Key statistics

• people experiencing homelessness are three times more likely to use emergency health services than the general population
• 45% of respondents reported self-medicating with drugs or alcohol to cope with mental health difficulties
• average age at death for people experiencing homelessness is between 43 and 46 years.

Key messages

• people experiencing homelessness often rely on informal networks, such as friends, family or peers, to learn about available services
• mistrust of formal institutions, lack of information and fragmented systems limit engagement with health and social care
• effective outreach depends on culturally sensitive approaches delivered through trusted community resources
• collaboration with community-based organisations is central to improving access
• many participants reported confidence in using the internet to access information and support.

Policy implications

• service information may need to be shared through informal and community-based channels as well as formal routes
• outreach models should be designed around trust, cultural sensitivity and existing community relationships
• digital access should be considered as part of service engagement strategies
• stronger integration between health, social care and community organisations may improve access.

Gaps

• limited evidence on how informal information pathways affect longer-term outcomes
• lack of evaluation of different outreach models and their effectiveness
• limited insight into how digital access varies across subgroups within the homeless population.

Commentary
This study highlights how homelessness intersects with inequities in access to health and social care. People experiencing homelessness face multiple barriers, including mistrust of institutions, fragmented services and limited access to information that is relevant to their circumstances.

Reliance on informal networks plays a dual role. These networks provide vital routes to information and support, but they can also limit access to preventative or coordinated care when connections to formal systems are weak.

The findings underline the importance of outreach approaches that are culturally sensitive and rooted in trusted local organisations. Delivering support through community-based providers can help overcome barriers linked to trust and engagement.

From a care equity perspective, the study points to the need for more integrated systems that recognise how people experiencing homelessness access information and support. Aligning health and social care services with trusted community organisations may reduce exclusion and improve access for people living in vulnerable situations.