The homelessness crisis must galvanise action from the future government

Emma Haddad, CEO of St Mungo’s The homelessness crisis must galvanise action from the future government. Reversing the recent and significant growth in homelessness will not be easy, but it is not impossible. Here are St Mungo’s suggested priorities for the next government to end homelessness and support people to rebuild their lives. We are, without a doubt, in a homelessness and rough sleeping crisis. Numbers for both are at all-time highs, with close to 4,000 people sleeping on the streets every night, and almost 80,000 households experiencing homelessness or at risk of it. Currently, our outreach teams are struggling to respond to the increasing number of people on the streets and our hostels are at capacity. There are not enough affordable or appropriate homes, making moving on from the streets more challenging than ever. St Mungo’s is here to end homelessness, but we cannot do it alone. We want to work constructively with whoever forms the next government to bring about fundamental change to a system that is failing. The situation is directly linked to political choices. We see the fall-out every day. People who have no choice but to sleep rough, people in work who cannot afford their rent, people who are fighting to rebuild their lives. It does not have to be like this. There are a number of different political choices that can be made after 4 July that can turn the tide on this crisis.   We are asking the next government to focus on four areas: emergency support, prevention, recovery, and a long-term plan to ensure there is sufficient, appropriate and affordable housing for people to live in. It is complex, but far from impossible.    First, we need to protect essential funding for homelessness support.  We need to ensure that the current funding through the Rough Sleeping Initiative (RSI) and wider local authority funding is continued and expanded, so there is sufficient emergency accommodation and support available to help the growing numbers of people on the streets.   Thousands of people rely on services supported by this critical funding and, despite skyrocketing demand, RSI funding is due to end in April 2025. If this funding is not extended, about a third of the projects that St Mungo’s delivers with local authorities may not be able to run. This funding must also be expanded, so that we can provide services that match the rapidly increasing demand and escalating running costs.   Second, we need to take steps to prevent people becoming homeless in the first place.   People living in the private rented sector are particularly vulnerable to homelessness. Recent government data shows that the private rented sector is increasingly unstable, with nearly 45% of households at risk of homelessness between October and December 2023 being in private rented accommodation. Despite being in the manifesto for the last government, progress was not made to pass the Renters’ Reform Bill. Urgent action is needed to protect renters from homelessness through comprehensive changes to current legislation.  We also know that many people sleeping on the streets for the first time are coming from government institutions. From asylum accommodation leavers to people discharged from hospital or released from prison, we know that things can be done to ensure no one leaves these institutions without having somewhere safe to stay.    The sharpest increase in homelessness from an institutional setting last year was from Home Office accommodation. Despite some positive changes, between July and December 2023 the number of people leaving asylum support accommodation and sleeping rough soared by an astounding 965.91%.      Third, there must be recognition of the complexities of homelessness and rough sleeping, and significant investment in recovery.   People sleeping rough experience some of the most severe health inequalities and are one of the most disadvantaged groups in our communities. We need to ensure that the health system is equipped to support people who have experienced homelessness.  One such measure is ensuring that Integrated Care Boards have a dedicated focus on eliminating the health inequalities that people like our clients face.  We need to reform the welfare system to remove barriers and disincentives to work. Almost two thirds of our clients in supported housing want to work, but many are reluctant because they know working will negatively impact their benefits.. This means that even when working more hours, their finances could fall off a cliff edge and put their housing at risk.  The next government must also remove restrictions to full housing benefit entitlements under Local Housing Allowance rates, to help people into housing.     Finally, we need more affordable and appropriate housing.   All too often, even when we can provide people with emergency support and have worked with them to prepare for independent living, we cannot find them the right home.  There simply isn’t the housing supply available. We need a long-term plan for more permanent housing. That means 90,000 new social homes per year, as well as supported housing and affordable private rented housing. We need a credible plan that shows how, over time, the new government will build capacity into the system which is appropriate to the needs and financial situations of all people experiencing homelessness.  The trauma of homelessness devastates too many lives. It should not exist in the twenty-first century. However, it can be prevented by targeting the causes, intervening early, and investing in the right approaches.

