Study provides evidence of link between autism and homelessness

Jun 13 2018

The first peer-reviewed study into autism and homelessness has been published, in the journal Autism.

The researchers found evidence suggesting that autistic adults are over-represented among the homeless population. They have called for more research to understand the links between autism and homelessness, to help prevent autistic people becoming homeless and to improve support for those who are already homeless.

Existing research & method

Anecdotal reports from autism clinicians and keyworkers, as well as two small studies from a few years ago, have suggested that there may be high numbers of autistic people in the homeless population. But this is the first academic research looking at this issue properly.

The researchers attempted to fill this gap by gathering initial evidence about the prevalence of autistic traits in homeless people. They worked with one homeless outreach team is the UK and screened 106 people they support to see if they could be autistic.

Results & discussion

12.3% of homeless people had a range of autistic 'traits' in line with diagnostic criteria. This is substantially higher than the general population autism prevalence of 1%. It is not clear that this 12% were actually autistic, but the screening suggested that they could be.

Writing in the journal, Autism, the researchers said: "If autistic difficulties are common among homeless populations, then this has important implications. Many people are homeless in the United Kingdom; the most recent estimate is that there are almost 5000 rough sleepers at any one point (Ministry of Housing, Communities and Local Government, 2017), and there is a much larger group of people with no stable accommodation who are termed the 'hidden homeless' (Crisis, 2017). There may therefore be a considerable number of homeless autistic adults who are not having their needs met and who are in an extremely vulnerable position."

Alasdair Churchard has a doctorate in Clinical Psychology from University College London and worked on this study alongside Morag Ryder, William Mandy and Andrew Greenhill. He said: "Our research shows that autistic people may be at higher risk of becoming homeless than the general population.

"It is well-known that life for homeless people is extremely mentally and physically hard, and those who are autistic are likely to have additional vulnerabilities which would only make their lives more difficult.

"Further research is required in this area, and we have been working with professionals in the homelessness field to raise awareness about the potential links between autism and homelessness."

Sarah Lambert, Head of Policy at the National Autistic Society, said: "This is an important and robust study, which suggests that there could be a significant number of autistic adults who are homeless - and potentially living without an understanding of their needs or appropriate support.

"It's well established that many autistic people struggle to get the support they need and face huge difficulties throughout their lives, including high rates of mental health problems, underemployment and social isolation. We've heard anecdotal reports of autistic adults falling through gaps in support and into homelessness but there's very little research into this or awareness of this as an issue.

"This is the first peer-reviewed study to provide initial evidence of a link between autism and homelessness and provides an important platform to get to grips with this issue. We now need further research to investigate this link, and to develop the right support for homeless autistic people and to prevent those at risk from falling into homelessness in the first place."

"Homeless autistic people have gone unrecognised and unsupported for far too long."

Case study

Dr. Andrew Greenhill, a clinical psychologist also involved in the research, said: "One person that stands out for me is an older man who had lived on the street for 45 years, in an inner city.

"He ran away from his family home because his relationship with his father was so poor and physically abusive. He then survived by following a regular routine and sleeping in the same place every night, relying on the food made available at day-centers and drop ins. He refused all professional help or contact, and existed in a 'bubble' whereby he refused all attempts to engage. It was clear that he found social engagement of any kind very distressing and was highly motivated to avoid this.

"Eventually he was admitted to hospital after it appeared he'd had a stroke, and was unable to care for himself. He eventually accepted a room in a low intensity 'cottage hotel' hostel, where there were few, if any expectations about things like form filling, attending meetings or assessments. He has since managed to maintain his preference for privacy and solitude whilst having his basic needs met, with support workers around to keep an eye on him and to help out if any difficulties arise."