How can we ethically respond to rough sleeping? A four-point framework

Housing Mental Health

Levels of rough sleeping have escalated rapidly in recently years, with reports of deaths on the street now increasingly common. The strong presence of homelessness-related commitments in all of the major UK political parties’ 2017 manifestos is welcome, but does little to dispel intense controversy over how best to intervene in this area.

At the most basic level, responses to rough sleeping can be distinguished by whether they explicitly seek to alter or ‘control’ the behaviour of homeless people (‘interventionist’ responses) or not (non-interventionist responses). Interventionist responses include the use of ‘force’, such as arresting people for begging, rough sleeping or associated activities, or excluding them from particular areas (using civil orders like ASBOs or Public Space Protection Orders). They also include ‘coercive’ approaches which seek compliance via a ‘threat of deprivation’, for instance, by making access to accommodation conditional on signing up to a support plan. ‘Persuasive’ techniques, such as ‘motivational interviewing’ are core to the more ‘assertive’ forms of street outreach now used in many major cities.

These interventionist approaches, and particularly ‘harder’ measures that employ force or coercion, are extremely controversial, often described as punitive or even as criminalisation. Some argue, however, that it is the non-interventionist stance of some soup kitchens, day centres, and traditional night shelters, generally run by faith-based organisations, that should be subject to moral censure, and that the ‘non-judgemental sanctuary’  that they offer can sustain damaging, even  life-threatening, patterns of behaviour among a highly vulnerable group of people.

These polarised and emotive debates pose a challenge to policy-makers and service providers, and risk obscuring the need for cool-headed reflection in determining the most ethical approach. In a recent paper, Suzanne Fitzpatrick, Sarah Johnsen and I propose a four-point framework (inspired by Ruth Grant, a political philosopher at Duke University) to cut through this contested moral territory.

First, does the intervention in question have a legitimate purpose? The idea that enforcement-based responses are pursued in defence of the aesthetic concerns and financial interests of wealthy gentrifiers has fuelled a great deal of the controversy that surrounds them. But in the UK at least, their adoption has also often been shown to be driven by the understandable concerns of ordinary local residents about health hazards like discarded needles or human waste in public spaces. The wellbeing of the homeless people targeted has also informed the Rough Sleepers Initiative of the 1990s as well as the more recent ‘No Second Night Out’ programme. Thus, despite widespread media hype, it is not the case that interventionist approaches necessarily reflect punitive intent on the part of politicians and policy-makers.

Second, does the intervention allow for a voluntary response on the part of those targeted, therefore respecting their autonomy and capacity for self-determination? Here, non-interventionist approaches may seem at first glance to have the ethical advantage over more controlling interventions. However, the waters are substantially muddied by clear evidence of the highly constrained capacity of some individuals sleeping rough, especially those suffering from severe addiction and/or mental ill health, to act autonomously – that is, in pursuit of their own settled and authentic preferences. In such circumstances, a refusal to countenance ‘paternalistic’ interventions which seek to safeguard, restore or establish some basic level of personal autonomy for a vulnerable adult appears to us (as to James Gregory in his paper Engineering Compassion) “more like a moral abnegation… than respectful distance”.

Third, what are the impacts of the intervention on the ‘character’ of those involved? There have been concerns, for instance, that commissioning practices that require faith-based organisations to engage in interventionist practices undermine their ethos of providing sanctuary and care unconditionally. Similar, homelessness organisations working with the police or UK Border Agency have been heavily criticised for ‘selling out’ and abandoning their core values. But we would argue that the material impact of homelessness interventions on their intended ‘beneficiaries’ should be given a much higher moral weighting than their impact on the character of the ‘benefactor’. An undue emphasis on the latter could be considered ethically dubious, even rather self-indulgent.

This takes us to our fourth, and most important, moral consideration: what are the actual outcomes of the intervention in question? In particular, is it effective in improving the wellbeing of rough sleepers and, crucially, is it more effective than alternative (less controlling) methods? For example, while there is evidence that ASBOs have led to positive benefits for some street homeless people, acting as a ‘crisis point’ prompting engagement with support services, the use of such strong enforcement measure can only be justified as proportional when used as a last resort. The full range of consequences of any intervention must also be considered, including unintended negative effects. This would include, for example, displacing rough sleepers into more dangerous or isolated areas of the city.

Equally, though, a key implication of this analysis is that the ‘tolerant’ approach taken by many soup runs, day centres and shelters ought to be subject to the same level of ethical scrutiny as interventionist responses. They should not be assumed to be morally unproblematic simply because terms like ‘unconditional acceptance’ sound innocuous. At a minimum, the possibility that tolerant approaches may inadvertently act to erode vulnerable people’s longer-term autonomy by sustaining them in street-based lifestyles must be taken seriously.

These four criteria are offered as a route through what continues to be an extremely polarised debate on how to best respond to escalating levels of rough sleeping. A priori arguments, emotional intuitions, the (good) intentions of staff and volunteers, or even the views of current users of a service, do not suffice to settle these controversies. Instead, we should pursue responses that have the most significant and lasting positive impacts on those at risk on the streets.

This was first published on the  British Politics and Policy blog