The homeless population are vulnerable to the impact of health inequalities and the more specialised the need, the more difficult it can be to have those needs met.
Neuropsychological needs are particularly prevalent, with those experiencing homelessness having an increased risk of suffering from a traumatic brain injury, dementia and neurological effects of substance misuse. Brain injury can impact a wide number of cognitive processes such as: memory, concentration, impulsivity, problem-solving and planning. It can also lead to personality changes, increased levels of aggression, difficulty maintaining employment and finances, and relationship breakdown. Neuropsychological impairments can make it difficult to manage everyday living in a stable environment with supportive friends, family, employment and education. The additional demands of surviving homeless and living a transient lifestyle inevitably have huge impact on rehabilitation.
Who are homeless people?
Many people think homeless people are only those who sleep in the streets or beg in public spaces. However there are several other ways to be homeless which encompasses a wider range of people. Our definition of homeless people includes those who: -
- Live in non-family spaces, without a tenancy agreement
- Sleep in saunas, casualty waiting rooms, religious spaces and public spaces
- Street (rough) sleepers
- Live in makeshift shelters or tents
- Only ever live in hostels, bed and breakfast rooms, and hotels
- Sleep at their place of work, when accommodation is not part of their employment contract
NeuroTriage aims to increase understanding of the links between homelessness and neuropsychological needs in service providers and service users. In addition, we are working to provide neuropsychological assessment, intervention and follow-on support to those experiencing homelessness and a brain injury or neurological deficit in Liverpool, as well as to already established provisions such as shelters, drop-in resources, drug and alcohol services, and social services
NeuroTriage hopes to bridge the gap between service provisions by engaging with the local homeless population by linking-in with local voluntary services that already support this community. Liverpool has a number of established organisations which support the homeless population. Examples include the Whitechapel Centre and Homeless Outreach Teams within NHS primary care and secondary care mental health services.
Our service design is being built in collaboration with existing services and people with lived experience of homelessness. Focus groups, individual meetings, conferences and events all contribute to developing a model which is both sustainable and cost-effective.
Our history and future
It can be difficult to design a service collaboratively, without having a starting point for discussion. In this case, we are confident that there are unmet neuropsychological needs. Initial discussions with services have confirmed that. We also know that an outreach model is most likely to ‘engage’ people who are homeless, and that we must reduce expectations of attending formal appointments at specific times, especially where repeat appointments are required. Our project began in September 2015 by looking to find a way for those needs to be met. We are now a registered Community Interest Company and continue to develop and evolve as we make connections with the local community and beyond.