How to register to vote if you’re experiencing homelessness

The general election has been called and we have a date – Thursday 4th July.   People who are experiencing homelessness or have no fixed address can vote. Voting is a vital opportunity for all of us to make our voice heard. Below is a brief guide on how to register to vote with key links. There is also guidance on the requirement for voters to have valid photo ID which was introduced last year, and how people who may not have mainstream ID can apply for a Voter Authority Certificate. If you, or anyone you know is experiencing homelessness, please read and share this information to make sure that everyone who wishes to vote has the opportunity.     When is the deadline to register to vote in the 4 July 2024 general election?  You need to register by 11:59pm on Tuesday 18 June 2024 to vote in the general election on Thursday 4 July.  If you want to vote by post, you must apply by 5pm Wednesday 19 June. And if you want a proxy vote, you must apply by 5pm Wednesday 26 June.   Further information on the election in your area, including lists of candidates and information on your polling station can be found here.    Who can register to vote?  To register to vote in the UK general election, you must be aged 16 or over. You must also be one of the following:  a British citizen  an Irish citizen living in the UK.  a Commonwealth citizen who has permission to enter or stay in the UK, or who does not need permission.    You can register to vote in the general election if you will be aged 18 or over on the day of the election. There are different rules for who can register and vote in Scottish Parliament, Welsh Senedd and local elections in Scotland and Wales. You can check which elections you’re eligible to vote in here.  You normally only need to register once – not for every election. You’ll need to register again if you’ve changed your name, address or nationality.   How do I register to vote?  The easiest way to register to vote is online, providing you know your National Insurance Number and date of birth.   If you can’t provide one or either of those things, you will need to contact your local Electoral Registration Office (they will also post a paper form to you if you require it). You could also download a Register to Vote form and return it by post.    How can I register to vote if I’m homeless/have no fixed address?  You can vote if you’re experiencing homelessness, remanded in custody, or a patient in a mental health hospital.   In order to vote, you need to give an address of a place where you have lived in the past, the place where you’re staying temporarily, or where you would be living if it were not for your current situation.  If you are experiencing homelessness with no fixed address, you can register to vote by giving details of where you spend a substantial amount of your time. This could be a night shelter, or hostel, a day service you go to regularly.    How do I vote?  Once registered, you can head down to your local polling station in person, which will usually be in a public building, like a school or a local hall.   If you live away from home or are abroad, you can vote by post.   If you are unable to vote in person, you can also ask someone to vote on your behalf, which is known as a proxy vote.  The eligibility criteria to vote in different elections can be found here.    Do I need photo ID to vote?  You’ll need to show photo ID when voting in person in some UK elections or referendums – this includes the 4 July general election.   This legislation came into effect from May 2023.  You’ll need it to vote in:  UK parliamentary elections, including general elections and by-elections. recall of MP petitions in England, Scotland and Wales local elections in England (including councils, mayors, the Greater London Authority and parishes) Police and Crime Commissioner elections in England and Wales neighbourhood planning referendums in England local authority referendums in England (including Council Tax increase referendums)    What photo ID is accepted?  You’ll need one of the following types of photo ID to vote:  a UK or Northern Ireland photocard driving licence (full or provisional) a driving licence issued by an EU country, Norway, Iceland, Liechtenstein, the Isle of Man or any of the Channel Islands a UK passport a passport issued by an EU country, Norway, Iceland, Liechtenstein or a Commonwealth country. a PASS card (National Proof of Age Standards Scheme) a Blue Badge a biometric residence permit (BRP) a Defence Identity Card (MOD form 90) a national identity card issued by the EU, Norway, Iceland or Liechtenstein a Northern Ireland Electoral Identity Card a Voter Authority Certificate an Anonymous Elector’s Document   You can also use one of the following travel passes as photo ID when you vote:  an older person’s bus pass  a disabled person’s bus pass an Oyster 60+ card  a Freedom Pass  a Scottish National Entitlement Card (NEC)  a 60 and Over Welsh Concessionary Travel Card  a Disabled Person’s Welsh Concessionary Travel Card  a Northern Ireland concessionary travel pass    What if I don’t have accepted photo ID?  If you do not have a type of photo ID that allows you to vote, you can apply for a Voter Authority Certificate.  You only need to apply for a Voter Authority Certificate if:  you do not have accepted photo ID.  you no longer look like the photo on your ID.  the name on your photo ID is different to your name on the electoral register.     You’ll need to apply by 5pm on Wednesday 26 June 2024 to get a Voter Authority Certificate for the 4 July 2024 elections.   How do

