Field study

In the Netherlands, people who have no postal address are beyond the reach of the authorities. Moreover, central government support for local authorities in monitoring homeless people ended on 1 January 2015. Nevertheless, the approach taken in the Maastricht study made it possible to collect a representative sample of health data for the subsequent period. The Homeless People Treatment and Recovery (HOP-TR) study collected data in various types of facilities, such as hostels, crisis shelters, walk-in centres and sheltered housing, and included people who were not currently receiving treatment. ‘People who have no postal address have virtually no access to their fundamental social rights,’ says lead researcher Coline van Everdingen. ‘Because they have vanished from the municipal radar, knowledge about their health is very fragmented and incomplete. In this study we arrived at a representative sample by combining data from seven cities.’

Interdependence

Most people in the population studied were men of lower socio-economic status who were long-term or intermittently homeless. The results of the field study give insight into the extent and interdependence of health problems among Dutch homeless people. The vast majority had health problems in two or more domains (95%). Almost all had mental health problems (98.6%), and addiction (78%), chronic physical conditions (59.2%) and intellectual impairments (39.9%) were also common. In many homeless people, the mental health issues met the criteria to be classified as a Serious Mental Illness (72.5%). ‘The indication of an SMI means that the person’s mental health problems seriously limit their social functioning. These limitations are both the cause and the consequence of the mental health problems,’ Van Everdingen says. ‘We therefore urgently need a public health system that can provide integrated, dynamic network care to anyone who needs it. And that certainly also applies to homeless people. This is the most important outcome of this study.’