Addiction psychiatry can reduce homelessness – and yet it’s at risk | Letters

Without urgent government funding and an increase in the number of doctors specialising in addictions, the numbers of people sleeping on the streets will only rise, writes Dr Jenny Drife

While discussions about the accuracy of the latest government figures for numbers of rough sleepers in England and Wales will no doubt continue (Homelessness: Ministry accused of under-reporting issue, 27 February), it’s important not to lose sight of the fact that even this estimate is an increase of 141% since 2010.

We need to remain focused on interventions that will prevent people ending up on the streets, or help them back into stable housing as quickly as possible.

One such intervention is substance misuse treatment. But with addiction psychiatry on the verge of extinction and addiction services subjected to swingeing financial cuts, it is hard to see how the government will end rough sleeping by 2024.

A recent report from the Royal College of Psychiatrists shows there are only 16 addiction psychiatry trainees in England. When the dwindling band of current consultant addiction psychiatrists retire, there’s a real danger their expertise will be lost for ever. Without them, services will be deprived of the specialist knowledge needed to treat people with complex social, physical and mental health needs.

While numbers of trainees fall and cuts to services continue unabated, substance misuse continues to be a life-threatening problem for nearly two-thirds of rough sleepers. Many will die because of their drug use and those who come to the streets with an addiction are more likely to get stuck there.

It’s vital that high-quality treatment of substance misuse is available to those sleeping rough or at risk of doing so. Without urgent government funding and an increase in the number of doctors specialising in addictions, the numbers of people sleeping on the streets will only rise.
Dr Jenny Drife
Adviser on homelessness and mental health, Royal College of Psychiatrists

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