady’ remains an iconic figure standing out amongst her male counterparts, an eccentric curiosity, a feature of the local scene. Didn’t Alan Bennett even write a poignantly amusing play about one such homeless woman?  They are a national treasure!  I fear that this cloying sentimentality that bedevils our approach to women rough sleepers means we are especially likely to find plenty of reasons why we must preserve their right to stay – and die – on our streets.     

But you live and learn. Now at Thames Reach we take a more forthright approach in our work with long-term rough sleepers; the ‘entrenched’, in the jargon of the day. We are more conscious of the damage done to body and soul by rough sleeping and highly sceptical of the notion that sleeping rough should be interpreted as a form of rugged independence.  

So when we found Mary sleeping rough in Barnet, north London we initially, over many months, did everything we could to persuade her to voluntarily move from the street. But it was hopeless.  Her belongings swelled around her, an irrepressibly rising tide of detritus as, over the weeks and months, kindly members of the public brought her food and clothing. Her mental and physical health deteriorated and each week she appeared to be getting weaker and weaker. With the winter looming we took the painful step, with the help of a supportive doctor who accompanied us onto the street to meet her on a number of occasions, of having Mary sectioned under the Mental Health Act and taken off the streets and into hospital against her will.

Over the next few days a distressed Mary attempted to abscond and return to the street. But gradually she settled and recovered her health, later moving to a registered care home where, delightfully, she is now visited and supported by some of the same members of the public who were feeding her when she was sleeping rough.  And then the most magnificent of final chapters was written when we were contacted by Mary’s daughter. She was separated from her mother as a baby and put up for adoption because, in the parlance of the day, she had been born out of wedlock.  She had been tenaciously searching for her birth mother over many years.  It doesn’t get much better in this work than a joyous family reunion and mother and daughter remain in close contact.

It could have been very different.  A few months after Mary was taken off the street we experienced one of the coldest winters for almost twenty years and in one grim week, two rough sleepers died in London.  Mary would have been in extreme danger and instead of telling a daughter the happy tale of her mother’s recovery we could easily have been passing on the devastating news of her untimely and unfortunate death in below zero temperatures, the mother she was now never going to meet. 

And I can assure you, if that had been the case we would not for one moment have had the effrontery to have insensitively attempted to outline to the grieving child the doctrine of that execrable conscience-salver – the lifestyle choice.         

American extremes: responses to homelessness in the United States

The United States is a land of extremes. Over the past decade I have travelled to Washington, New York and Boston to visit homelessness projects and the American experience has never failed to both inspire and appal. 

In 2003, supported by a grant from the London Housing Foundation, I visited New York with a group from London to investigate how not-for-profit organisations working with the City Authority were tackling homelessness. In a crowded week we ricocheted between the distressingly dreadful and the utterly uplifting. On Manhattan’s East Side we visited the 850-bed Bellevue shelter, an intake shelter for New York’s most chaotic and vulnerable people. Security guards outnumbered support staff. Under blankets, in crowded dormitories men moaned and whimpered.  Whist speaking to the manager in her office, one of those moments arrived which encapsulates an experience.  A resident, eyes caste down in embarrassment, entered to request the loan of a toilet roll. This was not a place where you could expect to retain your dignity.    

The most brutal manifestations of homelessness in the United States – rough sleeping and life within the shelter system - come with numbers which are gigantic in comparison with UK figures. The single night January 2012 street count in New York found 3,262 rough sleepers, more than six times the figure for London. The October 2012 statistics show that there were 46,146 individuals in New York shelters, including 9,725 families with children. 

Progression through the shelter system is a highly selective process with intake shelters such as Bellvue providing the first point of entry and staff from the not-for-profit organisations visiting and selecting from the intake shelters people who are appropriate for their projects, based primarily on support needs and motivation. For some the selection bar was clearly set too high, creating a desperate homeless underclass churning around the shelter system unable to take the next step on the pathway towards rehabilitation.

Yet the United States experience can be unforgettably uplifting and a visit to the Fortune Society in Harlem became for me nothing less than a moment of epiphany. The Fortune Society provides accommodation and support for offenders recently discharged from prison, many of whom had been literally bussed from the prison gates and off-loaded in central Manhattan. The accommodation was spotless and the programmes convincingly life-changing. The young salaried staff member showing us around was infectiously enthusiastic, evidently held in high regard by the residents and impressively authoritative as he gave an overview of the project. At some point he casually noted that he was not only an ex-offender himself but still a user of services at the Fortune Society.  As we delved further, it emerged that around 70% of the work-force comprised ex-offenders who had initially come to the Fortune Society as service users.

Later, after meeting the Fortune Society’s inspirational Chief Executive JoAnne Page, I squirreled away in my memory some of her phrases to contemplate further, including ‘we screen for one thing only – motivation’ in response to my scepticism about whether the organisation simply creamed off the most able to join the work-force. She talked freely about the ‘mother lode of talent’ to be found among service users and of the unquantifiable benefits derived from having colleagues who were living, breathing role models to inspire and transform new arrivals coming through the door of the Fortune Society.

On our return to London we put in place a programme to develop former service users so that they could successfully compete for and secure jobs at Thames Reach. It needed an utterly new approach to recruitment and a cultural adjustment within the organisation which, although we might have denied it, was operating on a rigid ‘us and them’ basis. Now around 67 of my colleagues, 22% of the workforce, are former service users, a transformation which has made us an immeasurably better, healthier organisation.  

This example illustrates a broader point about the approach taken by the most progressive homelessness organisations in the United States. Homelessness is, of course, about a lack of home and the shelter system graphically illustrates the miserable consequences of not having a settled base. But the American model starts from the position that a more fundamental change has to take place in the individual. There is a conviction that people should work, contribute and not rely on the ultimately demeaning and unfulfilling patchwork of subsidies and handouts that provides a considerably flimsier safety net than the current UK equivalent. Aspirations stretch higher, expectations are greater and a sense of entitlement, often in my experience the fog that bedevils candid self-reflection, virtually absent in the United States context. 

There is also a strong belief in rebuilding relationships with family and friends, reflecting a determination to return to natural support networks and avoid a lifetime of dependency on specialist support services. ‘Where do they move on to?’ I asked when visiting a drug rehabilitation project in Washington.  Mostly back to their families was the answer – where else?  

So that’s my ambivalent American experience. I feel profoundly indebted to the soaring, transformational belief in the capacity of people to change that seems part of the American psyche and I have been, at times, astonished to witness homeless Americans lost in a pitiless system from which there seems little chance of escape. Whether there is somehow a way of fusing together the best approaches from either side of the Atlantic is, as they say, the million dollar question.     

  

 This blog was published in Inside Housing on 12th October 2012