The earliest and most profound thing I have come to understand from the process of data collection is the profound distrust of health services and the wider society by the people who are living homeless. On reflection this should not have been such a surprise given that as a society we fail to provide enough welfare payment to provide even basic shelter and food. Nor are people living homeless provided with a safe place to camp. It’s enough to make me start to think that we should re-introduce slums – low cost housing where people affected by severe disadvantage can have a supportive community who understand the barriers to moving out of this environment.

Our attitude to the poor and disadvantaged is much like our bigotry and judgement of people from other cultures and religions, effectively we think that we are better and we are better because of our own superiority. The failure of our society, mediated I guess by the mainstream media, to engage with and reflect on our attitudes to people who are worse off than we are, limits us.

In fact people living homeless, if they have not been abused or had a mental illness before they become homeless, will have once they’ve been living out for a while. Both physical and verbal assaults are common and result in anxiety and post traumatic symptoms. In the main, drug and alcohol use comes after the homelessness as a strategy for coping with probably THE most stressful lifestyle in contemporary Australia.

To address these growing numbers of people becoming homeless and the consequent damage to their physical and mental health (with its implications for their ability to re-join the wider society), we will need to be much more inclusive. As a society we need to have a better understanding of the structural social dynamics that lead to homelessness, and be less judgemental of those who become trapped in the gears of the system that others of us benefit from. Decreasing inequality is an essential component.

In the meantime the way our society behaves toward those living out – targetting by police, abuse by mainstream members of society, physical attacks and robberies from within the street community and from outside, police and mental health take-down strategies exacerbate the distrust and alienation experienced. This distrust then inhibits people from using some services that have the potential to be helpful. This is most borne out in respect of health services illustrated by the low use of primary health services and the low life expectancy of 47 years. That’s about 20 years less than the also disadvantaged Aboriginal population.