Letter: Few homeless see psychiatrists

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Sir: I am a psychiatrist who works exclusively with homeless people in south-east London. I was surprised to read Adam Blue's letter (16 January), in which he suggested that hostels for the homeless routinely require their residents, as a condition of stay, to see a psychiatrist.

Where do they find all these psychiatrists?

Our team has the equivalent of one-and-a-quarter full-time psychiatrists. We accept referrals from 15 different direct-access hostels across south- east London with a total of around 500 beds.

Out of the more than 5,000 people who use these hostels every year, around 350 people are referred to the team. Many of those referred never see a psychiatrist, but are helped by another team member, usually a psychiatric nurse or social worker.

We are pushed to see even these numbers. So even if they wanted to, which I don't believe they do, these hostels could not get a psychiatrist to see every resident. Workers with similar teams in other parts of London tell me they have no greater access to psychiatrists' time than do we.

Hostel staff do refer residents to us, but this is usually for the very good reason that they are concerned for the welfare of the resident.

Of course, some will resent this interference. However, the overwhelming majority of those referred to services such as ours continue to see psychiatric staff entirely voluntarily.

This notion that psychiatric assessment is a condition of staying at such hostels may well discourage people from using them, but it is without foundation.


Senior Lecturer in Community Psychiatry

Guy's & St Thomas's UMDS

London SE1