The guidance was launched at Edinburgh's Access Point by health minister Susan Deacon, social justice minister Jackie Baillie, and Sue Irving, the Scottish executive's health and homelessness co-ordinator.
Homeless people have real and pressing health needs, including:
Mental health problems including stress, depression, lack of confidence, anxiety/panic, addictions;
Physical health problems including dental problems, weight loss, gynaecological problems, scars, hair loss; and
Emotional health problems including low self-esteem, guilt, anger, unable to create/maintain relationships and fear.
Susan Deacon said:
'For too long, the health needs of homeless people have been neglected. We are taking steps to resolve that across the spectrum of government. But much more remains to do. That is why earlier this year we created the post of health and homelessness co-ordinator, and why today we are issuing this guidance to the NHS.
'The action taken by NHS Scotland can make a real difference in helping homeless people to tackle many of the issues that sustain them in homelessness.
'That's why we are instructing the NHS to look afresh at whether and how it is delivering for homeless people. It is essential that they review their services in partnership with homeless people themselves in order to ensure that the services are reaching those for whom they are intended.
'And we will monitor the work of NHS boards to ensure that positive action is taken to meet the health needs of homeless people.'
Jackie Baillie, said,
'Homelessness is not simply the lack of a house. We know from the extensive work which has been done through the Rough Sleepers Initiative that many people who sleep rough have significant health problems and yet this self same group face real difficulties accessing appropriate services. They represent some of our most vulnerable and socially excluded citizens.
'I welcome this Guidance. It will help us remove the need for anyone to sleep rough by 2003 and it will help us tackle, and prevent homelessness throughout Scotland. NHS Boards, local authorities, other organisations and the voluntary sector must work together to ensure that homeless people receive the health services they need. In this way we can make sure that poor health does not contribute to homelessness, and that homelessness does not lead to damaged health.
Sue Irving, health and homelessness co-ordinator, said,
'I am delighted this Guidance is being issued today. Having worked with homeless people for many years I am all too familiar with they problems encountered in trying to access health services.
'The work that NHS boards will now embark upon is critically important if we are going to challenge the causes of homelessness in Scotland. I will therefore do all I can to support NHS boards in this work.'
Yvette Burgess, manager of the Access Point, said,
'Access to health services by people who are homeless is vital is their immediate and longer term needs are to be provided for. The executive's strategy is a welcome step towards ensuring that everyone in Scotland who becomes homeless receives adequate health care and that this is delivered in conjunction with housing and social work services.'
The Access Point provides a specialist health service for homeless people on a drop-in basis, intended to break down the barriers to access that prevent so many homeless people from having their needs met. The Access Point also provides housing and social work services within the same building.
Work already underway includes the development of frameworks to promote better services and greater social inclusion for groups at risk of marginalisation, for example through the Framework for Mental Health and the Learning Disabilities Review. In addition, Health Improvement Fund projects, the Executive's Drugs Strategy and forthcoming alcohol misuse plan all address the needs of homeless people.
The Royal College of Physicians (RCP) of London 1994 report Homelessness and Ill health reported that 57 per cent of homeless people surveyed reported depression and 48 per cent anxiety. Self-harm is also common. The report found that 24 per cent of their sample had skin problems and 19 per cent had persistent foot trouble.
A 1999 ONS survey in Glasgow found that 41 per cent of under 25s and 70 per cent of 25-34 year olds had drug problems and 61 per cent of homeless people aged 35 and over drank at hazardous levels.