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Mental Health
6 min read

The rough sleeper: an icon of injustice

Each rough sleeper is a raw illustration of injustice. On an awareness day for both homelessness and mental health, Jon Kuhrt reflects on the root causes and yet sees hope.

Jon Kuhrt is CEO of Hope into Action, a homelessness charity. He is a former government adviser on how faith groups address rough sleeping.

A black and white close up of the weather-beaten and wrinkled face and beard of a homeless man.
Portrait of a homeless man in Prague.
Ales Dusa on Unsplash.

In 2016, five-year Brooke Blair became an internet sensation after a video of her berating Prime Minister Theresa May went viral. As she put it, she was ‘very angry’: 

“Yesterday night, I was out on the streets, and saw a hundred and a million of homeless people. I saw one with floppy ears, I saw loads. You should be out there, Theresa May. You should be, biscuits! Hot chocolate, sandwiches, you should be building houses. Look, I'm only five-years-old. There's nothing I can do about it. I'm saving up money but there'll never be enough. You've got the pot of money, spend some and help people.” 

The video struck a chord because a young girl was passionately expressing the distress, anger, sympathy and bewilderment that so many feel when seeing people sleep rough in such a wealthy country.   

The image of a rough sleeper is an icon of poverty. And just as religious icons represent the sacred, so does each person sleeping rough. 

Each rough sleeper is a raw illustration of injustice and social breakdown.  The structural issues of poverty and inequality crystalize in the plight of a vulnerable person huddling in a doorway. In them we see an amalgam of both political failure and personal tragedy. 

It's personal because we know that each person has a different story about what led them onto the streets. We will always be moved far more by a person than any statistic.  

The image of a rough sleeper is an icon of poverty. And just as religious icons represent the sacred, so does each person sleeping rough. A precious human of infinite worth, imprinted with the divine, living in destitution. And just as restoring fragile religious icons is a specialist job, so the task of restoring those who have been homeless is often complex and intricate work. 

Today, 10 October, is both World Homeless Day and World Mental Health Day. The two are closely intertwined. It’s a good day to reflect on the nature of homelessness and what we can do in the work of restoration. 

We cannot simply remove the tip of the iceberg without addressing the deeper issues ... The water is getting colder and the iceberg is growing. 

Rough sleeping is just the tip of a far bigger homelessness iceberg. It receives the most attention because it’s visible and visceral. But it is just a small fraction of the total number of people who have no settled home who exist underneath the waterline: those sleeping in temporary shelters, hostels and squats, sofa-surfing or placed in B&Bs. 

It’s the visibility of rough sleeping that gives it political capital.  Whilst in power, Margaret Thatcher, Tony Blair, Theresa May and Boris Johnson all launched high profile initiatives with ambitious targets to reduce or end rough sleeping. 

In 2018, I was seconded from the Christian charity I was working for into the Civil Service as a specialist adviser on rough sleeping. In the four years I spent in this role I worked under four different Prime Ministers and six different homelessness ministers. Despite some significant progress made before and during the pandemic, the numbers of people sleeping rough and those in temporary accommodation are starting to rise again.  

We cannot simply remove the tip of the iceberg without addressing the deeper issues of poverty that it is connected to. The reality is that we have a deep housing crisis in this country. The water is getting colder and the iceberg is growing. 

But the challenge is that rough sleeping and homelessness are genuinely complex problems.  Politics and economics provide some of the answers but not all. After thirty years of working with people who are homeless, these are the key issues which lie behind homelessness. 

Poverty of resources 

The most obvious cause of homelessness is the lack of affordable housing. Housing is a resource which is not distributed fairly, and this inequity creates intense pressure and vulnerability. All of this is compounded by austerity, funding cuts and benefit sanctions which have withdrawn support services for vulnerable groups. 

As London has become an international playground for the uber rich, many new housing developments are simply investment opportunities. Often people sleep rough outside accommodation no one lives in. It is a stark picture of the failure of the housing market. 

