Sleep deprivation is a real problem for homeless people, and poses a major threat to their already vulnerable mental health. Sam Hancock reports.
Links between lack of sleep and poor mental health have long been made by the public health sector, but for one community, it is a relatively unexplored phenomenon. If you’re homeless, a serious lack of sleep is considered par for the course. Yet, sustained sleep loss can seriously impact our mind; for the homeless, it’s no different. If anything, it’s much worse.
Taz, 61, lost his house a year and a half ago, after his wife and daughters left him to begin a new life in Vienna. “When you sleep on the streets, anything you have in your pockets might be taken,” he said. “You have to deal with people trying to mug you or beat you up – so, in the end, it becomes easier to stay awake.”
Born in Nigeria and raised in London, Taz drifts between streets in Tower Hamlets and Hackney; he can be found on some days playing the Gangan, a Nigerian ‘talking’ drum, outside Shoreditch High Street station. He says sleep deprivation takes a toll on his mind, which is common in other homeless people he knows as well. “I end up talking to myself a lot because there’s no one else there,” he said. “Your mind starts playing games on you at the best of times, especially when you’re not sleeping. It’s really easy to become paranoid because there actually are people out to get you, who want to take what you have, so you start thinking everyone is.”
This cycle Taz describes is common in the homeless – wanting to sleep, attempting to, failing to for fear of staying safe and finally, prolonged sleep loss. John Groeger, a professor of psychology at Nottingham Trent University, who is also a sleep therapist, carried out a project last year which looks at sleep deprivation in the homeless. “In the grand scheme of things, it seems like such a trivial concern,” he said. “But actually, sleep is so critical to physical and mental health, and the kind of chronic sleep loss that homeless people experience hugely affects their everyday lives.”
Groeger said the years of sleep loss, which add up for people living on the street, could lead to a whole host of mental health issues, such as cognitive decline and poor emotional regulation. “Not only are the homeless more at risk than many others, because of their intensified vulnerability, but also in terms of their paths to recovery,” he said. “Addressing their sleep problems may be critical to enabling them to change these patterns when they do eventually, hopefully, get accommodation.”
Sheltered accommodation is not the only answer to fixing the problem though. Taz said hostels can be intimidating places, which provide a bed but very little else. “If you think about feeling safe at night, it’s when your door is locked and you know you can close your eyes. Hostels aren’t like that,” he said. “There are lots of people who try to steal your stuff, or take drugs, so although you’re under a roof, you don’t necessarily sleep very well. It’s not just about being inside – that doesn’t mean you’ll have a good night’s sleep.”
Amanda Elliot, Communications and Intelligence Manager for Healthwatch Hackney, helped to create a report about mental health in the homeless last year. “All the people we interviewed detailed significant sleep disturbance as a cause for their mental health issues,” she said. In the report, four homeless people, who asked to remain anonymous and have stayed in hostels like the ones Taz described, said their pressure-cooker conditions – including paper-thin walls, uncontrolled drug and alcohol use, thefts and people banging on the doors at night – meant they were living in a state of hyper-vigilance.
“Basically they were scared, which further eroded their already vulnerable mental health,” Elliot said. “As one hostel resident we spoke to puts it: ‘Dealing with noise and substance abuse when you are mentally unwell is really hard. These accommodations are very noisy, when sleep is the number one solution for recovery, being in a place where you can hear every single move from next door doesn’t make you better.’”
In addition to this, the services available to the homeless are seriously lacking when it comes to their mental health. Data published by the charity Homeless Link, which surveyed 2,500 homeless people across the UK, suggests that 80 percent of people living on the street report experiencing some kind of mental health issue every year – with just over half of them being officially diagnosed and treated by medical professionals.
Groeger said the first step towards solving this problem is to realise that it is just that: a problem. “There needs to be time and money invested in not just housing homeless people, but helping them to have total autonomy in their lives – of which sleep is a huge contributing factor,” he said. The report which Elliot’s team created likewise said a significant step in the right direction would be for “housing and mental health commissioners to work more closely together to protect vulnerable members of society.”
Taz said for his sleeping habits and mental health to improve, more people need to help and increased services should be made available to himself and his fellow community. “Some try – like the people who run the nicer hostels,” he said. “But at the end of day, you’re one person in a massive line and more often than not, you get turned away because there just isn’t enough room for anyone else. It’s no one’s fault, but it can be really frustrating when you just want a good night’s sleep and can’t get it anywhere.”
While the duty of improving sleep begins with homeless services, as well as charities that help house people living on the streets, it does not end with them. The government and local councils need to fund shelters more and place teams within them who specialise in ensuring rough sleepers are in fact sleeping at all.
The plight of homelessness is one that doesn’t have a one-track-resolution, but is one that can be rethought. Taz says sleep is “just another problem that becomes yours to deal with” when you’re homeless, but who’s to say he – and anyone else – has to do it alone?
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