Celebrating our volunteers

Over 50 years ago, a group of volunteers wanted to do something to help the people they saw sleeping on the streets. They founded St Mungo’s. Today, volunteers continue to play a vital part in our work to end homelessness and rebuild lives.   This Volunteers’ Week, we’re hosting celebrations to say a massive thank you to all 350 volunteers who have supported us this year. We’ll be announcing the winners of this year’s Volunteer Awards, with prizes generously donated by the Marsh Trust.  Iver Morgan, our Head of Volunteering, Apprenticeships, Involvement, and Student Placements, said:  “Whether they are answering the phones at Streetlink, translating for our clients,?delivering activities in our services, or using their lived experience to support others. Their contribution is immense. They give their time, skills and experience as we work to support people at a difficult point in their lives. We genuinely couldn’t run St Mungo’s without them.”  To mark Volunteers’ Week, we talked to some of our volunteers about their experiences. Pat runs a gardening club with the residents in one of our services:  “I noticed the rise of people on the streets in London, and I felt I had do something. I’m not qualified to do support work, but anyone can help, even in a small way. A professional gardener would turn up and the whole thing would be finished in a day. What they would do in three hours has taken me six weeks, because we work at the pace of the residents. I don’t get frustrated by that. It’s good for the residents, it’s good for me, and it’s good for St Mungo’s. Everybody benefits. Some of the residents have medical issues that impact their mobility, but there are still ways they can get involved. Even if they just sit and watch, they’re outside in the fresh air. And that’s a contribution. I ask the residents for instructions and involve them in the decision making process. As a volunteer, you need empathy. You’d have to have a heart of stone not to want to help these residents. There’s one resident who comes out to the garden every week, so I gave him his own gardening gloves. I said to him ‘here, these are for you. You take these and keep them in your room’. His face lit up. I’d like to thank St Mungo’s for giving me the opportunity to do this, and the staff who’ve made it possible. If you’re trying to build a career, especially in any kind of caring profession, a stint at St Mungo’s can only do you well. There’s a wide range of things you can do. The role I do is very specific, and it fits well with me. There are lots of other roles I couldn’t do – but there’s something for everyone.”  See how you can use your skills to make a difference by exploring our current volunteering opportunities. 

What is the Rough Sleeping Initiative?

The Rough Sleeping Initiative is a critical issue for organisations across the homelessness sector. And as the General Election looms, it’s more important than ever that we understand what the initiative is, and why it’s vital it is continued. So, what is the Rough Sleeping Initiative? The Rough Sleeping Initiative is a package of measures, including  a pot of funding allocated by the government to tackle rough sleeping. It exists to provide targeted support for frontline services who work directly with people who are sleeping on the streets. Who receives the funding? Local authorities receive the funding and distribute it to local services and charities. The initiative funds outreach teams, emergency accommodation and support workers. St Mungo’s has received part of this funding since its inception. Why hasn’t homelessness reduced in line with this funding? The cost of living crisis has soared in recent years, and this has put more people at risk of homelessness. So much so that data released in April 2024 showed a 33% increase in rough sleeping numbers in London. Moreover, the funding from the Rough Sleeping Initiative hasn’t increased in line with the rising demand for our services, and the increasing costs of running them. When is it due to end? The policy was implemented in 2018 with funding packages of different lengths. But with this package of funding starting in 2022; it is due to end in April 2025. If it ends as planned, this puts thousands of people experiencing homelessness at serious risk, as their access to services could end abruptly. What can be done about it? We are campaigning for the Rough Sleeping Initiative to be extended and uplifted alongside wider critical Government funding. As a result, frontline workers like ours to meet the growing demand for our services.

