Taking a public health approach to homelessness prevention

Guest blog contributor and Chief Executive of the Cyrenians homeless charity, Ewan Aitken, tells us about the current housing crisis in Scotland and how taking a public health approach can be part of the solution.

Our new strategic plan is being launched this week against the backdrop of a housing crisis. In November 2023, the City of Edinburgh Council took the unprecedented decision to declare a housing emergency. It did so to put pressure on Scottish Government to take action in the face of the highest number of homelessness cases on record and a critical shortage of social housing.

Councils across Scotland are unable to cope with requests for support; families are waiting for years in temporary accommodation; people are dying on the streets.

Working together

In the context of this crisis, we have to work together. Last year the Scottish Government commissioned Crisis and Cyrenians to co-chair the Homelessness Prevention Task & Finish Group, a panel of experts from the third sector, health, education, social care and justice, to look at how homelessness prevention duties for public bodies could play a role in significantly reducing homelessness. The group’s final report concluded that transformational change on homelessness prevention could be possible, but only if solving the housing crisis is accepted as everyone’s business.

A public health approach to homelessness prevention recognises that, like many health inequalities, homelessness is a complex social problem that arises from a system of multiple interrelated causes and consequences and addressing it effectively requires both population level prevention, as well as individual level interventions with services and sectors working together.

Understanding why people become homeless

We know homelessness impacts on the health of the nation, on the outcomes of our young people, on the life expectancies of people living in dangerous, lonely and precarious circumstances. A public health approach strives to stop people becoming homeless by addressing risk factors and offering support at the earliest opportunity rather than waiting until a crisis happens. It seeks to move away from addressing a lack of accommodation without addressing the underlying reasons why people have become homeless in the first place and recognises that the adverse outcomes homeless people experience are largely determined by the systems and social context around them rather than as a result of their individual choices and behaviour within their own control.

A public health approach to homelessness draws on a scientific evidence base that is multi-disciplinary, so it relies on knowledge from all sectors – social services, health, education, justice, policy and the private sector – and commits to people finding solutions to homelessness together.

A new strategy to support a public health approach

Our ambition with the launch of our new strategic plan is to lift homelessness from being siloed as a housing issue to homelessness being understood across all sectors as a public health issue.

We will do this in partnership with leaders across health, education, justice and social care, influencing policymakers to make the change in their decision-making with evidence informed by lived and learned experience of homelessness. We will do this by responding to evidence-based need with services we are best placed to provide.

Being part of the solution

Cyrenians is able to be part of the solution, and we will continue to work across over 60 services in central and south east Scotland to do exactly that, building relationships and delivering whole person, whole family and whole community interventions that meet people where they are, helping them towards where they want to be.

Our new strategic plan launches just as a very significant piece of legislation, the Housing (Scotland) Bill, has been introduced to Scottish Parliament. This proposes new duties on public bodies such as justice and health agencies to “Ask and Act” to prevent homelessness before people reach crisis. This offers significant potential for change. A public health approach to homelessness prevention means all sectors and agencies playing their part to ensure everyone has a safe and secure home which meets their needs.

For more information about Cyrenians and to read our Strategic Plan 2024-2027, please visit our website www.cyrenians.scot 

Find out more about Public Health Scotland's work in this area by reading our Housing and Homelessness Lead, Emma Doyle's, blog about the housing crisis.