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Prior homelessness and associations with health and violent victimisation

    By Dr Natasha Chilman, Research Associate, UKRI Population Health Improvement (PHI-UK), Population Mental Health Consortium, Kings College London

    In the United Kingdom, we have the highest rate of homelessness compared to other high-income countries. For many people homelessness is a temporary, although often very impactful, experience in their lives. However, there is a paucity of research and data looking at people who are formerly homeless and living in private households (i.e., rented or owned accommodation).

    This blog describes a new study which fills this gap, conducted by Dr Natasha Chilman from King’s College London and colleagues, including Professor Sally McManus from VISION.

    The study authors analysed data from the Adult Psychiatric Morbidity Surveys, which is a nationally representative survey of adults living in private households in 2007 and 2014. Out of 13,859 people, 535 people reported previous experience of homelessness.

    Some of the key findings of the study were:

    • A staggering 40% of people who formerly experienced homelessness had experienced violence in their homes at some point in their lives, compared to 7% of people who had never been homeless.
    • A quarter (24%) of people who formerly experienced homelessness reported experience of sexual abuse, compared to less than 5% of people who had never experienced homelessness.
    • Almost half (45%) of the formerly homeless group were currently experiencing depression or anxiety, compared to just 15% of people who had never experienced homelessness. People who formerly experienced homelessness were also experiencing more severe symptoms of these common mental disorders.
    • There were strong associations between former homelessness and health conditions, across common mental disorders, physical health conditions, alcohol/substance dependence, and multimorbidities. These associations persisted even after adjusting for a range of potential confounders, including indicators of socio-economic position and smoking.
    • Adjusting for adverse experiences including violence and abuse attenuated associations between former homelessness and alcohol/substance dependence related health outcomes, but not mental/physical health.

    The findings from this study highlight the urgent need for long-term integrated healthcare support for people who are formerly homeless to continue after they have secured private housing. There were severe inequalities in experiences of violence and sexual abuse for people who have experienced homelessness, underscoring the importance of both violence and homelessness prevention, and of trauma-informed approaches to support.

    To read the article or download the paper free of charge:

    The public health significance of prior homelessness: findings on multimorbidity and mental health from a nationally representative survey | Epidemiology and Psychiatric Sciences | Cambridge Core

    To cite:

    Chilman N, Schofield P, McManus S, Ronaldson A, Stagg A, Das-Munshi J. The public health significance of prior homelessness: findings on multimorbidity and mental health from a nationally representative survey. Epidemiology and Psychiatric Sciences. 2024;33:e63. doi:10.1017/S2045796024000659

    Or for further information, please contact Natasha at natasha.chilman@kcl.ac.uk

    Mental health outcomes of being a close relative of a serious assault victim

      There is a now sizeable body of evidence that shows how violence can harm health, across different populations (e.g., violence experienced by older people or by people with insecure migration status) and contexts (e.g., violence within the workplace).

      However, much less is known about the effects of violence on the close relatives of victims. This is particularly surprising considering the critical role that relatives play in providing support, care, and advocating for victims in the aftermath of violence.

      VISION researchers, Dr Elizabeth Cook and Professor Sally McManus, address this gap in their recently published, Indirect victims of violence: mental health and the close relatives of serious assault victims in England, an open access article in Social Science & Medicine. They conducted a secondary analysis of the 2014 APMS (a cross-sectional, household mental health survey of 7,519 adults in England). Lizzie and Sally wanted to find out what proportion of the population was closely related to a victim of serious assault, and to assess whether being a relative was associated to poorer mental health outcomes.

      They found that approximately 1 in 20 adults were closely related to a serious assault victim. The analyses showed that relatives were:

      • more likely to be anxious and twice as likely to be fearful in their neighbourhood
      • more likely to be dealing with multiple, other types of adversity such as their own experiences of serious assault and financial strains

      Check out their piece, Families of victims of violent assault have double the risk of anxiety – new study, in The Conversation, where they discuss their findings further as well as the implications for government approaches to counting the costs of the effects of violence for society.

      To read the article or download it free of charge:

      https://www.sciencedirect.com/science/article/pii/S0277953624007329

      To cite:

      Cook, E. and McManus, S. (2024). Indirect victims of violence: mental health and the close relatives of serious assault victims in England. Social Science & Medicine.

      To contact the authors:

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