This aspect of homelessness is the one that government can do most about. Brooke Blair was fundamentally right – Prime Ministers need to build more houses for those who need them.   

A poverty of relationships 

But homelessness is more than house-lessness.  Homes are more than bricks and mortar: they are places of relationships. 

And if you talk with anyone sleeping rough, you are likely to hear of relationships that have gone wrong with partners or with their wider family. Some are fleeing abuse or domestic violence; some have been perpetrators. Relational problems are often a key source of regret and shame; where people carry their deepest scars. 

In our concern for people’s rights to the resources they deserve, we should not lose sight of where humans find true meaning and fulfilment. We all have a deep need to know and be known, to love and to be loved.  We cannot get away from the importance of relationships and a sense of belonging. 

A poverty of identity 

Finally, and most deeply, is the issue of people’s inner identity. The essential relationship that everyone has with themselves.    

The rise in mental health problems are symptoms of a vulnerability of our inner well-being.  For people affected by homelessness, their experiences of exclusion and trauma are both a root cause and an on-going reason for their mental fragility.  

And the addictions to alcohol or drugs which are common to many rough sleepers are deeply connected to these psychological vulnerabilities.  Drugs become a form of self-medication to ameliorate pain.  And however negative, the lifestyle required to maintain addictions can be relatively exciting and can provide each give a day a clear goal. It can be hard to leave such an identity and embark on a demanding journey of recovery.

Homelessness doesn’t just end in a flat. It truly ends in community and connection.

So, in short, homelessness is far more than house-lessness. Houses are a key resource but homes are primarily places of relationships and identity. And the restoration of these cannot be just done by the government. It requires a whole community. 

Thirteen years ago, a Christian couple in Peterborough, Ed and Rachel Walker chose to invest their own inheritance into a house for people who were homeless.  The idea inspired others: it was simple and innovative: encourage people with wealth to invest in homes for those who are poor. And each home was attached to a local church which provides friendship and support and a critical sense of community.  

This is the roots of Hope into Action where I now work. We are now a national charity with 106 homes across the country and last year we housed over 400 people. Our model is a holistic response to the types of poverty I have described.  

Our tenants are provided with the resource of a great house where they feel safe and secure. And this is combined with relationships with housemates and the support of local church volunteers. And our whole focus is to empower our tenants to find a more positive identity: whether through purposeful work, on-going recovery or through exploring faith. Last year, fifty percent of our tenants chose to engage in church activities and six took the step to be baptised. 

Homelessness doesn’t just end in a flat. It truly ends in community and connection. In our work we see justice and generosity in how resources are shared, compassion in the relationships that are formed, and hope on which people can rebuild a positive identity. Just as a lone rough sleeper is an icon of poverty, each of our tenants is a symbol of hope. 

Article
Assisted dying
Death & life
4 min read

The cold truth of Canadian lives not worth living

Canada’s implementation of medical assistance shows that a society considers some lives not worth living.

Mehmet Ciftci has a PhD in political theology from the University of Oxford. His research focuses on bioethics, faith and politics.

A IV drip bag hangs from a medical stand.
Marcelo Leal on Unsplash.

Alan Nichols’ application for euthanasia mentions only one health condition as the reason for his request: hearing loss. “Alan was basically put to death,” according to his brother. He was hospitalized after being found dehydrated and malnourished in his house. He asked his brother to “bust him out” of the hospital as soon as possible. A month after being admitting, he was euthanized through MAID (medical assistance in dying), despite the desperate objections of his family and his primary health practitioner. They were informed of the procedure over the phone only four days before it took place. They have since reported Alan’s case to the police; they argue he was not in a fit state of mind to understand the procedure or make decisions for himself. He had no life-threatening conditions. He was vulnerable. 