Mental health is a shared journey

It’s Mental Health awareness week. Mental Health and homelessness are tightly connected and about three quarters of the people we work with need support for their mental health.   Leon Eckford, our Repairs and Voids Manager and member of our Lived Experience Network, shares his thoughts.  At St Mungo’s, we are dedicated to ending homelessness, recognising that lacking a stable home is a significant factor in mental health challenges. My experience as an Outreach Manager in Tower Hamlets highlighted how exposure to trauma and violence perpetuates the struggle for many people. Rough sleepers face constant risks, from physical violence to sexual assault, exacerbating mental health conditions like PTSD, depression, and anxiety. The struggle for basic needs like food and shelter deepens feelings of hopelessness and despair, further deteriorating mental wellbeing. Moreover, the physical toll of homelessness compounds these challenges, leading to a complex interplay between mental and physical health.   Mental Health Awareness Week serves as a global platform to educate, destigmatize, and advocate for better resources and support systems. Through seminars, workshops, and community events, the aim is to foster understanding and provide resources for those affected. Breaking down societal barriers and encouraging conversations around mental health is vital for overall wellbeing.   Several factors contribute to the rise in mental health issues. Improved societal attitudes lead more individuals to seek help, though reliance on medication as a quick-fix solution poses its own challenges. Reflecting on past societal norms, particularly regarding male mental health, underscores the progress made but also the work left to do in combating stigma.   Modern life introduces various stressors, from financial pressures to social media-induced comparisons, exacerbated by the isolation of the COVID-19 pandemic and now the cost-of-living crisis. Technology, while beneficial, also contributes to feelings of isolation. Personal experiences, such as growing up in a single-parent household, highlight the impact of family structure on mental wellbeing. While genetics and biology play a role, environmental factors significantly influence mental health outcomes.   Despite these challenges, there are simple strategies to manage mental health and emotional wellbeing. Recognising that it’s a journey, seeking support, and finding personalised coping mechanisms are crucial steps. This year’s campaign mantra, #momentsformovement, emphasizes the importance of staying active and connected.   Maintaining supportive relationships and seeking professional help when needed are vital for navigating mental health challenges. In closing, let’s prioritise peace, love, and light, remembering that mental health is a shared journey.  

NEW DATA: Government data shows 33% increase in rough sleeping numbers in London

Headline Statistics New data was released today (30 April 2024) by the Combined Homelessness and Information Network (CHAIN) which covers January to March 2024. In total, 4,118 people were recorded as rough sleeping in London between January to March 2024, this is an increase of 33% on the same period last year. 2,038 people rough sleeping for the first time, a 37% increase on the same figure this time last year. 511 people deemed to be living on the streets, 36% higher than the same figure this time last year. 1,637 people were intermittently rough sleeping, 29% higher than the same period last year. The Department for Levelling Up, Housing and Communities (DLUHC) also published data today for October – December 2023, which shows an increase in statutory homelessness. 78,980 households were homeless or at risk of homelessness, an increase of 8.8% from the same period last year. The figures also demonstrate an increasingly unstable private rented sector, with 44.4% of the households at risk of homelessness renting privately – an increase of 7.2% from last year. Chief Executive of St Mungo’s, Emma Haddad, said: “It is truly devastating to see yet another rise in homelessness across London and a 37% increase in those sleeping rough for the first time. Every day our outreach teams are trying to support more people off the streets, but the huge shortage of affordable and appropriate housing makes this really challenging. With the Mayoral and London Assembly Elections this week, and a general election to come, we urge those elected to make ending homelessness a priority. Homelessness devastates lives, and our collective focus must be on preventing it at all costs.”

Neurodiversity Celebration Week – My own experiences of ADHD

It is Neurodiversity Celebration Week, which is an excellent opportunity to spread awareness of neurodiversity and celebrate what it means to be neurodiverse. Lottie Baker, Service Manager at Grange Road, gives us an insight into her own experiences of Attention Deficit Hyperactivity Disorder (ADHD) and how this has positively impacted her work.  At 27 I was diagnosed with ADHD. I’d wondered about it for years, but I wasn’t diagnosed as a child so I figured I couldn’t have it. As research and information about adult ADHD grew, l realised more and more it matched my experience of the world. After years of thinking about it I decided it was time to resolve the lingering question mark.   After diagnosis, there’s relief, finally you know what is going on and why you find things harder than most people. There’s also a sense of sadness for many, reflecting on what you could have done if you’d known sooner or all the times you exhausted yourself trying to keep up with others, not knowing your brain simply worked differently to theirs and made it harder. It’s easy to fall into this thinking, but I also found that ADHD benefitted me in ways I wouldn’t have considered.   As a project worker ADHD helped me be proactive and step up to solve problems I saw needed to be addressed. My brain loves solving problems and puzzles, so I could apply this to my everyday work and use it to create opportunities for my development. I was also calm under pressure and during incidents. The adrenaline and high-pressure environment calmed my brain, in the same way ADHD medication does, and helped me zone in on what needed to be done. Looking back, I can see that ADHD made me a good fit for this line of work. In a sector where things change quickly, need urgent attention, require problem solving and quick thinking, my fast past brain thrives and can be used to its full potential.   To make the most of ADHD brains at work there needs to be support to utilise the strengths, but also support with challenges. So, I want to share some of the things I’ve found helped:   Be kind to yourself  Be honest: If you find something hard, talk about it and explain why it’s hard for you. You need to be honest about what support you need.  Change what you can: Adapt ways of working if you can. If things can’t be changed identify the barrier and how you can work around it (e.g. something is boring, and you find it hard to complete – can you factor in rewards or gamify it to make your brain more interested)   Find what works for you: What works for one won’t for another, so be flexible and test things out. There’s endless advice and tips online so research and find what works.   Share and talk about it: ADHD can make you feel isolated, if you can talk to other ADHD people. Don’t underestimate how much talking to someone who understands your experience can help.   There are a wide variety of webinars you can get involved with and resources you can download  on the Neurodiversity Celebration Week website.  

