#OTalk 18th Feb 2020 – Homelessness

This week Ruth Hawley @Ruth_Hawley and Beck Skelton @WintRebecca will be hosting here is what they had to say.

Homelessness is a growing issue within the UK and other countries.  The issue of homelessness is wider than being roofless and rough sleeping and includes those who don’t have the right to stay where they are, sofa-surfing or in temporary accommodation, and can be those with insecure or inadequate housing for their needs (Shelter, 2019).

The experience of being homeless impacts on occupational performance, participation and identity (Chard et al, 2009; Cunningham & Slade, 2019; Williams & Stickley, 2011) and those who experience homelessness can have complex health and social care needs and be at risk of occupational deprivation and injustice (RCOT, 2019).  

Occupational therapy, therefore, has much to offer for working with those who experience homelessness.  Indeed, homelessness has been the topic of the recently produced RCOT evidence spotlight which outlines some key reading and evidence available (RCOT, 2019).  A networking day in October 2019 at RCOT on Occupational Therapy and Homelessness saw a group of experienced and enthusiastic Occupational Therapists come together to discuss this topic, learn more about it and consider how to advance practice in this area.  As was evident on the day, occupational therapists can work with people with homelessness in many different contexts across physical health care, mental health care, in housing adaptations and social care settings as well as third sector or charity settings.  

Beck Skelton, an Occupational Therapist in Leeds has been working for a third sector organisation funded by Leeds CCG for 2 years. During 2018-19 over 160 people accessed the Occupational Therapy service. The work is varied as people present with a range of functional difficulties as a result of physical, psychological and social conditions. The role is temporarily funded as with many diverse roles. 

As identified on the networking day, to support occupational therapy in this area it would be helpful to have greater development of the OT role in working with people who are homeless, more research evidence and policy guidelines and to establish an effective forum for clinical support and sharing of good practice across the UK. 

In order to support these aims, Beck Skelton (Occupational Therapist working at homeless charity in Leeds) and Ruth Hawley (Senior Lecturer in Occupational Therapy at Derby University) would like to host this OTalk considering the following questions: 

Q1. Do you have any experiences of working with people who are homeless?

Q2. What do you think are the occupational needs of people who are homeless?

Q3. What do you think the occupational therapy role is when working with people who are homeless?

Q4. What do you think would be good next steps to support the development of this emerging area for occupational therapy? And how could these be implemented?


Boland, L. and Cunningham, M., 2019. Homelessness: Critical reflections and observations from an occupational perspective. Journal of Occupational Science, 26(2), pp.308-315.

Chard, G., Faulkner, T. and Chugg, A., 2009. Exploring occupation and its meaning among homeless men. British Journal of Occupational Therapy, 72(3), pp.116-124.

Cunningham, M.J. and Slade, A., 2019. Exploring the lived experience of homelessness from an occupational perspective. Scandinavian journal of occupational therapy, 26(1), pp.19-32.

Shelter (2019) What is homelessness? Available at: https://england.shelter.org.uk/housing_advice/homelessness/rules/what_is_homelessness   [Accessed 31 October 2019] 

RCOT (2019), RCOT Evidence Spotlight: Homelessness. London: RCOT

Williams, S. and Stickley, T., 2011. Stories from the streets: people’s experiences of homelessness. Journal of psychiatric and mental health nursing, 18(5), pp.432-439.

Post Chat Updates:

Online transcript from HealthCare# Project.

PDF of transcript #OTalk 18th February 2020 Transcript

The Numbers

1.924M Impressions
551 Tweets
77 Participants

#OTalk Participants


1 thought on “#OTalk 18th Feb 2020 – Homelessness”

  1. I work with homeless people in my capacity as an occupational therapist in orthopaedics in a very large inner city hospital. We face increasing problems discharging people safely and often have no recourse other than the third sector such as the one Becks works for. Many homeless people have an aversion to using this sectors’ resources and refuse to go to the homeless shelters. They are often scared and ill informed. In addition they have numerous co-morbidities including mental health issues making them extremely vulnerable. The hospital has few options with many homeless people other than to insist they leave. Our resources are finite and under pressure too. We have little time and few resources to follow up these people once they leave hospital. We rely on people like the hosts of this talk to pick up the pieces. The homeless are a complex group and the fixes are many and usually slow to achieve. I believe one of the keys to helping these people is to reduce or remove fear from their lives. A tough ask but only then can you tackle the root causes of their homelessness.
    We hospital based OT’s need the ability to carry on working with this group and build links with the third sector to support these OT’s to get that seamless handover once they are discharged. Becks and others like her need certainty of employment first and foremost. Our hospital trust could fund a position like hers, preferably more than one Becks, to get this seamless handover. She could be introduced to this patient group while they are in hospital and follow them out into the community. This alone could reduce the fear factor making further intervention more likely to succeed.


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