Mental health and homelessness in the social service providers' outlook (Luxembourg case)

Purpose
The purpose of this paper is to explore the perception of the mental health problems of the homeless population in a high-income country (Luxembourg) by social service providers and to develop proposals for better inclusion of homeless people into the mental health services and homeless people with mental health issues into society.

Design/methodology/approach
The study was of qualitative design and conducted using a semi-structured interview method (in person). The semi-structured interviews (seven participants) were conducted to analyse the challenges, practice approaches and prospects of stakeholders or decision-makers working in housing exclusion and homelessness. A secondary thematic analysis of this content regarding mental health issues was performed.

Findings
Three main themes in the social providers’ perception were identified related to mental health and homelessness: the general view on the mental health problems of homeless people (accent on substance use disorders [SUDs], overshadowing of other mental health conditions by the SUDs); the positive impact of housing and social services on the mental health of the homeless per se (role of social rhythms, social connectedness and multidisciplinary approach are emphasised); and the need for improvement of mental health services in the country (need for the long-term timely continuing mental health support and recognition of the importance of complex intersectional and multidisciplinary solutions).

Research limitations/implications
Mental health themes were not the primary focus while research was planned and conducted. They were revealed as results of secondary qualitative data analysis. Therefore, additional mental health-focused mixed methods research is needed to verify the conclusions. The paper is written on the results of the research project “Social Housing and Homelessness” (SOHOME), implemented at the University of Luxembourg with the financial support of the Fonds National de la Recherche of Luxembourg (FNR12626464). The sponsor had no involvement in the study design, the collection, analysis and interpretation of data or the preparation of the paper.

Practical implications
The study brings together different perspectives from social workers, stakeholders and decision-makers. The results show that there are cross-field connections between homelessness and mental health that require specialised and coordinated services. The first existing approaches seem to be promising in their continuation but need to be promoted by social policy.

Social implications
To promote social cohesion in the Luxembourgish society and also to include one of the most vulnerable people, the study points to the importance of the link between homelessness and compromised mental health. Appropriate support and service provision as well as social and affordable housing play a central role.

Originality/value
To the best of the authors’ knowledge, this study is the first of its kind, revealing several social work stakeholders’ perspective on the mental health of homeless people in Luxembourg.