During the autumn of 2021, Ideas Alliance teamed up with Groundswell to present a series of live screenings of Clarissa, a film created to help share the experiences of people affected by homelessness while accessing healthcare. The audience was made up of invited healthcare practitioners, NHS staff and staff working in homelessness support services, who all play a vital role in engaging people who are homeless with health services. People were keen to participate and spread the word amongst their networks. Each screening was followed by a discussion which helped the audience reflect on the health-inclusion issues raised in the film and to consider how small changes in practice or policy could create healthcare systems and experiences that work better for everyone. 

Clarissa was made by Chris Godwin from Inner Eye Productions in collaboration with Groundswell. Groundswell works with people with experience of homelessness, offering opportunities to contribute to society and create solutions to homelessness. Participation is at their core, because they believe that experience of homelessness is crucial in making decisions that affect lives and ultimately help people to move out of homelessness. Inner Eye Productions works with organisations who are looking to change mindsets, generate engagement and inspire innovation. Their approach is rooted in the power of film to inspire people to reflect on their own lives and think differently about others. Their films help change behaviour, but also systems, process and in some cases policy. The project has been funded by the Wellcome Trust.

Altogether, more than 500 people signed up to watch the showings. Even though the film, with the exception of London (which was an in-person event), was streamed online, the showings were organised into regional or country-wide events to encourage a discussion relevant to that area. Panellists and chairs for each event were invited from local healthcare, housing and homelessness support networks. Some of the people were known to Groundswell but many were researched and contacted and so, bringing all of these people together was a strength of the project in itself. 

The discussion sessions highlighted the need for a greater understanding of the impact of historic trauma and abuse and/or adverse childhood experiences in all areas of the workforce from administration to senior management. For example, Vicky O’Sullivan a Gateway Project Coordinator for Calico Enterprise said,

‘I’m currently managing a 30-bed supported housing unit in Burnley working with the homeless with complex needs and feel this is a great tool to use for learning within my team. It really shows cases the aspects of trauma we are supporting with on a day-to-day basis and how an individuals’ frustrations at times can be miscommunicated as aggression or reluctance to engage.’

Often, Clarissa was framed as a catalyst for change, exemplary of good health advocacy and compassionate, trauma-informed care, which could be used to generate greater empathy and understanding of people experiencing homelessness while accessing healthcare. Dr Wan-Ley Yeung had a conversation with a fifth year medical student who thought it should be shown at every medical school and said,

‘Set the seed early on in the career of medics so they have a greater understanding of the issues facing people affected by homelessness.’

Also high on the themes that arose from the discussion was the need for care, empathy and compassion as well as time to build trust. Flexibility, collaborative working, and co-production methods were valued where the input of those with lived experience of homelessness is built into services from initial design to final implementation. The resulting project report acknowledged that this will create a more barrier-free, inclusive healthcare experience and one that acknowledges the complex interactions between healthcare and homelessness, beyond the issue of housing to encompass both health and social care. 

Discussions became a space for reflection on practice, networking and sharing of resources, noting the difficulties of providing a good service for people experiencing homelessness that best meets their needs. For example, the complexities of registering with a GP, despite continued work in this area, including initiatives such as Groundswell’s ‘My Right to Healthcare’ cards to support registration.

Health inequalities highlighted across the country were further complicated by a lack of time and funds. Health outreach roles (such as the one played by Jenna, the nurse depicted in Clarissa) are not currently funded in many areas, as much as they are needed. 

The value of frontline work and research being undertaken highlighted a general sense of cultural change in attitudes towards those experiencing homelessness. Rosemary Stennett who works for an NHS Commissioning Organisation in London wanted to share the Clarissa with her whole team, she said,

‘I believe they should all watch this powerful film.’ 

The video is still available to screen online if you would like to use it in your work and there is also a resource to use during a training session to help people think about the issues raised: https://groundswell.org.uk/all-resources/clarissa/

CONTENT WARNING: Clarissa explores themes relating to childhood abuse, drug taking and drug dependency. Should you need further support in relation to these issues, please see the Groundswell support resources page for a list of organisations you can contact.