Neurodivergent people, particularly those who are autistic, appear to be overrepresented among people experiencing homelessness.1 Yet services are often not designed with their needs in mind. This mismatch can lead to people being misjudged, misunderstood, or missed altogether.
At Cordis Bright, we’ve been working as part of a consortium to evaluate the national Changing Futures programme, which supports people experiencing multiple disadvantage (three or more of the following: homelessness, mental ill-health, substance use, domestic violence and contact with the criminal justice system). Funded by the Ministry of Housing, Communities and Local Government and the National Lottery Community Fund, the programme also aims to support systems change in the 15 funded areas across England.
A large proportion of people experiencing multiple disadvantage are or have been homeless. That includes people sleeping rough, sofa-surfing, or staying in shelters and temporary accommodation. As part of the evaluation, we reflected with stakeholders on how well services meet the needs of different groups (see Changing Futures: Fourth interim report). Some stakeholders observed that neurodivergent people (diagnosed or not) form a significant proportion of those they support. Around a third of Changing Futures participants also reported a cognitive disability or some form of neurodiversity. This blog draws on those stakeholder reflections and the wider literature to explore the relationship between neurodiversity and homelessness, and what this means for service design and delivery.
What is neurodiversity?
Neurodiversity describes the natural variation in how people's brains work across the population. Most people can be described as neurotypical, as their ways of thinking, processing information and their behaviour align with societal norms. Neurodivergent people tend to think, process information or communicate/behave in ways that diverge from those norms in some way. There are several types of neurodivergence including autism, attention deficit and hyperactivity disorder (ADHD), dyspraxia, dyslexia, and Tourette’s syndrome, among others. For example, autistic people may have different communication preferences, sensory processing needs, and may carry out self-regulatory behaviours. Much of the current literature on neurodiversity and homelessness focuses specifically on autism.
What is the link between neurodiversity and homelessness?
As suspected by stakeholders we spoke to, there is evidence to suggest that the prevalence of neurodivergence (in particular autism/autistic traits) is high among people experiencing homelessness. However, this is not a well-explored research topic and the available studies are small-scale. For example, two small-scale studies suggest that between 12% and 18% of people accessing homelessness services may be autistic, compared to about 1% of the general population in the UK.1,2,3 Estimates of the prevalence of ADHD among people experiencing homelessness also vary.4
Research and anecdotal evidence from our discussions with Changing Futures stakeholders suggest a few reasons why neurodivergent people might be at risk of homelessness, including:
- Socioeconomic disadvantage. Not only are employment rates among neurodivergent/autistic people estimated to be lower than average, but they are more likely to be underemployed and in more precarious, lower paid and part-time jobs.5,6,7 This means that people may be less able to keep up with rent and other payments.
- Social isolation and limited support networks. Autistic adults may have smaller social networks of people on whom they can rely.6 This may be a result of challenges experienced in forging and maintaining relationships, and may be especially significant where there has been a breakdown in family relationships.
- Other compounding factors. Neurodivergence may also be linked to increased risk of other aspects of multiple disadvantage that are related to homelessness such a mental health issues and substance use.8,9,10,11
- Barriers to accessing support. Services, such as housing and homelessness services, may not be appropriately set up to meet the needs and preferences of neurodivergent people. For example, they may be overstimulating or built around rigid processes that don’t accommodate differences. Neurodivergent people may struggle to express their needs, mask traits, or lack a formal diagnosis, meaning they can get overlooked and are not prioritised.12 Behaviour may also be misinterpreted as "difficult" or "aggressive" rather than as signs of overwhelm or distress.6 This can mean that opportunities to help prevent homelessness or to support people out of precarious living situations might be missed.
How might neurodivergent people experience homelessness differently?
While research is still emerging, early studies suggest that homelessness can have distinct and compounding effects for neurodivergent individuals:
- Unsuitable accommodation. Temporary accommodation and hostels may be particularly unsuitable due to sensory sensitivities or difficulties with shared living environments.12
- Worsening mental health. Overstimulating environments, disruption to routines, and frustration with poor service fit and feeling misunderstood could lead to deterioration in mental health.12
- Heightened vulnerability. Autistic people may be at increased risk of victimisation, such as abuse or coercion into criminal behaviour.6
What are the implications for services?
Programmes like Changing Futures have supported local learning about whether specific services are working well for the range of people in need of support, including neurodivergent people, and how to improve on this. Often, adjustments made to ways of working with people more broadly can have a wider positive impact for everyone, not only for neurodivergent people. Factors that can support better provision include::
- Training. Staff need to understand neurodiversity to provide effective, respectful support. In particular, training could help staff to better recognise neurodivergence, as not everyone will have a formal diagnosis, and adapt working practices to better meet people’s needs.
