Encounters with homelessness are a part of life for city dwellers around the world. However, since the recession of 2007 the numbers of Europeans directly affected has intensified. Ruth Mattock, who is currently living in Paris, compares how homelessness is being tackled by British and French organisations.
On 18 March 2014, a small crowd gathered in the centre of Paris to remember the 453 homeless people who died on the streets of France in 2013. They are unknowns – remembered by a first name, a nickname or only a street number – but the collective Les morts de la rue hopes the ceremony will draw attention to premature death caused by living on the streets, a trend that has accelerated over the last few years.
Coming from the UK, I was struck by the situation in Paris. Homelessness is prevalent in the UK, but the visible population generally has at least a basic level of physical health, and I had never seen a child on the street. In Paris, there are people begging on every corner, sleeping in every metro station, lying on hot air vents in winter and rummaging in rubbish bins. They are very old and very young: families with small children sleep on the pavement at night, and encounters with mental illness and alcohol abuse are routine. Some are well presented; others have been severed from society too long, and live in rags and cardboard.
Perhaps because the problem is so visible, voluntary activity is popular. The Restos du Coeur alone, a food provision charity with which I currently volunteer, has over 60,000 volunteers, whereas the UK’s Crisis has 10,000. The Restos demand no specific skills, limited time commitments and it’s easy to get involved. By contrast, UK volunteering often involves applications, criminal record checks and even interviews.
The accommodation efforts are as impressive in scale, with thousands of beds available each night, through state and charity organisations. As part of a winter campaign in Paris, vulnerable people can be taken to the warmth of the metro stations, or given a bed in one of the sports centres commandeered for three-week periods, when beds are not available elsewhere. But the Samusocial, the state service responsible for allocating these beds, is overloaded, and turns away 31 per cent of eligible requests. The energy of the effort is disproportionate to such short-term results.
The French seasonal plan attempts to cater for the more pressing hardships of the winter months, but means that part of the service disappears on or before May 1st, increasing the weight on other services overnight. In temporary (rather than emergency) accommodation, French councils are obliged to guarantee one place for every 1000 of the population, but this takes no account of regional variation and the demand is far higher than provision.
In an attempt to reach the most isolated, Paris has a complex system of maraudes, whereby small teams, state and charity-run, cover a certain area of the city, approaching those in need with food and social contact. This regular contact provides a considerable source of knowledge about a person’s changing health, circumstances and problems. But coordination is limited, and information tends to move horizontally between volunteers, rather than vertically towards an action plan.
A key problem apparent in the homeless community is mental health, with French reports claiming one in three are affected by psychological issues. The corresponding UK figure is 70 per cent, which suggests the former has been underestimated. To improve access to care, in Paris specialised maraudes have recently been developed with teams of mental health and social workers (Équipes Mobiles de Psychiatrie et Précarité/EMPPs) in Paris, linked to hospitals. But here, too, expenditure is disproportionately high for limited results, perhaps due to what some would consider an outdated attitude to mental health. In France, the percentage of hospitalised patients is higher than those in other care programmes. Hospitalisation costs around €1000 a day, meaning that hospitals are rarely willing to take on a homeless person long term. More varied care plans are difficult to implement, as treatments like cognitive behavioural and occupational therapies are not widely available.
Of the people I have met on the streets, some have been outside the same supermarket or under the same bridge for years, even decades. Some have spent odd weeks in hospital, on ‘cures’, or spent a few nights in hostels, but too often they find themselves back on the same pavement, ever more accepting of their lot. Emergency measures teach them to survive there, rather than how to escape. Given the intensity and willingness of the existing efforts, better coordination and long-term plans could have an important effect. And there are signs of change. The Un chez soi d’abord scheme, following the US and Canadian ‘Housing First’ model, is being piloted in several French cities, giving participants a permanent residence and personalised care schemes as step one to reintegration. Stability, if it is to be the endpoint, has to be present from the start.
The views expressed in this article are those of the author and do not necessarily represent the views of Development in Action.
Have an opinion on this or another topic? Why not write for our blog? Click here to find out more and get in touch.