“One of my most treasured experiences with St Mungo’s” – The Client Challenge 2023

Person-centred support is so important when helping people recover from homelessness, engaging people in ways which bring out their unique talents and interests. We run events throughout the year so that the people we support can experience new things and explore what matters to them outside of homelessness.  Here, Regional Fundraising Coordinator Alexandra Henden talks about one of our most recent events, a camping and walking weekend in Dorset. This weekend I supported on the St Mungo’s Client Challenge which is an annual event where we bring together staff, volunteers and clients from all areas of the charity. We camp together and organise a walking challenge on both days with the option to stay behind enjoying other activities if walking isn’t for you, so it’s completely accessible. This year the challenge took place in Dorset and brought together our services in Bristol, Bournemouth and London. On the walks, we got to see some wonderfully picturesque spots in the wooded lowlands and the coast of Lulworth Cove, and in the evenings, there were creative activities including illustration and T-shirt printing, skill-building workshops on bushcraft, and music around the campfire. I have to say it will be up there as one of my most treasured experiences with St Mungo’s; discovering somewhere new, joining together in an activity and connecting a wonderful array of people from the charity across two days. Clients were also really enthused, and you can read a few of their quotes below: “A massive thanks to you and the rest of the staff as it was the best camping trip I’ve been on and my anxiety didn’t bother me all weekend” “I’m glad I went. And I’m also proud that I managed to travel home from Waterloo by myself, that’s boosted my confidence as well.” “Thanks for a great weekend really enjoyed it can’t wait for next one” To keep up to date with all our events, and the incredible work of our colleagues, volunteers and clients, you can follow us on Facebook, Twitter, and Instagram. You can also find out about how you can get involved and support us in our goal of ending homelessness.  

“Although my contribution can feel small, it has a big impact”

James is a Web Developer volunteer with our arts magazine, Homeless Diamonds. To celebrate our 50th Edition launched this summer, James shares his experience of volunteering with us and how the magazine has changed his perspective on homelessness. I’ve been volunteering as a web developer for Homeless Diamonds, an arts magazine which features a compilation of writing and art by people associated with St Mungo’s, for the past 8 years. I started volunteering as I was looking for something to do, to use my skills and give a little bit back, so the role within Homeless Diamonds was perfect for me! I built the website that hosts the digital copies of the magazine. When I first started, I had a backlog of past issues to upload. Now I help out three times a year, when the magazine comes out. My role is to make sure the latest edition is up on the website, formatted correctly and all the content links to the contributors are included. It’s fantastic being able to help, and although my contribution can feel small, it has a big impact in spreading the reach of Homeless Diamonds – and the wider the spread, the greater the impact! I always look forward to hearing when the latest edition is about to drop and feel privileged to get a sneak preview of the magazine before it’s printed. Through my volunteering with Homeless Diamonds, I’ve learnt that homelessness isn’t just a point in time, it’s a journey. When you see someone homeless, it’s easy to think there’s a quick fix – put them in a house – however there’s often a whole range of things that have got them to that point. To that end, I think there’s a lot of blame the individuals get for this, which is unduly put at their door, when it is often not something that they can fix independently. That’s why how St Mungo’s intercepts this journey and supports people in their recovery is so important. Homeless diamonds provides a lens on the thoughts and lives of St Mungo’s clients. The magazine gives a voice, which may be difficult to get out otherwise. I’d really encourage everyone to read even just a single edition as I know you will find it eye-opening. Check out the 50th edition here.