- Adapted environments. Accessible, low-stimulation environments and psychologically informed environments are important for creating spaces and services that are comfortable and welcoming to people who have experienced trauma, including those who are neurodivergent.13
- Clear and concise information. Important information needs to be clear and avoid use of jargon so that people can engage with it effectively.
- Person-centred support. Individualised, flexible support is vital to accommodate the varied needs of neurodivergent people. Trauma-informed approaches which recognise the impact of people’s past experiences and aim to prevent further trauma can also help meet a wider range of needs.
- Diverse workforce. Having staff with lived experience, including of neurodivergence, can improve empathy, trust and service relevance.
How Cordis Bright can help
Drawing on our experience in the multiple disadvantage space, we understand the complex, intersecting factors that contribute to and compound issues such as homelessness.
Cordis Bright supports clients to understand and respond to issues relating to homelessness and multiple disadvantage through inclusive research, evaluation and consultation. We help identify unmet needs through data analysis, evidence reviews and meaningful engagement with stakeholders and people with lived experience.
Our evaluations use accessible methods to explore what works and for whom, for example see our EDI in project work tool: Conducting accessible fieldwork for more information about our approach.
If you would like support with research and evaluation, we would love to hear from you. Please contact Hannah Nickson on hannahnickson@cordisbright.co.uk.
References
1. Churchard, A., Ryder, M., Greenhill, A., & Mandy, W. (2019). The prevalence of autistic traits in a homeless population. Autism, 23(3), 665-676. https://doi.org/10.1177/1362361318768484
2. Kargas, N., Harley, K. M., Roberts, A., & Sharman, S. (2019). Prevalence of clinical autistic traits within a homeless population: barriers to accessing homeless services. Journal of Social Distress and Homelessness, 28(2), 90–95. https://doi.org/10.1080/10530789.2019.1607139
3. Brugha TS, McManus S, Bankart J, Scott F, Purdon S, Smith J, Bebbington P, Jenkins R, Meltzer H. (2011)Epidemiology of autism spectrum disorders in adults in the community in England. Arch Gen Psychiatry; 68(5), 459-65. doi: 10.1001/archgenpsychiatry.2011.38. PMID: 21536975.
4. Gallagher, A. (2023). Homelessness amongst autistic people and people with ADHD: a systematic review of the prevalence rates and risk factors and a qualitative exploration of individual experiences.
5. Branicki, L. J., Brammer, S., Brosnan, M., Lazaro, A. G., Lattanzio, S., & Newnes, L. (2024). Factors shaping the employment outcomes of neurodivergent and neurotypical people: Exploring the role of flexible and homeworking practices. Human Resource Management, 63(6), 1001–1023. https://doi.org/10.1002/hrm.22243
6. Garratt, E. & Flaherty, J. (2023) ‘There’s nothing I can do to stop it’: homelessness among autistic people in a British city, Disability & Society, 38:9, 1558-1584, DOI: 10.1080/09687599.2021.2004881
7. Putz, C., Sparkes, I., & Foubert, J. (2021). Outcomes for disabled people in the UK: 2020. Office of National Statistics, 1-27.
8. Hollocks, M. J., Lerh, J. W., Magiati, I., Meiser-Stedman, R., & Brugha, T. S. (2019). Anxiety and depression in adults with autism spectrum disorder: A systematic review and meta-analysis. Psychological medicine, 49(4), 559-572. doi:10.1017/S0033291718002283
9. Katzman, M. A., Bilkey, T. S., Chokka, P. R., Fallu, A., & Klassen, L. J. (2017). Adult ADHD and comorbid disorders: clinical implications of a dimensional approach. BMC psychiatry, 17(1), 302. https://doi.org/10.1186/s12888-017-1463-3
10. Ressel, M., Thompson, B., Poulin, M. H., Normand, C. L., Fisher, M. H., Couture, G., & Iarocci, G. (2020). Systematic review of risk and protective factors associated with substance use and abuse in individuals with autism spectrum disorders. Autism, 24(4), 899-918.
11. Rohner, H., Gaspar, N., Philipsen, A., & Schulze, M. (2023). Prevalence of Attention Deficit Hyperactivity Disorder (ADHD) among Substance Use Disorder (SUD) Populations: Meta-Analysis. International Journal of Environmental Research and Public Health, 20(2), 1275. https://doi.org/10.3390/ijerph20021275
12. Stone, B., Cameron, A., & Dowling, S. (2023). The autistic experience of homelessness: Implications from a narrative enquiry. Autism, 27(2), 489-499.
13. Keats, H., Maguire, N., Johnson, R., & Cockersall, P. (2012). Psychologically informed services for homeless people. Dept of Communities and Local Gov.