Complex needs and adverse childhood experiences

It has long been acknowledged that some homeless people have complex support needs which go well beyond lack of a home, but the scale and nature of these needs was not well understood. In a series of linked projects, I-SPHERE has undertaken substantial qualitative and quantitative research that has demonstrated significant overlap between the adult offender, substance misusing and (single) homeless populations, and also the interrelationship between this form of ‘severe and multiple disadvantage’ and other complex issues such as mental ill-health, domestic violence and abuse,  and poverty. Our research has further established that the most extreme forms of severe and multiple disadvantage are heavily concentrated in areas of the country affected by long-term economic decline, and that the great majority of those affected have also endured ‘adverse childhood experiences’.

The table provides a summary of key recent research projects in this field.  For publications see our Publications section.

TitleAboutDatesFunderLead Researcher
Housing First EvaluationHeriot Watt is involved in a collaborative evaluation, led by ICF consulting, of the Housing First Pilots in England for the Ministry of Housing, Communities and Local Government.2018-2022Ministry of Housing, Communities and Local GovernmentSarah Johnsen
The Housing First Scotland Pathfinder projectThe Housing First Scotland Pathfinder project represents a significant development in the expansion of Housing First (HF) provision across Scotland within the context of a broader policy shift toward rapid rehousing by default. Funded by Social Bite and Scottish Government, the programme is being managed by Corra Foundation. It has involved the development of five Pathfinder Projects covering six local authority areas over a two-year period: Glasgow - 300; Edinburgh – at least 50 and up to 275; Aberdeen/Aberdeenshire – 120; Dundee – 100; Stirling – 20. In each, a consortium of service providers has been commissioned to deliver housing and wrap-around support for homeless people with complex needs. The research aims to document project outcomes, costs and operational lessons learned during the Pathfinder Project.
2018-2021Corra FoundationSarah Johnsen
Homelessness and destitution in Newcastle - Exploring the role of the ‘local state’ in the context of austerity and welfare reformThis study aims to illuminate how Newcastle’s ‘local state’ (NCC and key partners) has responded to the combined welfare reform, austerity and homelessness prevention challenges to date, and to consider how local policy and resources might best be deployed to address these challenges in the years ahead. Whilst the Homelessness Prevention Trailblazer will form the core of the research, the study will encompass Newcastle's wider ambition for a system change programme that creates "coherent responses to the most fundamental changes to the welfare state in 60 years"2018-2019Newcastle City CouncilBeth Watts
Centre for Homelessness Impact - evidence map of process evaluations of homelessness interventionsThe Centre for Homelessness Impact commissioned Heriot Watt to develop an evidence map of what works.
The Evidence and Gap Maps bring together evidence on homelessness interventions from around the world to highlight where evidence does or doesn’t exist on what works and why they work or not. It is designed to help target research investments faster and in a more strategic, impactful way.

Further information
2018Centre for Homelessness ImpactJenny Wood
Hard Edges Scotland Developing a profile of severe and multiple disadvantage with supplementary case studiesHard Edges Scotland will produce similar analysis as Hard Edges England for Scotland. It also provides an in-depth and holistic analysis of local systemic responses, taking account of service provider perspectives and service contexts. Using case study areas the research explores both contrasts and continuities in the challenges encountered, and changes required, across different sorts of places and communities.
2018Lankelly Chase Foundation
Robertson Trust
Suzanne Fitzpatrick
The Alternatives For Including Non-household Populations In Estimates Of Personal Well-being And DestitutionThis project is to look at alternative ways in which "non-household" populations can be counted in measures of living standards and personal well-being.
The project has two main stages:
• a review of literature and data sources covering the populations and settings of interest
• a detailed feasibility phase to test specific approaches to measuring the main characteristics and circumstances of a range of the populations of interest
The non-private household (NPHH) population includes people living in: care homes; long-stay hospitals; military accommodation; immigration removal centres; students in halls of residence; travellers in caravan sites; prisons; hostels for homeless; bed and breakfasts and unsupported temporary accommodation; homeless people sleeping rough; sofa surfers
The first stage has been completed and the report highlights what is known for each of the NPHH groups on the size of the population, living standards and well being and recommendations for improvements.

Further information
2018Office of National StatisticsGlen Bramley
Qualitative pilot evaluation of pharmacist input into clinical care of homeless peopleThis qualitative study will assess homeless people’s perceptions and personal experiences of dedicated clinical (prescribing) pharmacist input into their clinical care.

Find out more
2017-2019NHSSarah Johnsen
Eradicating ‘Core Homelessness’ in Edinburgh, Glasgow and Aberdeen: Providing and Evidence BaseThe research provides an evidence base for the disbursement of an estimated £4 million to relevant service provider organisations in Scotland’s four largest cities to work towards the eradication of the most extreme forms of homelessness.

Further information
2017-2018Social BiteBeth Watts
Ending Rough Sleeping – What WorksThe existing evidence base on the effectiveness of interventions with rough sleepers is piecemeal and scattered with key findings far from accessible to policy makers. For this reason Crisis commissioned this review of the existing international evidence base.
Further Information
2017CrisisSarah Johnsen
Time for ChangeAn evaluation of Shelter Scotland’s Time for Change project based in Dundee which aimed to establish and train volunteer peer mentors with lived experience of multiple and complex needs to assist homeless people to access and engage with services. The report evaluates the impact on volunteers and those helped and assessed effectiveness of the model as a mechanism for sustainable change.

Further information
2017Shelter Scotland The Scottish Government via the Eurpoean Social Fund’s Social Innovation FundSarah Johnsen
Hard Edges: Developing a profile of severe and multiple disadvantage in EnglandHard Edges provided a statistical profile of severe and multiple disadvantage in England for adults involved in the homelessness, substance misuse and criminal justice systems. Through interrogation of a range of data sets it estimates the numbers of people living with different combinantions of problems, their demographic and geographic pofile. The report identified strong links to poverty and mental ill-health amongst the SMD group and examined underlying causes, circumstances and triggers for people’s pathways in and out of the homelessness, substance misuse and criminal justice systems. Further information
2016-2017Lankelly Chase FoundationFilip Sosenko
Hard Edges: Developing a profile of severe and multiple disadvantage in EnglandHard Edges provided a statistical profile of severe and multiple disadvantage in England for adults involved in the homelessness, substance misuse and criminal justice systems. Through interrogation of a range of data sets it estimates the numbers of people living with different combinantions of problems, their demographic and geographic pofile. The report identified strong links to poverty and mental ill-health amongst the SMD group and examined underlying causes, circumstances and triggers for people’s pathways in and out of the homelessness, substance misuse and criminal justice systems.

Further information
2012-2015Lankelly Chase FoundationSuzanne Fitzpatrick
Homelessness MonitorThe Homelessness monitor is a longditudinal study commissioned by Crisis and funded by the Joseph Rowntree Foundation. The monitor defines ‘core’ and ‘wider’ homelessness and measures the scale of these phenomena for England, Wales and Scotland, as well as forecasting future trends. It examines the impact of policy and legislation on homelessness across the UK.

Further information

2011-2021CrisisGlen Bramley and Suzanne Fitzpatrick