Edinburgh Napier University

  Background: Research suggests that homeless people experience higher levels of mental and physical health problem than the rest of the population. Despite the greater need for healthcare, many homeless people face additional problems in accessing appropriate and timely healthcare. In 2004, an evaluation of a specialist physiotherapy service for homeless people in Glasgow revealed a need to raise awareness about physiotherapy and the services available amongst homeless people. While the Glasgow physiotherapy service stopped in 2008, this study re-visits the provision of physiotherapy services to homeless people, 10 years on, evaluating ‘StreetSmart’ a voluntary physiotherapy homeless service in Edinburgh.
Purpose: The purpose of the present study was to evaluate a specialist physiotherapy service for homeless people.
Methods: Semi-structured interviews were conducted with four homeless people who had made use of ‘StreetSmart’ (4 males, 29–45 years), three homeless people who had not used the service (3 males, 23–55 years) and four physiotherapists who were volunteers at ‘StreetSmart’ (3 males, 1 female, 29–42 years). Using an interpretative phenomenological approach participant's views and experiences of ‘StreetSmart’ were explored.
Results: Five themes were identified from the data. These included (1) Barriers to mainstream services, (2) Value of Physiotherapy for the homeless, (3) Views of the Physiotherapy Service, (4) Physiotherapy and homeless people, and (5) Future of the service.
Similar to the evaluation in 2004, barriers to mainstream services including personal barriers, access difficulties and the bureaucracy of the health system making access to healthcare difficult were identified. In contrast to findings from 2004 participants recognised the value of Physiotherapy for the homeless highlighting the physical and mental health benefits of physiotherapy. Participant's views of the specialist physiotherapy service included both positive and negative aspects. In agreement with 2004 findings, participants identified the diverse needs of the homeless population highlighting that one system for providing physiotherapy may not suit all homeless people.
Conclusion(s): The study provides evidence for the perceived value and benefits of a specialist Physiotherapy service for homeless people. Similar to findings from an evaluation 10 years earlier, one approach to providing physiotherapy services would not suit all homeless people as there is a diversity of needs. The need to raise awareness of what physiotherapy can offer and the availability of the specialist physiotherapy service continues to be an issue as it was in 2004.
Implications: Participants in this study highlighted that for some homeless people there are barriers to accessing mainstream physiotherapy services. However, for other there was a preference to make use of mainstream services. To support homeless people in accessing physiotherapy both mainstream and specialist services are needed. There continues to be a need to raise awareness of physiotherapy and the physiotherapy services available amongst homeless people.