NHS 'must do more to respond to rising numbers of homeless' Around 70% of people who use homelessness services have mental health problems. Health services needs to "up their game" to respond to rising levels of homelessness and people sleeping rough as the recession lingers and benefit cuts begin to bite, according to a report by the providers of NHS services. The NHS Confederation, representing all hospitals and providers who treat the homeless, warn that those on the streets often struggle to register with a GP and that many suffer from mental health problems that doctors refuse to treat unless they are "clean." About 70% of people who use homelessness services have mental health problems, and many self-medicate with alcohol or drugs. For a range of NHS-funded services, we are not treating homeless patients for mental health who are intoxicated. People are not accepted because they use drink or drugs. Clearly they do need to be referred for therapy, so it's not good enough to say, 'Go away and clean yourself up,'," said the confederation's mental health network director, Steve Shrubb. Shrubb said there was concern in the NHS that homeless numbers were increasing at a time when the health regulator Monitor warned of cuts of 7% a year for three years. He said the government's own estimate that 2,200 people were sleeping rough on any one night in England - a jump of 23% on the previous year - was too low. "We probably have that in London alone," he said. Shrubb pointed out that a study by the University of York revealed that 23,000 people were already in emergency accommodation, slipping in and out of homelessness. A lot of our members tell us that this is the tip of the iceberg. There are a lot of particularly young people moving from couch to couch, staying on friends' floors. It only takes a small crisis for them to be on the streets. We need to get an idea of how big this problem is. Charities backed the report and warned that the government's programme on mental health might be too narrow. Peter Cockersell, the director of health and recovery at St Mungo's, a homeless charity, said the government's focus on improving access to psychological therapies (IAPT), centred around cognitive behavioural therapy, was in some cases obscuring those with the greatest needs. We are seeing counselling and therapy services [for the homeless] closed down. IAPT is getting bigger but it is working with a much narrower group of clients," Cockersell said. One of St Mungo's clients, Len, a former alcoholic who spent eight years on the streets, told the Guardian that he had only "got clean because of the therapy provided by the charity. That's all been cut now.