Perspectives on Homelessness: A Qualitative Study With Clinical Psychologists in Secondary Care Mental Health Services

Abstract

Aims: People who are homeless are among the most vulnerable and socially excluded populations. While they have several mental health and physical health needs it has been suggested that many barriers prevent them from accessing the support they need. Healthcare professionals’ attitudes have been identified to have a significant influence in accessing care. Clinical psychologists have a significant role to play in working with homelessness, but their views towards homelessness are yet to be explored. This study evaluated clinical psychologists’ perspectives towards homelessness, what influences them and how they influence their practice. Method: Semi-structured interviews were conducted with twelve clinical psychologists working in secondary care mental health services. Thematic analysis was performed to identify their views towards homelessness. Results: The analysis identified three themes: (1) ‘Homelessness is a complex, social phenomenon’ describing the multi-layered nature of homelessness, whilst identifying non-blaming attitudes with the recognition that homelessness can happen to anyone, (2) ‘Homelessness is not for psychology’ describing that people affected by homelessness are not suitable for psychological therapy unless their basic needs are firstly met and (3) ‘Our role as Clinical Psychologists’ describing that clinical psychologists are not just therapists and acknowledging the influence clinical training, experience working with the population, and values have on professionals’ perspectives towards homelessness. Conclusion: Concluding this study identified that clinical psychologists have a significant role in ending psychological distress rooted in health and social inequalities. Services and organisations will need to nurture and support clinical psychologist to work with homelessness while they address service barriers to develop accessible services for all. Clinical training will need to prepare future psychologists to work more systemically to address the social determinants of health and help clinical psychologists to develop skills in consultations, working at a wider systemic level and at a policy level to address social issues such as homelessness, which contribute to psychological distress.