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Finding the key that opens the door

7th February 2017

Thea Fitch, one of our London Homeless Health Programme board members, writes about her experience of homelessness and how NHS clinicians and staff can support people who are homeless.

Just like anyone else, people who are experiencing homelessness deserve the chance to have a meaningful and satisfying life.

Part of the role of someone working in health and social care is to remind people who are homeless (who are probably facing all sorts of complex health and housing challenges) that they are valued. We need to let them know that they have just as much right to care and compassion as anyone else.

Leaving home at 16 was the start of a long personal journey into homelessness for me, and a 20 year battle with complex mental and physical health difficulties. After several intensive hospital admissions, time spent sofa surfing, in hostels, and insecurely housed, I became what is often termed a ‘revolving door patient’, with little hope of finding a way out.

I now have a place I can call home, a place that feels safe and warm and where I have the choice to stay for as long as it suits me. I have a job that I love working in mental health for the Central and North West London NHS Foundation Trust, supporting other people in their recovery and wellbeing. I have skills and strengths that health care and social workers helped me to find and build on.

I know only too well the barriers to getting treatment when you are homeless. You don’t have support or any hope that things can be different. You lack the confidence and understanding of unfamiliar health care systems. You feel undeserving and worthless. These things can make it impossible to identify the help you so desperately need, never mind figure out where to get it.

This is why the London Homeless Health Programme’s work to improve accessibility and health services for people who are homeless is so important. Without getting input from people who are homeless in London themselves, it will be much harder to provide appropriate and effective health services for this community. The programme recognises this and through peer led focus groups, which I was involved in, produced the ‘More than a Statistic’ report. This report has given people who are homeless in London a voice.

What helped me to stop the revolving door, and to find a home, was being seen and respected as an individual. Not being defined by my problems or my label of ‘damaged’ or ‘vulnerable’ or ‘homeless’. This is why I am so pleased to be involved with the work of the London Homeless Health Programme. As one of the peer researchers running focus groups with rough sleepers, hostel dwellers, sofa-surfers, asylum seekers and the chronically insecurely housed I felt the power and value of hearing first hand about people’s experiences of accessing health care. There is power in respecting the impact of lived experience. It can change how we deliver services so that we provide care in a way that is meaningful to people, and therefore potentially more effective.

Being homeless is hard. People need respect, compassion and empathy. They need to be seen, heard and valued. People usually don’t end up homeless because they have had easy lives up to that point. Having no security, no stability, no support system, along with the demoralizing and damaging effect that homelessness can have on mental and physical health, means just surviving feels like a battle. We need to do everything we can as health care workers to break the cycle, the revolving door. I would urge all health care workers to read the ‘More than a statistic’ report. People who are homeless deserve to have their voices heard.

About the author

Thea Fitch is currently working for Central and North West London NHS Foundation Trust as a Senior Recovery Trainer, the Physical Health and Wellbeing Lead for the Recovery and Well being College. Her history of homelessness and mental and physical health challenges has meant that she is passionate and dedicated to supporting people to feel empowered, valued and hopeful.

For more information about our Homeless Health programme contact Susan Harrison, Head of Health & Homeless for the NHS across London, at



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