With low levels of voter registration among people who are homeless, and a deadline of 22nd May to register for the General Election; can homelessness services increase democratic engagement in time to make a difference?
Empowering people to bring back their smile
My name is Rob and I’m one of the Peer Researchers involved in Groundswell’s Healthy Mouths Health Audit. We spoke to over 260 homeless people from across London about their oral health, including people who are street homeless, people living in hostels and people in other insecure accommodation. The great thing about ‘Peer Research’ is that we use our personal experience of homelessness to shape the research and deliver all the fieldwork. This means participants are more likely to trust and answer your questions honestly. We wanted to create a clear picture of the state of homeless people’s oral health, what the driving issues are and to understand the impact this is having on people’s lives.
Before joining the staff team at Groundswell, I volunteered as a Homeless Health Peer Advocate, supporting people one-to-one to make and attend health appointments. This role involved helping people to identify any health concerns and encouraging them to take control of their health. Dental issues were a very visible problem and it was really common for people to report that they were in a lot of pain. Going to the dentist was always a difficult appointment to get people to – in fact; it has one of the highest dropout rates of all of our appointments. The research was aimed at better understanding why this was such a big issue for people.
We learnt that Dental problems are having a really damaging impact on homeless people’s quality of life. It’s a widespread issue with 90% of people having had a problem with their mouth since they have been homeless. In one of my early surveys, I was interviewing someone who had been in chronic dental pain for more than two years. The pain was so severe that he could only eat soups or food that didn’t involve having to chew.
Attendance at the dentist was far lower than the general population and this was often due to the practical barriers and competing priorities that homeless people can face when trying to use mainstream services. A key example of this was how confusion around entitlement to NHS treatment was so widespread among participants - 58% of participants were unclear what they were entitled to with an NHS Dentist.
There are practical steps that homelessness services can take in supporting people to maintain good oral health. Sometimes it’s about providing the tools, like having tooth paste and tooth brushes readily available and making sure that people know they are on offer. Another step is to provide more low sugar food options. 60% of people surveyed are classified as high sugar users. When I was running focus groups people expressed that they were always given plates of biscuit and cakes – but they wanted healthier options.
It’s also important to get to know and understand the issues that may be stopping someone from getting the help they need. For some people, it could be as simple as bringing up the topic in conversation and finding what is preventing them from making a dental appointment.
I spoke to a number of participants who had been encouraged, in some cases press-ganged, into going to the dentist by a support worker at their hostel. There was one gentleman who had not been to the dentist in over 15 years and had been in a lot of pain. He had just had a new key worker assigned to him, she took the time out to talk to him about his oral health and discovered that he was scared of the dentist because of a past negative experience. His support worker had gone out of her way to take him, even coming in on her day off. It made all the difference for him – he went to the dentist and stuck out a course of treatment. It’s worth checking whether anyone needs support to attend – over half of participants told us that they would be happier to go to a dentist if they had someone to go with them.
It’s also worth getting to know your local dentist and introduce your service to the dental practice. This will help them get a better understanding of your client group that they will be working with.
We’ve produced an ‘Action Guide’ based on the research – it’s designed to help people to make better use of the dentist by preparing information before they go. It also offers handy hints and tips on how to keep your mouth healthy.
The people we spoke to really wanted to get their teeth sorted – they just needed the opportunity to do it.
You can read the report and see our Action Guide at www.Groundswell.org.uk/Healthy-Mouths/
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Groundswell Peer Researcher
Rob has been involved with Groundswell for over two years. He began volunteering with Groundswell in 2014 offering one-to-one support as a Homeless Health Peer Advocate, first specialising in supporting people diagnosed with tuberculosis. Rob is also a board member for the London Homeless Health Programme.
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