Canada’s relaxed laws around MAID came to international attention when CTV News reported that a fifty-one-year-old woman chose MAID after failing for two years to find housing that would allow her to manage her multiple chemical sensitivities. Despite the best efforts of friends and even her doctors to get her suitable housing in Toronto, letters left behind documented her desperate yet fruitless search for help. She begged officials at all layers of government to help find an apartment free from the chemicals and cigarette and marijuana smoke that worsened her symptoms. “The government sees me as expendable trash, a complainer, useless and a pain in the a**,” she said in a video days before her death. 

These are only some of the terrible stories that have been reported after Canada became the first Commonwealth country to legalise assisted suicide and euthanasia. Advocates of MAID will point to how comfortable Canadians are with it. As a recent poll revealed, MAID is supported by 73 per cent of Canadians, with 27 per cent supporting MAID even if the only affliction is poverty, 28 per cent for homelessness, and 20 per cent for any reason whatsoever. Those numbers may shift as disability activists and medical professionals continue to raise the alarm over the consequences of growing numbers choosing MAID, from 2,838 deaths in 2017 to 10,064 in 2021. 

MAID was introduced in 2016... Only those suffering from incurable diseases whose death was “reasonably foreseeable” were eligible, initially. 

There are two reasons why the Canadian example teaches us to remain firmly opposed to the legalisation of assisted suicide and euthanasia in the UK.  

The first is that the slippery slope in this case is real. Campaigners for Dignity in Dying claim they want only the legalisation of assisted suicide, not of euthanasia. The latter involves a doctor directly administering lethal drugs, without requiring the patient’s participation. (MAID permits both, although euthanasia is the method used in 99 per cent of cases.) They argue there is no evidence that legalising assisted suicide in the UK would lead to a loosening of laws over time. But this is contradicted by the timeline of events in Canada.  

MAID was introduced in 2016 following the Supreme Court of Canada’s ruling in 2015 that the criminalisation of assisted suicide violated the Canadian Charter of Rights and Freedoms. Only those suffering from incurable diseases whose death was “reasonably foreseeable” were eligible, initially. But the MAID evangelists did not wait long before complaining that this was too restrictive. The courts obliged, and in 2019 the court of Quebec found the “reasonably foreseeable” condition to contravene the Charter. In 2021 the laws were changed to allow MAID for those whose natural death was not foreseeable, but who have a condition considered intolerable by the applicant. Those suffering only from mental illnesses will be eligible for MAID in March 2024.  

The slope becomes more slippery still: the government is considering further expansion to allow “mature minors”, vaguely defined as children mature enough to make their own treatment decisions, to ask to be killed, even against a parent’s wishes.     

A society that kills those who ask to be killed has already made a choice to consider some lives not worth living,

The second lesson is about what kind of society we want to be. For a doctor to present the option of being killed, which Canadian doctors are now obliged to do whenever “medically relevant”, even if the patient does not bring it up first, does not expand patients’ freedom. It is rather an invitation to despair. This is frequently forgotten when some think that denying patients the choice to seek death is “imposing Christian values” as one cleric of the Anglican Church of Canada said. Roman Catholics, Evangelical Christians, and others have opposed MAID because a society that kills those who ask to be killed has already made a choice to consider some lives not worth living, and to invite those already made vulnerable by their pain and distress to see themselves as a burden to others. Not to mention the perverse incentives created to reduce medical and palliative care.  

We can and should support those who are frail and in need of care at the end of their lives to die with dignity, without hastening their deaths, without deeming their lives no longer worth living. Dame Cicely Saunders and other pioneers of the hospice movement have shown us what an alternative to assisted suicide and euthanasia would look like. Hospices put into practice the parable of the Good Samaritan, who responded with pity to the man beaten by robbers, bandaging his wounds and giving him a place to rest and receive care. Jesus tells the parable to show what it means to be a good neighbour to someone and how to react with compassion to suffering. What would have been the message of the parable if the Samaritan had instead reacted to the sight of the suffering man by reaching for his dagger?