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Significant childhood adversity linked to increased risk of homelessness

People in Wales who have suffered significant adversity in childhood are 16 times more likely than the general population to experience homelessness, according to a new study by Public Health Wales.

The study also finds that ‘resilience factors’ in childhood, such as feeling part of a community or having a trusted, stable relationship with an adult, have the effect of protecting against these experiences leading to homelessness.

The findings suggest that negative health and social outcomes such as homelessness could be reduced by mitigating or preventing Adverse Childhood Experiences (ACEs). 

Seven per cent of people in Wales have experienced homelessness. This compares to previously reported figures in Scotland of five per cent, and England of nine per cent.

Lead author Dr Charlotte Grey, Public Health Researcher at Public Health Wales, said:
“Everyone should have a stable and secure place to live, because we know that homelessness has a devastating impact on physical and mental health and wellbeing.

“The factors that cause homelessness are complex, including a lack of affordable housing, unemployment, disadvantage, and traumatic life events. This report provides strong evidence of a significant link between Adverse Childhood Experiences (ACEs) and experiencing homelessness in later life.”

Co-author Louise Woodfine, Principal Public Health Specialist and Housing Lead for Public Health Wales, said: 
“This report provides hope that the picture of homelessness in Wales can be improved by reducing and preventing ACEs. It also provides evidence that harms can be mitigated if individuals who have suffered childhood adversity feel part of a community, have access to a trusted relationship with a stable adult, or have access to a supportive school community, among other assets that improve resilience.”

Lindsay Cordery-Bruce, Chief Executive of homelessness and rough sleeping charity The Wallich, said:
“A traumatic event doesn’t automatically lead to a person to becoming homeless. However, experiences like these, that aren’t recognised or treated at the time, can impact a person to such a large extent that it becomes likely that more trauma, such as experiencing homelessness, can occur further down the line.

“Acknowledging ACEs is just one side of the coin to addressing and preventing homelessness.  The Wallich is taking steps to get more of our clients who need counselling the support they need.  It’s reassuring to see other public bodies, like Public Health Wales, looking at the complex and wider social causes of homelessness because ending it is going to take a whole community response.”

The report highlights a number of considerations for further action to tackle and mitigate ACEs, including:
•    Improving capacity and awareness of ACEs in public services by ensuring a multi-agency, trauma-informed approach that puts an emphasis on prevention rather than responding to crises
•    Better understanding and addressing of the support needs of both children and vulnerable adults, rather than focusing on the behaviour that presents itself, and recognising the importance of a trusted relationship with community and family as well as in services for those who have experienced ACEs
•    Enabling early years’ settings like schools to ensure early action takes place to support the vulnerable child and their family
•    To help public bodies adopt a ‘children’s rights’ approach, to empower children and help them to understand what is happening to them and how they can communicate their experiences and access support

The report is the result of analysis of the Public Health Wales 2017 ACE and Resilience survey data of 2,497 people, together with interviews with 27 people with lived experience of homelessness and 16 service providers who have a role to play in early preventative action.

More than eight in 10 (87 per cent) of those with lived experience of homelessness said they had experienced at least one Adverse Childhood Experience (ACE) compared with a Welsh average of 46 per cent.

Half of those with lived experience of homelessness (50 per cent) reported they had experienced four or more ACEs. This compares to just over one in 10 (11 per cent) in the wider population.

Negative coping behaviour - such as unhealthy relationships, not being able to cope with rules and substance misuse - often starts in teenage years in response to a chaotic home life, and can lead to not coping academically and poor school attendance. These reactive behaviours continue into adulthood, resulting in homelessness. Vulnerable children and adults need early support to help them manage their trauma and build resilience.

The study aimed to explore the relationship between adversity in childhood and later risk of homelessness, as well as to explore the key opportunities for early intervention.

The study supports the need to think about homelessness in a different way and consider new ways to reduce and prevent homelessness through preventing and mitigating ACEs in children, and supporting vulnerable adults who find ACEs to be both a cause of homelessness and a barrier to accessing support.

Report

Voices of those with lived experiences of homelessness and adversity in Wales: Informing prevention and response 2019