Recognising the past when planning for the future

An advance statement for people who have experienced homelessness   Compassion in Dying and St Mungo’s, in partnership with their residents, have developed an Advance Statement for people who have experienced or are experiencing homelessness.     Why   We know that when people are able to consider and record their preferences for treatment and care, and are supported to do so, it can have a positive effect on their end-of-life experience. It also provides peace of mind and reassurance to people in the present, knowing that steps have been taken to ensure their wishes will be respected in the future.  For people experiencing homelessness, there is often little support available to plan ahead. As the CQC reported, the needs of homeless people are not well understood or considered by health and care services and where services do exist, they are often fragmented and work in relative isolation.  In light of this, Compassion in Dying and St Mungo’s worked in partnership at their registered care homes, to co-develop the advanced statement for people experiencing homelessness. St Mungo’s care homes provide care and support to individuals with a range of complex needs, all of whom have experience of homelessness. The aim was to work with St Mungo’s residents to find out what information they needed to enable them to make a decision about if planning ahead was right for them, and what support they needed to do so.     A form that resonates and better conversations  Through a series of workshops and one-to-one conversations with residents at two St Mungo’s homes, we learnt a lot about how people who have experienced homelessness feel about the notion of choice and making decisions about the future.  Some people found thinking about advance care planning hard and others felt it was pointless. Some people did want to plan ahead because they had been affected by the deaths of others, and found doing so gave them confidence in what might happen in the future. People shared deeply personal experiences and insights into what would make an advance statement feel relevant to them.   We are publishing the form so that other people who have experienced homelessness can have access to a way to record their wishes that has been designed by people who have walked in similar shoes to them. And so that professionals who might be having such conversations understand how some people who have experienced homelessness perceive advance care planning, and why some might not want to have such conversations.     Starting a conversation by exploring identity  We asked people to bring one thing to a conversation that was important to them and their identity. Suggesting day-to-day items like warm socks if they feel the cold, a favourite record or a book they’ve enjoyed.  People spoke passionately about what mattered to them. They discussed music they enjoyed and watching TV: “Things like having access to TV and Wi-Fi can make a big difference to our lives”. They also chatted about the foods and drinks they liked, this was particularly important to many: “I like Strongbow and a large Whiskey.”    The importance of the past  Talking about the important things in their lives now, made many people reflect on their history and experiences. Some shared stories from before they became homeless and the important parts of their identity back then, such as religion, family and socialising.  Some talked about their achievements and the people they had met along the way. Times they were proud of were important to share. One person spoke about spending time writing about their past as a way of processing and that looking back was a cathartic way of living in the present: “I write autobiographical stuff, people I have met in my life.”  Other people mentioned their addictions, and one talked about how his experience as a homeless person made him realise he likes to help other people.     Current needs were often more important than thinking about the future  When thinking about their health and care wishes for the future, many people instead wanted to talk about their current needs. A common theme was how they struggled to get the care they needed and suffered from ill health with little support: “at the moment some people don’t feel listened to and feel that their needs are not being fulfilled”.  This often led on to speaking about the multiple struggles people were contending with, such as financial troubles and benefit support: “people have a lot of different problems to cope with right now”. For some advance care planning was, understandably, low on the list of much more pressing things that needed addressing in their lives: “What’s the point? We need to change the bigger picture”.  It’s important to acknowledge that for many people who have experienced homelessness, advance care planning may be challenging and emotive and they may not want to engage in it. This should always be respected.    The absence of choice  The concept of having choice felt alien and therefore difficult for some people to engage with. For most, they said that they are not offered a lot of options in their life, be that where they live, what they eat or how they choose to spend their time. A common response to questions about what matters to them was “I don’t mind”.  The sessions also brought out some deeper feelings that people were grappling with, with many reflecting on the independence they once had: “Independence is very important to people, and it can be frustrating to feel you may have lost some control of your life”. Similarly some talked about the lack of agency they continually felt.  For some people, being asked about what they would want to happen to them in certain situations in the future therefore felt more like a confrontation of choice, rather than the considered process of planning that was intended.   The feeling of absence of choice is not unique to those experiencing homelessness when it comes to health and care services. This