The high prevalence of complex and gendered-related issues affecting the lives of homeless women makes it important for social workers to build meaningful and trusting relationships with this hard-to-reach group. Homeless women "are used to making themselves invisible in order to survive" and many barriers currently prevent them from accessing the services they need. But when homeless women feel valued and listened to, they are able to begin to take control of their own lives.

These new findings come from the Bristol TARA project, a longitudinal study of the service use and needs of homeless women led by Dr Emma Williamson at the University of Bristol. Interviews over 18 months with a group of homeless women aged 19 to 59 confirmed their ongoing struggle to survive the impact of a large number of traumatic, and often gender-related, life events. These included experience of childhood abuse, mental health problems, domestic or sexual violence, drug or alcohol dependencies, sex work and involvement with the criminal justice system. More than half the women reported having at least six of these problem areas to deal with and their experiences contributed to the multiple service needs they identified. The research team interviewed 38 women initially, 28 women six months later and 22 at a third and final interview. Information was collected from various sources about participants who dropped out of the research.

The study also interviewed 15 practitioners, from a range of services, asking both general questions about their roles and experience, as well as about their experiences of working specifically with individual clients.

Often homeless women may not sleep rough but end up in precarious, and often dangerous, places instead, thereby contributing to their invisibility. Both service users and practitioners recognised the need for a pivotal key worker to facilitate access across services, share information between workers, and improve joint working across agencies. A meaningful and trusting relationship was crucial for maintaining contact with women who might be moving and changing phone numbers several times within a short duration.

Strikingly, none of the study's participating homeless women referred to having a social worker for themselves as adults. They did refer to mental health teams, workers within housing services and a wide range of third sector support workers. This finding suggests that other workers, often housing support workers, are currently fulfilling functions that in the past social workers would have carried out, for example by providing and co-ordinating services.

The study's experiences of interacting with homeless women may be relevant for social care staff. The women said they had found it "humiliating and disempowering" to have to re-tell their life story to a large number of practitioners, over and over again. In order to recognise that homeless women may not feel safe or ready to disclose traumatic personal information, questions needed to be asked at different points in time and not just at an initial assessment, confirming that repeated contact is essential. For example, the issue participants found most difficult to discuss concerned whether they had had any children and this often only emerged at later interviews.

A number of practical lessons were learnt that improved the ability of researchers to maintain contact such as: not telephoning in the morning, as those on medication take time to surface, as do sex workers; recognising that women may have no credit on their phone and that some were very wary of calls from numbers they did not recognise. A short text message confirming identify and indicating that a call would be made from the same number in five minutes proved surprisingly effective.

Many women, including those who had made progress over the course of the research, still felt vulnerable at times to relapse and felt that some form of ongoing, low level support (such as 'on demand', infrequent telephone contact with a pivotal key worker) would reduce the risk of them, and other homeless women, re-entering the system. The study concluded that "commissioners need to recognise that limiting provision to only short term interventions is an inefficient use of resources, and a failure of care, if it results in women becoming homeless again".

The summary findings from this research can be viewed here