Social Assistance   –  Health & Mental Health

  Home & Housing  –  Recovery & Participation

Articles and References





homelessnesS  is  a  real  structural  society's  malaise  symptom .

Homeless  people  living in  severe & chronic  social -  physical  -  psychical precariousness is as a symptom of  the  malaise of our society and a permanent injury to  democracy, to fundamental rights and social cohesion. 

It is a process,  that needs of    time    -    repetition    –    addiction of lacking.


When the person have lost everything,  there is no more that the body for cry and the street to get lost !

Homeless living in severe & chronic  socialphysical - psychical precariousness are a symptom of the malaise of our society and a permanent injury to democracy, to fundamental rights and social cohesion.  They are almost a provocation & challenge, for those who are working in this social and Health/MH  field  and for responsible of the polis and citizens.

Two questions will be the basis of our reflections and exchange of knowledge and experience:

1.  Some homeless people - with mental health problem permanent rough
     sleeping or in emergency centres and squats giving the impression to
     refuse any  institutional offer of assistance ?

   2.  HOW THESE SERVICES TO PERSON : contribute to promote  DIGNITY
        (rights)WELL-BEING  ( psychic – physic – social)  ?


1.  Poverty in EU increasingmonetary poverty, material deprivation and low 
  work  intensity
,  (cf. 
EUROSTAT  Statistics Explained)

2.   Number of homeless in EU increasing :  (CRISIS estimation UK)

3.   Average of mentally illness  is between 3 and 4/10, minimum recognized in
   all  studies about the homeless living in permanent way in the streets are
   mentally  illness average of mentally ill among the homeless


We assist in Europe to this contradiction: more it increases the number of the people in situation of poverty, more their problems and needs are complex both social and sanitary, strictly tightly connected and more decreasing the services, the personnel, the budget, the investments and the strategies.


The motive, first of all, it is that these people don't count and they are not even held able to find again their place in the social context, to find or to find again their place in social community.


Austerity creates a real stressful on people, especially when people cannot make project for future  for himself and family .

The passage from daily worry to desperation and passage to an action of violence against himself or against others, damaging himself or others, this passage above all if in situation of preceding vulnerability, it is not so rare then.

Worsening of mental condition aggravates the way a person functions at family, at work etc. which ultimately may result in relations falling apart, loss of work, consequently loss of a home, loss a family, loss health and pleasure of life.

This in turn is an extreme stress in itself with all the consequences stress has on a person and his/her mental condition.

So we have in fact a vicious circle, a spiral where the original financial stress of austerity generates a psychical suffering, and those mental problems generating further material deprivation and further mental degradation

The  ‘life expectancy’  in homeless is reduced of the around 40/50%, living in permanence in a situation suicidal that at times it concludes also with acting out.

Barriers and discriminate access to health /mental health services :

    Access to the health and mental health services in the city and in hospital;
it’s very difficult for these people, because of the different barriers, both individual and institutional

    Impossible for workers in health services to offer more time because the reduction of personnel and bureaucratisation of the time, that make impossible to stablish a very relationship

    Unpreparedness to approach and to work with this people, outreaching where they are

  • Reduction of beds and available of professional workers ;

    Difficult collaboration for integrated and sustainable care and cure ...

    Frequent burnout of the operators, working with these persons


PERSON  FIRST  &  DIGNITY - WELL-BEING projects was and are an opportunity for 

    1.   Meet, listen and understand deepest, the voice of people who has become voice-
      less because identity-less,  home-less,  health-less,  hope-less… and excluded.
      Analyse and to mostly evaluate where the problem him finds .

    2.   Highlight in more detail the frequent non-observance of the respect of the
      fundamental rights

    3.   Underline the symptomatic character of this dysfunction both to social level &
      sanitary together

    4.   Be careful above all kind of rationalizations of expense with dramatic consequences
      to middle and long term

    5.   Prevent those that could result to be of the negative consequences because of
      discriminatory social policies discriminatory and stigmatizing.

    6.   Lobbying to competent European Institutions, recommending some priorities in
      social & health policy.

    7.   Identify and disseminate information about some innovative practices and coherent
      projects ;

    8.   Solicit and to prepare  training, capacity building, exchanges experiences and
      personnel among the European colleagues that operate in the sector of the mental
      health and social

    9.   Facilitate the networking between public and privacy, social and health/ mental
      health for integrated answers

   10. Reach an operational and daily consent, beyond the institutional and official consent.



ETHOS classifies homeless people according to their living situation:

  rooflessness (without a shelter of any kind, sleeping rough)

  houselessness (with a place to sleep but temporary in institutions / shelters)

   living in insecure housing (threatened with severe exclusion due to insecure
     tenancies,  eviction, domestic violence)

   living in inadequate housing (in caravans on illegal campsites, in unfit housing,
     in extreme  overcrowding

-   700,000 homeless people in Europe. (2021)

-   “a home for all by 2030”   :   the  EU  has launched the European platform
      on  combating  homelessness !... 

-   the most extreme form of  social exclusion”..... is homelessness
     declaration  of 
Nicholas Schimdt  EU Commissioner


HOME sweet home : missing or is not sufficiently emphasized the affective dimension, because even in an unhealthy house you can live very strong and intense emotional relationships that allow will grow strong and  healthy.



mental health   as  an integral and essential component of health, indeed, there is no health without mental health.  Mental health is more than the absence of mental disorders.

The WHO constitution states: "Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity."

Mental health is a state of well-being in which an individual realizes his or her own abilities, cope with the normal stresses of life, can work productively and is able to make a  contribution to his or her community.

In this positive sense, mental health is the foundation for individual well-being and the effective functioning of a community.


More than 450 million people suffer from mental disorders. (WHO 10years ago)

More than
970 million 1/8 people  suffer  from mental disorder
(WHO 2020)

Many more people have mental problems. 

Mental health is determined by socio-economic, biological and environmental factors.


The vulnerability  is not a characteristic of homeless but of person everyone  has his Achilles heel but not  all of them are injured.


Q U E S T I O N S  :   about  EMERGENCY  SERVICES  are the interventions

  •  integrate social & health ? . . . ,

  •  coherent with real request of person in need ? . . .,

  •  respectful of the dignity ? . . . ,

  •  accessible to marginalized and excluded people ?...,

  •  are sufficient and adequate services in emergency center?