I’m standing in the street on a cold December morning trying to persuade James to come into hospital. He’s been reluctant to see me, his psychiatrist, but he eventually agreed as long as it was out here in the open because, as exposed as we are, this feels safer to him.
Our frozen breath hangs in the air, punctuating our conversation and he’s shivering, having spent the night in a shop doorway in Leeds. He’s not dressed for these conditions and his few possessions including his smashed dead phone lie pitifully next to him where he sits on a small patch of frosted grass. I hear his belly growl and he tells me he hasn’t eaten for a couple of days. He is perilously thin and I think he’s lost a couple more teeth.
As we talk, a heavily wrapped older acquaintance from the streets interrupts us to ask James for the money that he lent him two days ago. “Tomorrow, I promise” he apologises and the bearded man limps away, muttering profanely.
James wants neither hospital nor treatment. What he wants is something I can’t give him. Shelter.
There is no doubt that James’s mental illness has contributed to his current situation. He has unusual ideas about terrorism and torture which he feels compelled to share very forcefully with those around him. Even as we speak he jumps up to accost passers-by, to warn them of these dangers. They hurry away, frightened by his perceived aggression and his disturbing apocalyptic prophecies.
His behaviour towards others has accelerated his spiral downwards from having a flat of his own to these desperate straits. Problems with neighbours started him along a track of emergency accommodation, grubby bed and breakfasts, hostels and drug rehab placements until he was finally expelled, at the end of the line, from the homeless shelter.
Along the way he has been exploited by unscrupulous private landlords with their terribly neglected properties and he has been shunned by family and friends who care but who cannot cope with his intensity. And each exclusion has made him all the more difficult to house and increasingly vulnerable.
Christmas is traditionally a time when we are asked to consider the homeless. This year, as with so many issues, the vogue has been to add a “mental health” tag. Whilst this tag is frequently a trivialising distraction its relationship with homelessness is something we really should talk about.
Privileged commentators have suggested that homelessness and rough sleeping should be considered separate entities. James’s unhappy story clearly teaches us that they lie upon a continuum. And when we think about what it means to be “home”-less for those with mental illness we must look beyond a question of mere shelter to all of those currently languishing in hospital and long term out of area placements, as well as the myriad of hostels and tenuous temporary accommodations. None of us would think of these places as our homes.
The song “The Streets of London” calls on us to open our eyes to the untold stories of others including the homeless. The familiar line “So how can you tell me you’re lonely and say for you that the sun don’t shine” brings to my mind all those I support who face another Christmas on the streets. We will try our best this year to help them find somewhere warm to “celebrate” the festive season. In Leeds, as in London, homeless shelters prepare to open their doors to all if the temperature drops below zero but surely we must do more as this is a public health crisis, worsened by cruel austerity, which we can’t continue to ignore.